~ ~ CA BIY FILED STATE OF FLORIDA une AGENCY FOR HEALTH CARE ADMINISTRATION Jered Hey STATE OF FLORIDA, AGENCY FOR PEPARLRONT €L Lae! HEALTH CARE ADMINISTRATION, acy Petitioner, AHCA NO: 2002039042.“ as” -“, ve Bra WOODLAND FIELD, INC., os 2 Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA"), by through the undersigned counsel, and files this Administrative Complaint against WOODLAND FIELD, INC., (Woodland Field, Inc.) pursuant to Section 120.569, and 120.57, Florida Statutes, (2001), alleges: 1. This is an action to REVOKE the license and to impose an immediate moratorium on admissions to provide assisted living facility services and to operate as an assisted living facility issued to Woodland Field Inc. The Agency also intends to impose an administrative fines against Woodland Filed Inc., pursuant to Section 400.419(1)(b); Section 400.414(1)(A&(g), Section 400.415(1), and Section 400.4174, Fla. Stat. (2001). JURISDICTION AND VENUE 2 This Agency has jurisdiction pursuant to 400, Part III and Section 120.569 and 120.57, Florida Statutes, (2001). 3. Venue lies in Duval County, Jacksonville, Florida, pursuant to Section 120.57, Florida Statutes, (2001); and S8A5, Florida Administrative Code (2002), 28.106.207, Florida Administrative Code. (2002). PARTIES 4. AHCA is the regulatory authority responsible for licensure and enforcement of all applicable statues and rules governing assisted living facilities pursuant to Chapter 400, Part Hl, Florida Statutes, (2001), and Chapter 58A-5, Florida Administrative Code (2002). 5. Woodland Field Ine. is a for-profit corporation, whose 4-bed assisted living facility is located at 8236 Moncrief Dinsmore Road, Jacksonville, Florida. Wooldland Field Inc. is licensed as an assisted living facility license #418567, certificate number 11495, effective December 8, 2001 through December 7, 2003. Woodland Inc. was at all times material hereto, a licensed facility under the licensing authority of AHCA, and required to comply with all applicable rules, and statutes. COUNT I WOODLAND FIELD INC RETAINED AN EMPLOYEE WHO DID NOT MEET THE BACKGROUND SCREENING REQUIREMENTS AND DID NOT HAVE AN EXEMPTION FROM DISQUALIFICATION STATE TAG AILLIS-STAFF RECORDS STANDARDS Section 400.4174(2), Fla. Stat. (2001) BACKGROUND SCREENING; EXEMPTIONS 6. AHCA realleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7 During rhe follow-up survey on April 29, 2002, Woodland Filed Inc. retained an employee who did not meet the background screening requirements and did not have an exemption from disqualification. The above constitutes a violation of Section 400.4174(2), Fla. Stat. (2001), requires that the owner or administrator of an assisted living faciliry must conduct level 1 background screening, as set forth in Chapter 435, on all employees hired on or after October 1, 1998, who perform personal services as defined in s. 400.402(17). The agency may exempt an individual from employment disqualification as set forth in chapter 435. Such persons shall be considered as having this requirement if: (a) Proof of compliance with level 1 background screening requirements obtained to meet any professional licensure requirements in this state is provided and accompanied, under penalty, by a copy of the person's current professional license and an affidavit of current compliance with the background screening requirements. (b) The person required to be screened has been continuously employed in the same type of occupation for which the person is seeking employment without a breach in service which exceeds 180 days, and proof of compliance with the level | screening tequirement which is no more then 2 years old is provided. Proof of compliance shall be provided directly from one employer or contractor to another, and not from the person screened. Upon request, a copy of screening results shall be provided by the employcr retaining documentation of the screening to the person screened. (c) The person required to be screened is employed by a corporation or business entity or related corporation or business entity that owns, operations, or manages more than one facility or agency licensed under this chapter, and for whom a level I screcning was conducted by the corporation or business entity as a conducted of initial or continued employment. This is an uncorrected class II deficiency. Fine: $5,000.00. The above constitutes a violation of Section 400.419(1)(b), Fla. Stat. (2001), provides that a class II violations are those conditions or occurrences related to the operation and maintenance of a facility or to the personal care of residents which the agency determines directly threaten the physical or emotional health, safety, or security of the facility residents, other than class I violations. A class II violation is subject to an administrative fine in an amount not less than $1, 000 and not exceeding $5,000 for each violation. A citation for a class II violation must specify the time within which the violation is required to be corrected. The above constitutes a violation of Section 400.415(1), Fla. Stat. (2001), requires that a facility the license of which is denied, revoked, or suspended pursuant to s. 400.414 may he subject to immediate imposition of a moratorium on admissions to run concurrency with licensure denial, revocation, or suspension. The above constitutes a violation of Section 400.414(1)(f), Fla. Stat. (2001), requires that a determination that a person subject to level 2 background screening under s. 400.4174(1) does not meet the screening standards of s. 435.04 or that the facility is retaining an employee subject to level 1 background screening standards under s. 400.4174(2) who does not meet the screening standards of s. 435.03 and for whom exemptions from disqualification have not been provided by the agency, The above constitutes a violation of Section 400.4140), Fla, Stat (2001), requires that a determination that an employee, volunteer, administrator, or owner, or person who otherwise has access to the residents of a facility does not meet the criteria specified in s. 435.03(2), and the owner or administrator has not taken action to remove the person. Exemptions from disqualification may be granted as set forth in s. 435.07. No adrainistrative action may be taken against the facility if the person is granted an exemption. WHEREFORE, AHCA intends to impose an administrative fine against Woodland Field, Inc. for violations of Section 400.419(1)(b); Section 400.414(1)(N&(g), Section 400.415(1), and Section 400.4174(2), Fla. Stat. (2001). Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes (2001). Specific options for adininistrative action are set out in the attached Election of Rights (one page) and explained in the attached Explanation of Rights (one page). All request for hearing shall be made to the Agency for Flealth Care Administration, and delivered to the Agency for Health Care Administration, Building 3, MSC 3, 2727 Mahan Drive, Tallahassee, Florida 32308, Michael O. Mathis, Senior Attorney. RESPONDENT IS FUTHER NOTIFED THAT THE FAILURE TO REQUEST A HEARING WITHIN 21 DAYS OF RECEIPT OF THIS COMPLAINT WILL REASULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. 2th Respectfully Submitted this 13 ay of Ane 2002, Leon County, Tallahassee, p Florida. Michael ©. Mathis Fla. Bar. No. 0325570 Counsel for Petitioner, Agency for Health Care Administration Bldg. 3, MSC #3 2727 Mahan Drive Tallahassee, Florida 32308 (850) 921-0055 (office) (850) 413 9313 (fax) Karen Swann Lealand McCharen Agency for Health Care Administration CERTIFICATE OF SERVICE | HEREBY CERTIFY that a true | and correct copy of the foregoing has been served by certified mail on \3 a day of June, 2002 to Harriett Wallace, Administrator, Woodland Field, Inc., 8236 Moncrief-Dinsmore Road, Jacksonville, Florida 32219. Michael ©. Mathis, Esq.

Docket for Case No: 02-003142

Orders for Case No: 02-003142