STATE OF FLORIDA we AGENCY FOR HEALTH CARE ADMINISTRATION. te STATE OF FLORIDA “ AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, AHCA No: 2002004201 vs. Return Receipt Requested 7000 1670 0011 4847 9818 ee JOAN LINDSAY (Owner) ,7- ay ALTERNATIVE CARE III 0 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 Joan Lindsay (Owner) of Alternative Care III (hereinafter “Alternative Care III”) pursuant to 28-106.111 Florida Administrative Code (2000) (F.A.C.) and Chapter 120, Florida Statutes ("Fla. Stat."), hereinafter alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine in the amount of two thousand ($2,000) dollars pursuant to Section 400.419(1) (a), Fla. Stat. JURISDICTION AND VENUE 2. This court has jurisdiction pursuant to Sections 120.569 and 120.57, Fla. Stat. and Chapter 28-106.207 F.A.C. 3. Venue lies in Broward County, Florida pursuant to 120.57, Fla. Stat. and Chapter 28-106.207, F.A.C. PARTIES 4, AHCA is the enforcing authority with regard to assisted living facility licensure law, pursuant to Chapter 400, Part III, Fla. Stat., and Chapter 58A-5, F.A.C. 5. Alternative Care III is an assisted living facility located at 1763 Nw 85'* Drive, Coral Springs, Florida 33065 and is licensed under Chapter 400, Part III, Fla. Stat. and Chapter 58A-5, F.A.C. COUNT I ALTERNATIVE CARE III FAILED TO ENSURE THAT ALL FUNDS HELD BY THE PRIOR LICENSEE WERE TRANSFERRED TO THE CURRENT LICENSEE 58A-5.014 (2) (c) F.A.C. (FISCAL STANDARDS) CLASS III 6, AHCA re-alleges and incorporates (1) through (5) as if fully set forth herein. 7. During the complaint investigation conducted on 8/09/01 and based on interview with the current owner/administrator of the assisted living facility it was determined that no funds that had been previously held by the prior owner were transferred to the current owner/administrator. In addition, there were no records and/or documentation available covering the time that the prior owner/administrator held the license for the ALF. The facility was given until 9/09/01 to correct this deficiency. 8. When a follow up visit was made on 10/08/01 and based on interview with the current owner/administrator it was determined that no funds that had been previously held by the prior owner were transferred to the current owner/administrator. 9. Based on the foregoing, Alternative Care III, violated 58A-5.014(2) (c), F.A.C., an uncorrected class III violation which carries, in this case, an assessed fine of $1,000. COUNT IT ALTERNATIVE CARE III FAILED TO RETURN A DECEASED RESIDENT’S SECURITY DEPOSIT TO THE PERSONAL REPRESENTATIVE OF THE DECEASED RESIDENT 400.427(7), Fla. Stat. (RESIDENT RECORDS STANDARDS) CLASS III 10. AHCA re-alleges and incorporates (1) through (5) as if fully set forth herein. 11. During the complaint investigation conducted on 8/09/01 and based on interview with the owner/administrator and interview with the son of the deceased it was determined that when the resident was initially placed at the facility in 1999, a security deposit of $1,000 was paid to the prior holder of this assisted living facility’s license. The resident died on January 11, 2001. at this point in time, there has been no refund of the security deposit. In addition, there were no records at the facility covering the time that the resident resided there. The facility was given until 9/09/01 to correct this deficiency. 12. When a follow up was conducted on 10/08/01 and based on interview with the current owner/administrator it was determined that a refund has still not been made to the personal representative of a former resident who, when initially placed at the facility in 1999, a security deposit of $1,000 had been paid to the prior holder of this assisted living facility. The resident died in January 11, 2001. At this point in time, there has been no refund of the security deposit. In addition, there were no records at the facility covering the time that the resident resided there. The facility underwent a change of ownership in April 2001. 13. Based on the foregoing, Alternative Care III violated 400.427(7), Fla. Stat., herein classified as an uncorrected Class III violation, which carries, in this case an assessed fine of $1,000. CLAIM FOR RELIEF WHEREFORE, the Plaintiff, State of Florida, Agency for Health Care Administration requests the following relief: A. Make a factual and legal finding in favor of the Agency on Counts I and II. B. Assess against Alternative Care III an administrative fine of $2,000 for two Class III violations 400.419(1) (c), and 400.424(3) (a) Fla. Stat. c. Grant such other relief as the court deems is just and proper. Respondent is notified that it has a right to request an administrative hearing pursuant to Sections 120.569 and 120.57, Florida Statutes (2001). Specific options for administrative action are set out in the attached Election of Rights and explained in the attached Explanation of Rights. All requests for hearing shall be made to the Agency for Health Care Administration, and delivered to the Agency for Health Care Administration, Manchester Building, First Floor, 8355 NW 53°7 Street, Miami, Florida 33166; Nelson Rodney. RESPONDENT IS FURTHER NOTIFIED THAT FAILURE TO REQUEST A HEARING WITHIN TWENTY-ONE (21) DAYS OF RECEIPT OF THIS COMPLAINT, PURSUANT TO THE ATTACHED ELECTION OF RIGHTS, WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. Issued this LI day of flow , 2002. ine ‘A 11d Assistant General Counsel Agency for Health Care Administration 8355 NW 53*° Street Miami, Florida 33166 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing complaint and election of rights was sent by U.S. Certified Mail, Return Receipt Requested to Joan C. Lindsay, Owner/administrator, Alternative Care III, 1763 NW 85°" Drive, Coral Springs, FL 33065 on if Uf , 2002. Copies furnished to: Diane Reiland Field Office Manager Agency for Health Care Administration 1710 East Tiffany Drive West Palm Beach, Florida 33407 Gloria Collins Finance and Accounting Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 ALF Unit Program Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308

Docket for Case No: 02-002498