STATE OF FLORIDA ho DIVISION OF ADMINISTRATIVE HEARINGS os zeny WAR KEY WEST CONVALESCENT CENTER, J Petitioner, DOAH CASE NO: 01-4120 provider no.: 207756 audit no.: NHO00-145R 1B AS Wi ve. ADMINISTRATION, Ra rdeton Ko aves 04-0147 SMA Respondent. / of PLANTATION KEY CONVALESCENT . co se CENTER, . SQ Petitioner, . ag DOAH Case No. 01-4122 nr Audit no. NH 00-147R We ~, Provider no. 208906 fs AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. MARATHON MANOR, Petitioner, DOAH Case No. 03-4121 Audit no. NH 00-146R Provider no. 209899 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. FINAL ORDER THE PARTIES resolved all disputed issues and executed a Settlement Agreement, which is incorporated by reference. The parties are directed to comply with the terms of the attached Settlement Agreement. Based on the foregoing, this file is CLOSED. i DONE AND ORDERED on this the 14 day of TF ath 2004, in Tallahassee, Florida. iz Rhonda M. Medows, MD, Secre Agency for Health Care Administration A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A SECOND COPY ALONG WITH FILING FEE AS PRESCRIBED BY LAW, WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES, REVIEW PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE FLORIDA APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN 30 DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies Furmished to: Peter A. Lewis, Esquire Bob Sharpe, Deputy Secretary Goldsmith, Grout & Lewis, PA Agency for Health Care Administration 307 West Park Avenue, Suite 200 * 2727 Mahan Drive, MS #08 Tallahassee, FL 32308 Tallahassee, Florida 32308 (Interoffice) Brevin Brown, Esquire Lisa D. Milton Agency for Health Care Administration Administrator of Audit Services 2727 Mahan Drive, Bldg. 3, Mail Stop #3 Medicaid Program Analysis Tallahassee, FL. 32308 (Interoffice) (nteroffice Mail) Florence Snyder Rivas Administrative Law Judge Division of Administrative Hearings (nteroffice) to CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of this Final Order was served on the above-named person(s) by U.S. Mail, or the method designated, on this the /CAiay of DARE 2004. = adh Agericy Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida STATE OF FLORIDA ~|AHCA AGENCY FOR HEALTH CARE AGENCY FOR HEALTH CARE ADMINISTRATION JEB BUSH, GOVERNOR RHONDA M, MEDOWS, MD, FAAFP, SECRETARY April 23, 2002 CERTIFIED MAIL RETURN RECEIPT 7000 1530 0000 5397 1663 Ms. Theresa B. Cleveland 11000 Prosperity Farms Road, Suite 100 Palm Beach Gardens, FL 33410 Re: Florida Medicaid Audit Appeal for Key West Convalescent Center Cost Report NHO00-145R #207756 FYE 12/31/98 Dear Ms. Cleveland: Upon further review of the audit adjustments and additional information, the following changes will be made in exchange for dismissal with prejudice of the related audit appeals. Audit Adjustment #16 ($91,101) will be reduced by $90,237 to ($864). Audit Adjustment #17 ($56,400) will be reduced by $34,276 to ($22,124). Audit Adjustment #18 ($70,471) will be reduced by $31,712 to ($38,759). The terms of this letter are for settlement purposes only. The assertions made herein are not to be considered admissions on the part of the agency. This letter should not be considered a settlement document unless incorporated into a settlement document. The above audit report will be revised and reissued to reflect appropriate changes necessitated by this agreement. If these changes are in accord with your understanding, please forward this letter to your legal counsel for drafting of a settlement stipulation. Your assistance in bringing this matter to a close is appreciated. If you have any questions concerning this letter, please call me at (850) 414-2774. ey Terry D. Hiog Audit Evaluation a Review Analyst Ce: Lisa D. Milton, Administrator of Audit Services, AHCA Kelly A. Bennett, Assistant General Counsel, AHCA Visit AHCA Online at 2727 Mahan Drive * Mail Stop 21 www. fdhe.state.fl.us Tallahassee, FL 32308 | STATE OF FLORIDA ~|AHCA AGENCY FOR HEALTH CARE NGENGY FOR HEALTH CARE ADMINISTRATION JEB BUSH, GOVERNOR RHONDA M. MEDOWS, MD, FAAFP, SECRETARY April 23, 2002 CERTIFIED MAIL RETURN RECEIPT 7000 1530 0000 5397 1670 Ms. Theresa B. Cleveland 11000 Prosperity Farms Road, Suite 100 Palm Beach Gardens, FL 33410 Re: Florida Medicaid Audit Appeal for Marathon Manor, Inc. Cost Report NHO00-146R #209899 FYE 12/31/98 Dear Ms. Cleveland: Upon further review of the audit adjustments and additional information, the following changes will be made in exchange for dismissal with prej iudice of the related audit appeals. Audit Adjustment #9 ($78,430) will be reduced by $79,695 to $1,265. Audit Adjustment #15 ($58,228) will be reduced by $26,203 to ($32,025). The terms of this letter are for settlement purposes only. The assertions made herein are not to be considered admissions on the part of the agency. This letter should not be considered a settlement document unless incorporated into a settlement document. The above audit report will be revised and reissued to reflect appropriate changes necessitated by this agreement. If these changes are in accord with your understanding, please forward this letter to your legal counsel for drafting of a settlement stipulation. Your assistance in bringing this matter to a close is appreciated. If you have any questions concerning this letter, please cal] me at (850) 414-2774. an Audit Evaluatidn andReview Analyst Ce: Lisa D. Milton, Administrator of Audit Services, AHCA Kelly A. Bennett, Assistant General Counsel, AHCA Visit AHCA Online at 2727 Mahan Drive * Mail Stop 21 www.fdhe.state flus Tallahassee, FL 32308 STATE OF FLORIDA ~ -LAHICA | AGENCY FOR HEALTH CARE SSEREV EGA TEAL CARE ADMINISTRATION JEB. BUSH, GOVERNOR RHONDA M. MEDOWS, MD, FAAFP, SECRETARY April 23, 2002 CERTIFIED MAIL RETURN RECEIPT 7000 1530 0000 5397 1687 Ms. Theresa B. Cleveland 11000 Prosperity Farms Road, Suite 100 Palm Beach Gardens, FL 33410 Re: Florida Medicaid Audit Appeal for Plantation Key Convalescent Center Cost Report NH00-147R #208906 FYE 12/31/98 Dear Ms. Cleveland: Upon further review of the audit adjustments and additional information, the following changes will be made in exchange for dismissal with prejudice of the related audit appeals. Audit Adjustment #10 ($102,320) will be reduced by $85,387 to ($16,933). Audit Adjustment #16 ($56,819) will be reduced by $25,568 to ($31,251). The terms of this letter are for settlement purposes only. The assertions made herein are not to be considered admissions on the part of the agency. This letter should not be considered a settlement document unless incorporated into a settlement document. The above audit report will be revised and reissued to reflect appropriate changes necessitated by this agreement. If these changes are in accord with your understanding, please forward this letter to your legal counsel for drafting of a settlement stipulation. Your assistance in bringing this matter to a close is appreciated. If you have any questions concerning this letter, please call me at (850) 414-2774. Ce: Lisa D. Milton, Administrator of Audit Services, AHCA Kelly A. Bennett, Assistant General Counsel, AHCA Visit AHCA Online at 2727 Mahan Drive ¢ Mail Stop 21 www fdhe.stateflus Tallahassee, FL 32308 Key West Convalescent; Marathon Manor, Plantation Key Convalescent DOAH Case numbers 01-4120, 01-4121, 01-4122 SETTLEMENT AGREEMENT « Page 1 of 8 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS KEY WEST CONVALESCENT CENTER, Petitioner, DOAH CASE NO: 01-4120 v. provider no.: 207756 audit no.: NH00-145R AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / PLANTATION KEY CONVALESCENT CENTER, Petitioner, v. DOAH Case No. 01-4122 Audit no. NH 00-147R Provider no. 208906 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. MARATHON MANOR, Petitioner, v DOAH Case No. 01-4121 Audit no. NH 00-146R Provider no. 209899 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. Key West Convalescent; Marathon Manor, Plantation Key Convalescent DOAH Case numbers 01-4120. 01-4121, 01-4122 SETTLEMENT AGREEMENT Page 2 of 8 SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and KEY WEST CONVALESCENT CENTER, MARATHON MANOR, AND PLANTATION KEY CONVALESCENT CENTER, (“PROVIDERS”), by and through the undersigned, hereby stipulate and agree as follows: 1. This Agreement is entered into between the parties for the purpose of avoiding the costs and burdens of litigation. PROVIDERS are Medicaid providers in the State of Florida, operating nursing homes that were audited by the Agency. The Agency conducted audits of the PROVIDERS’ cost reports for the period ending December 31, 1998. In its Audit Reports issued on August 13. 2001, AHCA notified PROVIDERS that a review of the cost reports revealed that, in its opinion, some claims in whole or in part were not reimbursable by Medicaid. The Agency further notified the PROVIDERS of the adjustments, which AHCA was making to the cost reports. In response to the Audit Reports, PROVIDERS filed timely petitions for administrative hearings that were assigned DOAH Case Nos. 01-4120. 01-4121, and 01-4122. In its petitions for administrative hearing. PROVIDERS identified specific adjustments that it appealed. Key West Convalescent; Marathon Manor, Plantation Key Convalescent DOAH Case numbers 01-4120, 01-4121, 01-4122 | SETTLEMENT AGREEMENT . 6. Subsequent to issuance of the Audit Report, AHCA and PROVIDER exchanged documents and discussed the adjustments that were at issue. 7. As a result of the aforementioned exchanges, the parties agree that the Agency’s adjustments which were the subject of these proceedings, as they relate to the cost report for the year ending December 31, 1998, shall be resolved as follows: KEY WEST CONVALESCENT CENTER NHO00-145R: Audit Adjustment # 16 ($91,101) was reduced by $90,237 to ($864). Audit Adjustment # 17 ($56,400) was reduced by $34,276 to ($22,124). Audit Adjustment # 18 ($70, 471) was reduced by $31,712 to ($38,759). MARATHON MANOR, INC. NH00-146R: Audit Adjustment # 9 ($78,430) was reduced by $79,695 to increase expense by $1,265. Audit Adjustment # 15 ($58.228) was reduced by $26,203 to ($32,025). PLANTATION KEY CONVALESCENT CENTER NHO00-147R: Audit Adjustment # 10 ($102,320) was reduced by $85,387 to ($16,933). Audit Adjustment # 16 ($56,819) was reduced by $25,568 to ($31,251). 8. All other Audit Adjustments not specifically identified above remain adjusted pursuant to the Audit Report. 9. In order to resolve this matter without further administrative proceedings. PROVIDERS and AHCA expressly agree that the adjustment resolution, as set forth above, will resolve and settle this case completely. As such. by this agreemem constitutes PROVIDERS’ withdrawal of the petitions for administrative hearing. with prejudice. Key West Convalescent; Marathon Manor, Plantation Key Convalescent DOAH Case numbers 01-4120, 0)-4121, 01-4122 SETTLEMENT AGREEMENT Page 4 of 8 10. | PROVIDERS and AHCA further agree that the Agency shall recalculate the per diem rate for these time periods, and issue a notice of the recalculation. Where PROVIDERS were overpaid, PROVIDERS will remit payment to the Agency in the full amount of the cost within forty-five (45) days of such notice, unless the parties enter into a written agreement to otherwise establish a repayment plan. Where PROVIDERS were underpaid, AHCA will remit payment to the PROVIDER in the full amount of the underpayment within forty-five (45) days of such notice. 11. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 PROVIDERS Key West Convalescent Center 3300 PGA Boulevard Suite 330 Palm Beach Gardens, FL 33410 Plantation Key Convalescent Center 48 High Point Rd. Tavernier, FL 33070 Marathon Manor 320 Sombrero Marathon, FL 33050 And payments shal] clearly indicate that it is per a settlement agreement, shall reference the DOAH Case Numbers. and shall reference the audit numbers. 12. PROVIDERS agree that failure 10 pay any monies due and owing under the terms of this Agreement shal] constitute PROVIDERS’ authorization for the Agency. without further notice. to withhold the total remaining amount due under the a re SSS ESR rat EERE CS eR Key West Convalescent, Marathon Manor, Plantation Key Convalescent DOAH Case numbers 01-4120, 01-4121, 01-4122 SETTLEMENT AGREEMENT , Page 5 of 8 13. 14. 16. terms of this agreement from any monies due and owing to PROVIDERS for any Medicaid claims. PROVIDERS and AHCA reserve the right to enforce this Agreement under the laws of the State of Florida, the Rules of the Medicaid Program, and all other applicable rules. This settlement does not constitute an admission of wrongdoing or error by any of the parties with respect to this case or any other matter. However, the parties believe that this matter should be settled because the parties have agreed to the terms contained within this agreement. Each party shall bear its own attorneys’ fees and costs, if any. The signatories to this Agreement, acting in a representative capacity, represent that they are duly authorized to enter into this Agreement on behalf of the respective parties. The parties further agree that a facsimile or photocopy reproduction of this agreement shall be sufficient for the parties to enforce the agreement. PROVIDERS agree, however, to forward a copy of this agreement to AHCA with original signatures, and understand that a Final Order may not be issued until said agreement is received by AHCA. This Agreement shall be construed in accordance with the provisions of the laws of Florida. Venue for any action arising from this Agreement shall be in Leon County, Florida. This Agreement constitutes the entire agreement between PROVIDERS and the AHCA, including anyone acting for. associated with or employed by them. concerning all matters and supersedes any prior discussions, agreements or a) a PE Key West Convalescent: Marathon Manor, Plantation Key Convalescent DOAH Case numbers 01-4120, 01-4121, 61-4122 SETTLEMENT AGREEMENT Page 6 of 8 20. 21. understandings; there are no promises, representations or agreements between PROVIDERS and the AHCA other than as set forth herein. No modification or waiver of any provision shall be valid unless a written amendment to the Agreement is completed and properly executed by the parties. This is an Agreement of settlement and compromise, made in recognition that the parties may have different or incorrect understandings, information and contentions, as to facts and law, and with each party:compromising and settling any potential correctness or incorrectness of its understandings, information and contentions as to facts and law, so that no misunderstanding or misinformation shall be a ground for rescission hereof. PROVIDERS expressly waive in this matter its right to any hearing pursuant to sections 120.569 or 120.57. Florida Statutes, the making of findings of fact and conclusions of law by the Agency, and all further and other proceedings to which it may be entitled by law or rules of the Agency regarding this proceeding and any and all issues raised herein, other than enforcement of this Agreement. PROVIDERS further agree that the Agency shal] issue a Final Order which is consistent with the terms of this settlement, that adopts this Agreement and closes this matter. This Agreement is and shal] be deemed jointly drafted and written by all parties to it and shall not be construed or interpreted against the party originating or preparing it. Key West Convalescent; Marathon Manor, Plantation Key Convalescent DOAH Case numbers 01-4120, 01-4121, 01-4122 SETTLEMENT AGREEMENT Page 7 of 8 . 22. To the extent that any provision of this Agreement is prohibited by law for any reason, such provision shall be effective to the extent not so prohibited, and such prohibition shall not affect any other provision of this Agreement. 23. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. KEY WEST CON SCENT CENTER “Ahn igi pes Dated: OE ‘ | (t ; 2003 py: theresa fs} Caveor& (print name above) CEO. ITS: (print title above) PLA One BC NVALESCENT CENTER : eben Dated: Octo. | (- 2008 By: — S. Never, (print name above ITS: e ‘az O . (print title above) MARATHON MANOR, INC. “A MDGe Chipped Dated: OG la - 2008 By: theresa 8. Clave (print name above) ITS: ae (print title above) ——- : oO ; , / ws ier ol ee Dated: 7 of. of . - 2092" Pete Lewis, Esquire Attorney for Petitioners Goldsmith. Grout. & Lewis. P.A. 307 West Park Avenue Tallahassee. FL 32308 AGENCY FOR HEALTH CARE Key West Convalescent, Marathon Manor, Plantation Key Convalescent DOAH Case numbers 01-4120. 01-4121, 01-4122 SETTLEMENT AGREEMENT Page 8 of 8 ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 “Pre : | Dated: alg ; sof Bob Sharpe Deputy Secretary, Medicaid “Lil Mb GE Dated: Ze Y » 20027 Wall : Valle Chit Cofix -~Acting General Counsel B wf) ——~ Dated: 277 , 20027 Kelly A.Bennett Brevia Brown Assistant General Counsel

Docket for Case No: 01-004121MPI