LA-1 787 STATE OF FLORIDA ron pn AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, CASE NO: 2002012901 vs. HANOOMAN, INC., d/b/a KISSIMMEE RETIREMENT CENTER, Respondent. ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (hereinafter “AHCA”), by and through the undersigned counsel, and files this Administrative Complaint against Hanooman, Inc., d/b/a Kissimmee Retirement Center (hereinafter “Respondent”) and alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine on Respondent in the amount sixteen thousand dollars ($16,000) pursuant to Sections 400.414 (1) (e) and 400.419(1) (a) and (b), Florida Statutes. This action incorporates by reference the “order of Immediate Moratorium” issued on February 14, 2002. 2. The Respondent is cited for the deficiencies set forth below as a result of survey appraisal on or about February 13, 2002. JURISDICTION AND VENUE 3. This Court has jurisdiction pursuant to Sections 120.569 and 120.57, Florida Statutes and Chapter 28-106, Florida Administrative Code. 4, Venue lies in Osceola County, Division of Administrative Hearings, pursuant to Section 120.57 Florida Statutes, and Chapter 28 Florida Administrative Code. PARTIES 5. AHCA, Agency for Health Care Administration, State of Florida is the enforcing authority with regard to assisted living facility licensure law pursuant to Chapter 400, Part III, Florida Statutes and Rules 58A-5, Florida Administrative Code. 6. Respondent is an assisted living facility located at 702 Verona Street, Kissimmee, FL. Respondent, is and was at all times material hereto, a licensed facility under Chapter 400, Part III, Florida Statutes and Chapter 58A-5, Florida Administrative Code. RESPONDENT FAILED TO PROVIDE STAFF TRAINING AND EDUCATION TO PREPARE FOR MENTAL HEALTH RESIDENTS VIOLATING RULE 58A-5.019(2) (b), F.A.C. CLASS I DEFICIENCY 7. AHCA re-alleges and incorporates paragraphs (1) through (6) as if fully set forth herein. 8. Based on interview and record review it was determined that the Respondent failed to provide staff with sufficient education, training, and preparation to care for ten (10) mental health residents. Record review revealed seven (7) of the ten (10) residents have a history of aggressive/violent behaviors. Record revealed approximately one (1) year ago, Staff #2 had a previous experience with a resident-to-resident altercation in which the residents turned on Staff #2 and injured her. Staff #2 was left alone with residents on the night of February 12, 2002. Staff #2 did not have the training or experience to care for the residents in a physical altercation or crisis. After becoming aware of the resident’s altercation, Staff #2 locked herself in a bedroom to telephone 911 and the facility’s administrator. Staff #2 yelled “stop” at the residents in the altercation as she exited the building. When asked why she locked herself in the bedroom staff #2 responded, “I know they are all crazy.” Staff #2 stated she made no attempt to intervene with the residents in the altercation. The resident’s charts do not contain any documentation that the staff working during the resident’s altercation attempted to intervene in the altercation. 9. This is a violation of Rule 58A-5.019(2) (b), Florida Administrative Code, which requires all staff to be assigned duties consistent with his/her level of education, training, preparation, and experience. Staff providing services requiring or certification must be appropriately licensed or certified. All staff shall exercise their responsibilities, consistent with their qualifications, to observe residents, to document observations on the appropriate resident’s record, and to report the observations to the resident’s health care provider in accordance with Chapter 58A-5, Florida Administrative Code. 10. The above referenced violation constitutes the grounds for the imposed Class I deficiency and for which a fine of five thousand dollars ($5000) is authorized pursuant to Sections 400.414 (1) (e) and 400.419(1)(a) and (b), Florida Statutes. RESPONDENT FAILED TO MAINTAIN MINTMUM STAFFING STANDARDS VIOLATING RULE 58A-5.019(4) (a), F.A.C. CLASS II DEFICIENCY 11. AHCA re-alleges and incorporates paragraphs (1) through (6) as if fully set forth herein. 12. Based on record review and staff interview it was determined that the Respondent failed to maintain minimum staffing standards of 212 staff hours weekly for a facility with ten (10) residents. The staffing scheduled only showed 182 staff hours. Respondent did not employ the staff necessary to maintain the minimum staff hours, adhere to their staffing schedule as written, insure the scheduled staff were on the premises nor insure staff were working their scheduled shifts. 13. This is a violation of Rule 58A-5.019(4) (a), Florida Administrative Code, which requires for six (6) to 15 residents the staff requirement is 212 staff hours for each week, 14. The above referenced violation constitutes the grounds for the imposed Class I deficiency and for which a fine of one thousand dollars ($1000) is authorized pursuant to Sections 400.414 (1) (e) and 400.419(1) (a) and (b), Florida Statutes. COUNT III RESPONDENT FAILED TO PROVIDE STAFF TRAINING AND EDUCATION TO PREPARE FOR MENTAL HEALTH RESIDENTS VIOLATING RULE 58A-5.019(4) (b), F.A.C. CLASS I DEFICIENCY 15. AHCA re-alleges and incorporates paragraphs (1) through (6) as if fully set forth herein. 16. Based on record review and interview it was determined that the Respondent failed to provide enough staff to prevent harm to the residents as evidenced by the altercation on February 12, 2002 and subsequent death of one of the residents. Record review revealed six of the ten residents, including the two involved in the altercation, to have aggressive behaviors. Resident records indicate that Respondent should have had a greater than the minimum weekly and hourly staff requirements of qualified staff to provide resident supervision. 17. This is a violation of Rule 58A-5.019(4) (b), Florida Administrative Code, which requires notwithstanding the minimum staffing requirements specified in paragraph (a), all facilities, including those composed of apartments, shall have enough qualified staff to provide resident supervision, and to provide or arrange for resident services in accordance with the residents scheduled and unscheduled service needs, resident contracts, and resident care standards as described in Rule 58A-5.0182, Florida Administrative Code. Rule 58A-5.0182, Florida Administrative Code requires an assisted living facility to provide care and services appropriate to the needs of residents accepted for admission to the facility. 18. The above referenced violation constitutes the grounds for the imposed Class I deficiency and for which a fine of five thousand dollars ($5000) is authorized pursuant to Sections 400.414 (1)(e) and 400.419(1) (a) and (bo), Florida Statutes. COUNT IV RESPONDENT FAILED TO PROVIDE A SAFE AND DECENT LIVING ENVIRONMENT, FREE FROM ABUSE AND NEGLECT VIOLATING SECTION 400.428(1) (a), F.S. CLASS I DEFICIENCY 19. AHCA re-alleges and incorporates paragraphs (1) through (6) as if fully set forth herein. 20. Based on record review and interview it was determined that the Respondent failed to provide care and services to ensure the residents the right to live ina safe environment, free from physical abuse from other residents and neglect from facility staff. During the events of the altercation on February 12, 2002, resident #1 provoked resident #2 who responded with violence which escalated to an altercation that resulted in death by Strangulation of resident #2 by resident #1. Before the altercation staff #2 had gone into her private bedroom. After about ten minutes, staff #2 heard the noise from the altercation and resident #5 attempted to summon staff #2 by knocking on her bedroom door, staff #2 locked herself in her room. Staff #2 did not provide any assistance to the struggling residents or other facility residents. 21. This is a violation of Section 400.428(1) (a), Florida Administrative Code, which requires every resident of a facility to have the right to live in a safe and decent living environment, free from abuse and neglect. 22. The above referenced violation constitutes the grounds for the imposed Class I deficiency and for which a fine of five thousand dollars ($5000) is authorized pursuant to Sections 400.414 (1)(e) and 400.419(1) (a) and (b), Florida Statutes. WHEREFORE, the Plaintiff, State of Florida, Agency for Health Care Administration requests: A) That the imposition of the moratorium issued by the Agency on February 14, 2002 be upheld; B) Factual and legal findings in favor of the Agency on Counts I through IV; C) The Court to order relief with a fine against the Respondent pursuant to Sections 400.414(1) (e) and 400.419(1) (a) and (b), Florida Statutes in the amount of $16,000.00 (Sixteen Thousand & 00/100 Dollars); and D) All other general and equitable relief allowed by law. The Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes. Specific options for administrative action are set out in the attached Explanation of Rights (one page) and Election of Rights (one page). All requests for hearing shall be made to the attention of Michael Sasso, Senior Attorney, Agency for Health Care Administration, 525 Mirror Lake Drive, North, Saint Petersburg, Florida, 33701. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO REQUEST A HEARING WITHIN 21 DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY . Respectfully submitted, “YuchadD baoos Michael asD [| sircon AHCA - Senior Attorney 525 Mirror Lake Drive North, St. Petersburg, Florida 33701 I HEREBY CERTIFY that a true copy hereof has been sent by U.S. Certified Mail Return Receipt No. 7001 2510 0007 5976 5544, to Mahadeo Hanooman, Registered Agent for Kissimmee Retirement Home at 702 Verona Street, Kissimmee, FL 34742, on the /3”, day of March, 2002. Puhal Michael Sasso, Esquire Copies furnished to: Mahadeo Hanooman Registered Agent for Kissimmee Retirement Center 702 Verona Street Kissimmee, Florida 34742 (Certified U.S. Mail) Administrator Kissimmee Retirement Center 702 Verona Street Kissimmee, Florida 34742 (U.S. Mail) Michael Sasso AHCA - Senior Attorney 525 Mirror Lake Drive North Sebring Building, Suite 310G Saint Petersburg, Florida 33701

Docket for Case No: 02-001787