STATE OF FLORIDA COT IS 9 “AGENCY FOR HEALTH CARE ADMINISTRATION rae Cp es Lenny ae hh Oan STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION, Zoey Petitioner, a = Oo vs. CASE NO: 2002019001 02-2562 DESOTO HEALTH & REHABILITATION, Wye ( chored L.L.C., d/b/a DESOTO HEALTH & REHABILITATION, Respondent. FINAL ORDER Having reviewed the Amended Administrative Complaint dated June 6, 2002, attached hereto and incorporated herein (Ex. 1), and all other matters of record, the Agency for Health Care Administration (“Agency”) has entered into a Stipulation and Settlement Agreement with the parties to these proceedings, and being otherwise well advised in the premises, finds and -- concludes as follows: The attached Stipulation and Settlement Agreement (Ex. 2), is approved and adopted as part of this Final Order and the parties are directed to comply with the terms of the Stipulation and Settlement Agreement. ORDERED: 1. “The attached Stipulation and Settlement Agreement is approved and adopted as part of this Final Order and the parties are directed to comply with the terms of the Stipulation and Settlement Agreement. 2. A total fine of $76,000.00 is hereby imposed upon the Respondent. The fine is due and payable as follows: $15,000 due and payable on September 15, 2002 $15,000 due and payable on October 15, 2002 $15,000 due and payable on November 15, 2002 $15,000 due and payable on December 15, 2002 $16,000 due and payable on January 15, 2003 ea9009 3. Checks should be made payable to the “Agency for Health Care Administration.” The checks, along with a reference to this Case number, should be sent directly to Gloria Collins Agency for Health Care Administration Office of Finance and Accounting 2727 Mahan Drive, Mail Stop # 14 Tallahassee, Fl. 32308. 4. Unpaid fines will be subject to statutory interest, and may be collected by all methods legally available. DONE and ORDERED this c“day of Spl lon. , 2002, in Tallahassee, Leon County, Florida. Medows, MD, Secretary Health Care Administrati A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO 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 OF 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 furnished to: Karen L. Goldsmith, Esq. Goldsmith, Grout & Lewis, P.A. 2180 Park Avenue North, #100 Post Office Box 2011 Winter Park, FL 32790-2011 (U. S. Mail) Eileen O'Hara Garcia, Esq. Senior Attorney Agency for Health Care Administration 525 Mirror Lake Dr. N. #330D St. Petersburg, FL 33701 (Interoffice Mail) Gloria Collins Finance & Accounting Agency for Health Care Administration 2727 Mahan Drive Mail Stop Code #14 a Tallahassee, Florida 32308 (Interoffice Mail) Elizabeth Dudek Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive Bldg #1 Mail Stop Code #9 Tallahassee, Florida 32308 (Interoffice Mail) Wendy Adams Agency for Health Care Administration 2727 Mahan Drive, Bldg #3 MS #3 Tallahassee, FL 32308 (Interoffice Mail) Health Care Administration an Drive, Bldg #1, MS Code #33 Tallapassee, Florida 32308 Agency f CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of this Final Order was served on the above-named person(s) and entities by U.S. Mail, or the method designated, on this the | a) day of OCA , 2002. . ealand McCharen, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 921-8177 , EXHIBIT ia STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS AGENCY FOR HEALTH CARE ) ADMINISTRATION, ) ) Petitioner, ) ) -VS.- ) Case No. 02-2562 ) DESOTO HEALTH AND ) REHABILITATION, L.L.C., D/B/A ) DESOTO HEALTH AND ) REHABILITATION ) ) Respondent. ) / STIPULATION AND SETTLEMENT AGREEMENT Petitioner, Agency for Health Care Administration (“Agency”) through their undersigned representatives and DeSoto Health & Rehabilitation, L.L.C., DeSoto Health and Rehabilitation (“DeSoto”) pursuant to Section 120.57(4), Florida Statutes (2000) each individually, a “party” collectively as “parties,” hereby enter into this Stipulation and Settlement Agreement (“Agreement”) and agree as follows: WHEREAS, DeSoto is a nursing home licensed pursuant to Chapter 400, Part IT, Florida Statutes (2001) and Chapter 59A-4, Florida Administrative Code (2001), and WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over nursing homes pursuant to Chapter 400, Part II, Florida Statutes; and WHEREAS, the Agency served DeSoto with a notice of intent to impose an administrative fine based on a survey ending March 13, 2002; and WHEREAS, the Agency imposed a moratorium effective March 15, 2002; and WHEREAS, the parties have agreed that a fair, efficient and cost effective resolution of this dispute would avoid the expenditure of substantial sums to litigate the dispute; and WHEREAS, the parties have negotiated and agreed that the best interests of all the parties will be served by a settlement of this proceeding; NOW THEREFORE, in consideration of the mutual promises and recitals herein, the parties intending to be legally bound, agree as follows: 1. All recitals are true and correct and are expressly incorporated herein. 2. Both parties agree that the “whereas” clauses incorporated herein are binding findings of the parties. 3. Upon full execution of this Agreement, DeSoto agrees to a withdrawal of its Petition for Formal Administrative Proceedings; agrees to waive any and all appeals and proceedings; agrees to waive compliance with the form of the Final Order (findings of fact and conclusions of law) to which it may be entitled including, but not limited to, an informal proceeding under Subsection 120.57(2), a formal proceeding under Subsection 120.57(1), appeals under Section 120.68, Florida Statutes; and declaratory and all writs of relief in any court or quasi-court (DOAH) of competent jurisdiction. 4. Upon full execution of this agreement, DeSoto agrees to pay Seventy Six Thousand ($76,000.00) Dollars in administrative fines and survey fees as follows: a $15,000 due and payable on September 15, 2002 $15,000 due and payable on October 15, 2002 $15,000 due and payable on November 15, 2002 $15,000 due and payable on December 15, 2002 $16,000 due and payable on January 15, 2003 cag TS In the event, that any payment is not received by the Agency for Health Care Administration on the due date, the Agency for Health Care Administration shall have the authority to withhold that amount from the next due Medicaid reimbursement check. In the event that that is 11. This Agreement is binding upon all parties herein and those identified in the aforementioned paragraph ten (10) of this Agreement. 12. The undersigned have read and understand this Agreement and have authority to bind their respective principals to it. 13. This Agreement contains the entire understandings and agreements of the parties. 14. This Agreement supercedes any prior oral or written agreements between the parties. 15. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement by DeSoto or related facilities, its successor or any resulting organization shall be void. The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement: ele 7 ear gy ELIZABETH DUDEK K N L. GOLDSMITH, ESQUIRE DEPUTY SECRETARY GOLDSMITH, GROUT & LEWIS, P.A. AGENCY FOR HEALTH CARE 2180 Park Avenue North, #100 ADMINISTRATION Post Office Box 2011 2727 Mahan Drive Winter Park, FL 32790-2011 Tallahassee, FL 32308 407/740-0144 Attorneys for Respondent Florida Bar No. 274534 Date signed: WS; Je Zz Date signed: o~ -~FA/ “OD Guth ike — ESQUIRE ACTING GENERAL COUNSEL AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive Tallahassee, FL 32308 Date signed: g 1: 2 zfz

Docket for Case No: 02-002562