PAGE 10/22 Kee'd SP for g3/@e@/2002 29:56 8584749795 THE HEALTH CENTER _ STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION AGENCY FOR HEALTH CARE ADMINISTRATION, , Lay, Vey. e Petitioner, LA ALS Sf vs. Case No. 2002015481 THE HEALTH CENTER OF PENSACOLA, INC. d/b/a THE HEALTH CENTER OF PENSACOLA The Respondent. ADMINISTRATIVE COMPLAINT COMES NOW the AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA”), by and through the undersigned counsel, and files this Administrative Complaint against THE HEALTH CENTER OP PENSACOLA, INC. a/b/a THE HEALTH CENTER OF PENSACOLA (“Respondent”), pursuant to sections 120.569, and 120.57, Florida Statutes, and alleges: NATURE OF THE ACTION 1. This is an action to uphold Respondent's conditional licensure status. JURISDICTION AND VENUE 2. This tribunal has jurisdiction pursuant to sections 120.569 and 120.57, Florida Statutes. evar 4 Oe 65/68/2802 89:56 8504749795 PAGE 11/22 THE HEALTH CENTER 3. Venue shall be determined pursuant to Rule 28- 106.27, Florida Administrative Code. PARTIES 4. AHCA is the regulatory agency responsible for licensure of nursing homes and enforcement of all applicable federal regulations, state statutes and rules governing skilled nursing facilities pursuant to the Omnibus Reconciliation Act. of 1987, Title Iv, Subtitle Cc (as amended); Chapter 400, Part II, Florida Statutes, and; Chapter 59A-4 Fla. Admin. Code; respectively. Ss. Respondent is a skilled nursing facility in the ‘State of Florida, whose 180-bed nursing home is located at 8475 University Parkway, Pensacola, Florida. 32514. Respondent is licensed as a skilled nursing facility license #SNF14130961; certificate number 8393, effective February 12, 2002. Respondent was at all times material hereto, a licensed facility under the licensing authority of AHCA,. and was required to comply with all applicable . regulations, statutes and rules. '@5/08/2002 89:56 85847497935 THE HEALTH CENTER PAGE Court x THE STABBING OF RESIDENT #1 VIOLATES THE STATUTES AND RULES GOVERNING NURSING HOMES AND COMPROMISED THE RESIDENT’ S ABILITY TO ATTAIN, OR MAINTAIN, THE RIGHEST PRACTICABLE LEVEL OF WELL-BEING, AND DENIED THE RESIDENT THE RIGHT TO BE FREE FROM ABUSE. 42 CFR 483.13 (2); Section 400.23(7) (5), Foa. Srat.; Sectton 400.022(1) (0), Fua. STAT.; Section 400.23(8) (B}, FLA. STAT., AND; Rone 59A-4.1288, Fua. Apmin. Cove 6. AHCA re-alleges and incorporates by reference paragraphs (1) through (5) as if fully set forth herein. 7. AHCA surveyors conducted a survey of Respondent’s facility on February 12, 2002. Staff interview, record review and surveyor observation brought to light the following: a. Resident #1 had significant cognitive impairment and an inability to carry on any meaningful conversation, b. Resident #1 resided in facility’s locked Alzheimer's unit. c. On, or about, November 22, 2001, staff member R.J. stabbed Resident #1 in the hand with a fork during supper. The stabbing of Resident #1 constituted abuse. 8. Pacility staff stabbing Resident #1 denied the resident’s right to be free from physical abuse in 12/22 (5/88/2082 89:56 8504749795 THE HEALTH CENTER PAGE violation of 42 CPR 483.13(b), section 400.022(1) (0), Fla. Stat. and Rule 59A-4.1288, Fla. Admin. Code., respectively, to wit: a) b) c) a) 9. 42 CFR 483.13(b) states: The resident has the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and involuntary seclusion. Rule 59A-4.1288, Fla. Admin. Code states: Nursing homes that participate in Title XVIII or XIX must follow certification rules and regulations found in 42 CFR 483, Requirements for Long Term Care Facilities, September 26, 1991, which is incorporated by reference. Non-certified facilities must follow the contents of this rule and the standards contained in the Conditions of Participation found in 42 CFR 483, Requirements for Long Term Care Facilities, September 26, 1991, which is incorporated by reference with respect to social services, dental services, infection control, dietary and the therapies. Section 400.022(1), Fla. Stat. states: All licensees of nursing home facilities shall adopt and make public a statement of the rights and responsibilities of the residents of such facilities and shall treat such residents in accordance with the provisions of that statement. The statement shall assure each resident the following: Section 400.022(1) (0), Fla. Stat. states: The right to be free from mental and physical abuse... a Facility slaflfl stabbing Kesident #1 compromised Resident #1’s ability to maintain, or reach, his or her highest practicable well-being and is a class II deficiency as defined in section 400.23(8) (b), Fla. Stat. to wit: a) Section 400.23(8), Fla. Stat. states: The agency shall adopt rules to provide that, when the criteria established under subsection (2) are 13/22 85/88/2082 99:56 a) 1o, 8504749795 THE HEALTH CENTER PAGE nol met, such deficiencies shall be classified according to the nature and the scope of the deficiency. The scope shali be cited as isolated, patterned, or widespread. An isolated deficiency is a deficiency affecting one or a very limited number of residents, or involving one or a very limited number of staff, or a situation that occurred only occasionally or in a very limited number of locations. A patterned deficiency is a deficiency where more than a very limited numbor of residents are affected, or more than a very limited number of staff are involved, or the situation has occurred in several locations, or.the same resident or residents have been affected by repeated occurrences of the same deficienl practice but the effect of the deficient practice is not found to be pervasive throughout the facility. A widespread deficiency is a deficiency in which the problems causing the deficiency are pervasive in the facility or represent systemic faiture that has affected or has the potential to affect a large portion of the facility's residents. The agency shall indicate the classification on the face of the notice of deficiencies as follows... Section 400.23(8) (b), Fla. Stat., defines a class Il deficiency as: . : A deficiency that the agency determines has compromised the resident's ability to maintain or reach his or her highest practicable physical, mental, and psychosocial well-being, as defined by an accurate and comprehensive resident assessment, Plan of care, and provision of services. A class II deficiency is subject to a civil penalty of $2,500 for an isolated deficiency, $5,000 for a patterned deficiency, and $7,500 fora widespread deficiency. The fine amount shall be doubled for each deficiency if the facility was previously cited for one of more class I or class II deficiencies during the last annual inspection or any inspection or complaint investigation since the last annual inspection. A fine shall be levied notwithstanding the correction of the deficiency. Pursuant to the requirements of 400.23(7), Fla. Stat. and 400.23(7) (b), Fla. Stat., respectively: 14/22 a 05/08/2082 69:56 a} b) 8584749795 THE HEALTH CENTER PAGE Section 400.23(7), Fla. Stat. states: The Agency shall, at least every 15 months, evaluate all nursing home facilities and make a determination as to the degree of compliance by each licensee with the established rules adopted under this part as a basis for assigning a licensure status to that facility. The agency shall base its evaluation on the most recent inspection report, taking into consideration findings from other official reports, surveys, interviews, investigations, and inspections. The agency shall assign a licensure status of standard or conditional to each nursing home. Section 400.23(7) (bh), Pla. Stat. defines conditional licensure status as: .the presence of one or more class I or class IT deficiencies, or class III deficiencies not corrected within the time established by the agency, is not in substantial coupliance at the time of the survey with criteria established under this part or with rules adopted by the agency. If the facility has no class I, class II, or class IIT deficiencies at the time of the follow-up survey, a standard licensure status may be assigned. Count Iz THE FACILITY’S FAILURE TO SUCCESSFULLY IMPLEMENT ITS ABUSE POLICY VIOLATES THE STATUTES AND RULES GOVERNING NURSING HOMES AND COMPROMISED THE RESIDENT’ S ABILITY TO ATTAIN, OR MAINTAIN, THE HIGHEST PRACTICABLE LEVEL OF WELL-BEING. 42 CFR 483.13 (c) (1) (1); Secrron 400.23(7), Fra. Star.; Section 400.23(7) (8), Fua. STaAT.; Secrion 400.23(8) (3), Fua. STAr., AND; Rout S9A-4.1288, Fua. Apmtnw. Cops 11. AHCA re-alleges and incorporates by reference paragraphs (1) through (10) as if fully set forth herein. 12 During the survey conducted on February 12, 2002, AHCA surveyors determined the following: a. Staff member, M.M., stated she heard staff member RJ. 15/22 . @5/88/2002 89:56 ted 8564749795 THE HEALTH CENTER PAGE tell Resident #1, “If you keep messing with other peoples’ food, I’m going to stick {or slab) you.” M.M. then saw R.J. stab Resident #1 in the hand with a fork. Yet another staff member (A.B.) stated on the Friday after the incident that R.J. told her that she (R.J.) had stuck Resident #1 because the resident wouldn't stop reaching into other residents’ plates. -M.M. did not report the incident, as required by facility policy, for two days. -A.R. did not report the incident, as required by facility policy, for a day. . The perpetrator did not self-report. . Neither M.M., nor A.B. called the abuse hotline as_ required by facility policy and section 415.1034 (1) (a) (4), Fla. Stat. Section 415.1034(1) (a) (4), Fla. Stat. requires MANDATORY REPORTING by (a) Any person, including, but not limited to, any: (4) Nursing home staff; assisted living facility staff; adult day care ceuler stafr; adult family-care home staff; social worker; or other professional adult care, residential, or institutional staff; Respondent failed to successfully implement its abuse policy and the abuse-reporting requirement was violated by 7 16/22 . 85/88/2002 99:56 8504749795 THE HEALTH CENTER PAGE 17/22 facility staff. 13. Respondent’ s failure to successfully implement its abuse policy violates the requirement of 42 CFR 483.13 (c) (1) (i) and Rule 59A-4.1288, Fla. Admin Code., respectively, to wit: a) Section 483.12(c) (1) (i), Fla. Stat. states: The facility must develop and implement written policies and procedures that prohibit mistreatment, neglect, and abuse of residents and misappropriation of resident property.’ b) Rule 59A-4.1288, Fla. Admin. Code states: Nursing homes that participate in Title xvrrz or ‘XIX must follow certification mules and regulations ‘found in 42 CPR 483, Requirements for Long Term Care Facilities, SepLember 26, 1991, which is ‘incorporated by reference. Non-certified facilities must follow the contents of this rule and the standards contained in the Conditions of Participation found in 42 CPR 483, Requirements for Long Term Care Facilities, September 26, 1991, which is incorporated by reference with respect to social services, dental services, infection control, dietary and the therapies. 14. Respondent’s failure to successfully implement its abuse policy compromised Resident #1's ability to maintain, or reach, hia or her highest practicable well- being and ig a class II deficiency as defined in section 400.23(8) (b), Fla. Stat. 15. The above constitutes grounds for the imposition ef conditional licensure status, pursuant to section 400.23 (7) (b), Fla. Stat. THE HEALTH CENTER PAGE 18/22 65/08/2002 69:56 8504749795 CLATM FOR RELIEF WHEREFORE, the Agency respectfully requests the following relief: 1). Factual and legal findings in favor ot the Agency on Counts I and II; 2). Uphold the imposition of the conditional license dated February 12, 2002, copy attached {Ex.1). Respondent is notified that it has a right to request an administrative hearing pursuant to section 120.569 and 120.57, Florida. Statutes. Specific options for administrative action are set out in the attached Blection ef Rights (ome page) and explained in the attached Explanation of Rights (one page). All requests for hearing shall be made to the Agency for Health Care Administration, and delivered to the Agemcy for Health Care Administration, Building 3, MSC #3, 2727 Mahan Drive, Tallahassee, Florida, 32308; Virginia Daire, Agency Clerk. THE HEALTH CENTER PAGE 19/22 45/88/2882 89:56 8504749795 RESPONDENT IS FURTHER NOTIFIED THAT tae, FAILURE. TO REQUEST A HEARING WITHIN 21 DAYS oF icpurr’ COR, THIS hy COMPLAINT WILL RESULT IV AN ADMISSION OF THE/FACTS ALLECAD IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. Respectfully submitted. Dated this Ka day of ey, 200 - 4. : e/a Christine T. Messana Fla. Bar. No. 0153818 Counsel for Petitioner Agency for Health Care Administration Bldg. 3, MSC#3 2727 Mahan Nrive Tallahassee, FL 32308 (850) 922-5873 (office) (850) 413-9313 (fax) ee: Elizabeth Dudek CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been served by certified mail on this Ate. day of Ad 1 2002 to: The Health Center of Pensacola, Inc., d/b/a The Health Center of Pensacola, 8475 University Parkway, Pensacola, Florida 32514 Chg SA Christine T. = 10

Docket for Case No: 02-002789