STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS WATERCREST NURSING AND REHABILITATION CENTER, INC. DOD dy pepe D/B/A WATERCREST CARE CENTER LAT AWM PL Petitioner, JUDGE: C.B. ARRINGTON? Sg. RENDITION NO.: AHCA~O2-0176-S-MDR ~ AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / FINAL ORDER THE PARTIES resolved all disputed issues and executed a settlement agreement, which is attached and 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. Le DONE AND ORDERED on this the_~3 _dayof J ul , 2002, in Tallahassee, Florida. Rhonda MiMed ws, MD, Secretary vi or 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 Fumished to: Peter Lewis Goldsmith, Grout, and Lewis, P.A. 307 West Park Avenue, Suite 200 Tallahassee, FL 32301 Kelly A. Bennett Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 Bob Sharpe Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #8 Tallahassee, Florida 32308 James Estes Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #21 Tallahassee, Florida 32308 Willie Bivens, Finance & Accounting Administrative Law Judge DOAH, The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addresses by U.S. Mail on this the /, Ve Y day of ( pools f. , 2008 (Dryelbve Thaw 52 Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 May.21. 2002 10:45AM Watercrest Agreement Case No,: 02-0261MPI Page 1 of 6 ; STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS a WATERCREST NURSING AND REHABILITATION CENTER, INC, D/B/A WATERCREST CARE CENTER Petitioner, CASE NO: 02-00261MPI y. JUDGE: C. B. ARRINGTON AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and Watercrest Nursing and Rehabilitation Center, Inc., d/b/a Watercrest Care Center (“PROVIDER”), 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. 2. PROVIDER is a Medicaid provider in the State of Florida. 3. In a notice dated July 2, 2001 (the "Final Notification Letter") AHCA gave Bayshore Convalescent Center (“Bayshore”) final notification that changes in Bayshore’s cost reports had caused negative adjustments to Bayshore’s Medicaid Reimbursement rate totaling $249,598.98 (the “Overpayment”). The Final Notification Letter stated that if payment wasn’t received immediately the Agency would begin withholding a percentage of Bayshore’s future ——_— Qo May. 21. 2002 10:40AM No.6633 =P. 2 Medicaid payments. The Final Notification letter was sent to Bayshore’s business address. At the time that it was received, Bayshore had sold its operation to PROVIDER. PROVIDER is the successor to Bayshore. In response to the Final Notification Letter, PROVIDER filed a petition for a formal administrative hearing that was assigned DOAH Case No. 02-0026MPI. PROVIDER’s petitioner challenged only the Agency's ability to collect these monies from it as a successor to Bayshore. 4. In order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: (a) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. (b) PROVIDER agrees to pay AHCA $200,000.00 (the “Settlement Amount”) as full and complete settlement of all claims in this proceeding against PROVIDER before the Division of Administrative Hearings (DOAH Case No. 02-0026MPI). (c) PROVIDER and AHCA agree that full payment as set forth above will resolve and settle this case completely and release both parties from all liabilities arising from the findings in this action against PROVIDER. (d) PROVIDER agrees that it will not rebill the Medicaid Program in any manner for claims that were not covered by Medicaid, which are the subject of the audit in this case. (e) IfAHCA has currently collected withholdings in excess of $200,000.00 from PROVIDER on this matter, AHCA agrees to retum the excess, . Within 45 (forty-five) days of a final order adopting this Settlement May. 21. 2092 10:46AM () (g) ) No.6633 PP. 3 Agreement, AHCA shall reimburse PROVIDER the sum in excess of $200,000. This settlement in no way restricts, hinders, limits, or requires, AHCA to pursue recovery of the Overpayment, or any part thereof, from any other potentially liable party, including Bayshore, or any successors to PROVIDER. This Agreement is limited only to AHCA and PROVIDER. Without obligation to do so, should AHCA decide to pursue any other potentially liable parties and if AHCA is successful in actually recovering all, or part, of the $249,598.98, plus interest, fees, and costs, from any other liable party, AHCA shall reimburse PROVIDER for the portion of that is in excess of $49,598.98, exclusive of any designated interest, and fees and costs, Any monies that AHCA is required to reimburse to PROVIDER pursuant to subsection (g), shall be reimbursed to PROVIDER within 45 (forty- five) days of actual deposit of funds from the other liable parties. This includes, but is not limited to, lump sum payments, repayment schedules, and other payment arrangements. 5. Payment by AHCA shall be deemed made if it is sent to PROVIDER’s last known address, or if it has been transmitted electronically to PROVIDER. 6. This Agreement shall be construed in accordance with the provisions of the laws of Florida, the Rules of the Medicaid Program, and all other applicable rules and regulations. Venue for any action arising from this Agreement shall be in Leon County, Florida. May.2). 2002 10:46AM No-6633 oP. a4 7. This settlement does not constitute an admission of wrongdoing or error by either party 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. 8. Each party shall bear its own attorneys’ fees and costs, if any. 9, 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. PROVIDER shall furnish the actual originally signed Settlement Agreement to AHCA, and a final order may not be issued until the original has been received. 10. This Agreement constitutes the entire agreement between PROVIDER and AHCA, including anyone acting for, associated with or employed by them, concerning all matters and supersedes any prior discussions, agreements or understandings; there are no promises, representations or agreements between PROVIDER and 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. 11. 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. 12. PROVIDER expressly waives 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. PROVIDER May. 2). 2002 10:46AM No.6633 P. § further agrees that the Agency should issue a Final Order which is consistent with the terms of this settlement, that adopts this agreement and closes this matter. 13. PROVIDER, does hereby discharge the State of Florida, Agency for Health Care Administration, and its agents, representatives, and attorneys of and from all claims, demands, actions, causes of action, suits, damages, losses and expenses, of any and every nature whatsoever, arising out of or in any way related to this matter, 14. This Agreement is and shall 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. 15. To the extent that any provision of this Agreement is prohibited by law for any reason, such provision shail be effective to the extent not so prohibited, and such prohibition shall not affect any other provision of this Agreement. 16. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. Watercrest Nursing and Rehabilitation Center, Inc., d/b/a Watercrest Care Center Was <4 Dated: S/ gilor , 2002. Cee? Leper By: Au; “len (Print name above) ETER LEWIS, ESQUIRE ArToRNY FOR PETITIONER Dated: oyfoe , 2002, vt May.21. 2062 10:47AM No.6633 P. 8 AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 ow Dated: 2002. BOB SHARPE Decuty Secret Serepenter-Geners] vy eLVACIY fae. Mreriiaaied 7 ALBA Dated: — tpe 2002. WILLIAM ROBERTS Acting General Counsel : Dated: Yor, 2 , 2002. NETT for Anthony Conticello / Assistant General Counsel

Docket for Case No: 02-000026MPI