STATE OF FLORIDA me AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR iA HEALTH CARE ADMINISTRATION, (Vickie A Petitioner, ACHA NO. 2001073721 - CASE NO. 02-0672 °°... ¢ vs. IMPERIAL HEALTHCARE CENTER & RESIDENCE, Respondent. FINAL ORDER Having reviewed the Notice Of Intent dated December 14, 2001 (Ex. 1), and all other matters of record, the Agency for Health Care Administration (“Agency”) finds and concludes as follows: FINDINGS OF FACT 1, The Agency issued a Notice Of Intent stating an intent to impose a_ conditional licensure status against the Respondent, IMPERIAL HEALTHCARE CENTER & RESIDENCE, a nursing home, for a violation of Chapter 400, Part II, Florida Statutes, and Chapter 59A-4, Florida Administrative Code. 2. The Respondent was sent the Notice Of Intent on December 14, 2001, by U.S. Mail. The Respondent was advised of its advised of its right to request an administrative hearing, being provided with an Election of Rights form and an Explanation of Rights form. The Respondent subsequently filed a Petition for Formal Administrative Hearing (Ex. 2) denying the allegations of fact contained in the Notice Of Intent, and requesting to be afforded a Formal proceeding, pursuant to 120.57(1), Florida Statutes, Subsequently, the Respondent withdrew its request for a hearing. 3. The facts as alleged and found, establish that: Respondent was issued a conditional license effective 11/29/01 as a result of the survey completed on 11/29/01 during which a Class II deficiency was cited due to the facility's failure to adequately assess, develop or implement care plans to address the significant weight loss of three residents. This is a violation of Rule 59A-4.1288, Fl. Admin. Code, a Class II deficiency, with the imposition of a conditional licensure status. CONCLUSIONS OF LAW 1. The Agency has jurisdiction over Respondent pursuant to the provisions of Chapter 400, Part II, and Sec. 120.569, Florida Statutes (2001). 2. As alleged in the Notice Of Intent, the Respondent is in violation of Chapter 400, Part II, Florida Statutes (2001), and Chapter 59A-4, Florida Administrative Code. The violation consisted of one Class II deficiency. 3. The Respondent expressly waived its right to a hearing and consented to the entry of a Final Order, adopting the allegations and conclusions set forth in the Notice Of Intent and imposing the sanction sought. Based on the foregoing findings of fact and conclusions of law, it ORDERED: 1. The Respondent's Notice of Voluntary Dismissal (Ex. 3) filed October 31, 2002, be accepted. 2. The Respondent's change in licensure status to conditional is upheld. DONE and ORDERED this