STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS PLANTATION NURSING AND REHABILITATION CENTER, “7 ; 4 Deyn-clend “HR. * Petitioner, KOMN- CMG 8 fon CASE NO: = 02-3633 : y. JUDGE: R. Meale STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / FINAL ORDER THE PARTIES resolved ail disputed issues and executed a settlement agreement which is attached and incorporated by reference. The parties are directed to comply with the terms of the attached settlement agreement. Based on the foregoing, this file is CLOSED. DONE AND ORDERED on this the 1G day of Novembee_, 2003, in Tallahassee, Florida. Rhonda M. Medows, , Secretary Agency for Health Care Administration A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A 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 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: Peter A. Lewis, Esquire Goldsmith, Grout & Lewis, P.A. 307 West Park Avenue, Suite 200 Tallahassee, Florida 32308 Anthony L. Conticello, Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (Interoffice) Judith E. Hefren, Deputy Inspector General Medicaid Program Integrity Agency for Health Care Administration 2727 Mahan Drive, MS #5 Tallahassee, Florida 32308 (Interoffice) Jean Lombardi Finance & Accounting Medicaid Accounts Receivables Agency for Health Care Administration 2727 Mahan Drive, MS #14 (Interoffice) Robert Maryanski Medicaid Program Development Agency for Health Care Administration 2727 Mahan Drive, MS #20 (Interoffice) Robert E. Meale Administrative Law Judge DOAH (Interoffice Mail) Robert Butler Bureau Chief Medicaid Program Analysis 2727 Mahan Drive, Mail Stop #21 Tallahassee, Florida 32317 (interoffice Mail) CERTIFICATE OF SERVICE IT HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addresses by U.S. Mail on this the \q day of ‘ M a HEN, 2003. j j (4 Char tens hp peo's io ( Lealand McCharen, Esquire Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5873 No. 7886 2. 2 0 STATE OF FLORIDA oy DIVISION OF ADMINISTRATIVE HEARINGS ; ® on ad PLANTATION NURSING AND REHABILITATION CENTER, Petitioner, CASENO: 02-3633 v. JUDGE: R. Meale STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and PLANTATION NURSING AND REHABILITATION CENTER (“PROVIDER”), by and through their undersigned authorized representatives, hereby stipulate and agree as follows: WHEREAS, PROVIDER applied for interim rate adjustments to its Medicaid rates at its nursing home facility: WHEREAS, the Agency initially denied PROVIDER’s interim rate adjustment request based upon the information submitted by PROVIDER in its application; WHEREAS, PROVIDER filed an administrative petition with the Division of Administrative Hearings for final hearing challenging the Agency’s denial, which was assigned Case No. 02-3633; WHEREAS, both parties requested that that the final hearing be postponed to allow the PROVIDER to submit additional information and documentation regarding the necessity for the interim rate adjustment requests; WHEREAS, the information and documentation provided sufficient justification for the Agency to grant an interim rate adjustment as set forth in this Settlement Agreement (the “Agreement”). 1, This Agreement is entered into between the parties for the purpose of avoiding the costs and burdens of litigation. 2. In order to resolve this matter without further administrative proceedings, PROVIDER and AHCA expressly agree as follows: a. The Agency agrees to grant PROVIDER an interim rate increase for the following components of its Medicaid rates for the incremental increases to costs associated with the conversion of 36 nursing facility beds to pediatric beds effective F ebruary 1, 2002, as set forth herein: i. The Operating Component interim rate = $2.37 ii. The Direct Patient Care Component interim rate = $8.87 iii, The Indirect Patient Care Component Interim rate $7.35 b. Pursuant to the Florida Title XIX Long Term Care Reimbursement Plan, the interim rate methodology as described in Section IV.J will apply to this interim rate. The interim rate increases are subject to audit in accordance with Section II. 3. The Parties reserves the right to enforce this Agreement under the laws of the State of Florida, the Rules of the Medicaid Program, and all other applicable rules and regulations. 4. The parties agree to bear their own attomey’s fees and costs, if any. 5. The signatories to this Agreement, acting in a representative capacity, represent that they are duly authorized to enter into this Agreement on behalf of the respective parties. Furthermore, PROVIDER agrees that its signature alone binds PROVIDER. PROVIDER shall furnish the actual signed Settlement Agreement to AHCA. 6. This Agreement shall be construed in accordance with the provisions of the laws of Florida. Venue for any action arising from this Agreement shall be in Leon County, Florida. 7. This Agreement constitutes the entire agreement between PROVIDER and the AHCA, including anyone acting for, associated with or employed by them, concerning all matters and supersedes any prior discussions, agreements or understandings; there are no promises, representations or agreements between PROVIDER and the AHCA other than as set forth herein. No modification or waiver of any provision shall be valid unless a written amendment to the Agreement is completed and properly executed by the parties. 8. This is an Agreement of settlement and compromise, made in recognition that the parties may have different or incorrect understandings, information and contentions, as to facts and law, and with each party compromising and settling any potential correctness or incorrectness of its understandings, information and contentions as to facts and law, so that no misunderstanding or misinformation shall be a ground for rescission hereof. 9. PROVIDER expressly waives in this matter its right to any hearing pursuant to sections 120.569 or 120.57, Florida Statutes, the making of findings of fact and conclusions of law by the Agency, and all further and other proceedings to which it may be entitled by law or tules of the Agency regarding this proceeding and any and all issues raised herein. PROVIDER further agrees that the Agency shall have the authority to issue a Final Order which is consistent with the terms of this settlement, that adopts this agreement and closes this matter. 10, PROVIDER, does hereby discharge the State of Florida, Agency for Health Care Administration, and its agents, representatives, and attomeys of and from all claims, demands, actions, causes of action, suits, damages, losses and expenses, of any and every nature whatsoever, arising out of or in any way related to this matter, Case No.: 02-3633, and AHCA’s actions herein, including, but not limited to, any claims that were or may be asserted in any federal or state court or administrative forum, including any claims arising out of this agreement, by or on behalf of Facility, except as provided by paragraph no. 3. 11. This Agreement is and shal] be deemed jointly drafted and written by all parties to it and shall not be construed or interpreted against the party originating or preparing it. 12. To the extent that any provision of this Agreement is prohibited by law, for any reason, such provision shall be effective to the extent not so prohibited, and such prohibition shall not affect any other provision of this Agreement, 13. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees, 14. All times stated herein are of the essence of this Agreement, 15. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. PLANTATION NURSING AND REHABILITATION CENTER, / a ad a Dated: CEREUAEY 12 aogg PLANTATION NURSING AND REHABILITATION CENTER, By; ARMAUIDO VAZQUEZ (print name above) Its; Di2 OF Pewee oosencas (print representative capacity) Place Corporate Seal Above Dated: , 2003. A Ss, 2, PETER LEWIS, ESQ, Attorney for Petitioner PLANTATION NURSING AND REHABILITATION CENTER, PLANTATION NURSING AND REHABILITATION CENTER, By: (print name above) Its: (print representative capacity) PETER LEWIS, ESO. Attorney for Petitioner Dated: Dated: » 2003. Place Corporate Seal Above , 2003. fuds ffi gurM AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 ' Tallahassee, FL 32308-5403 x) 4 “ Yip Be 4 Lido Lok C3 Dated: HUA (7 2003, VALDA CLARK CHRISTIAN General Counsel oc Dated: Hid , 2003, ROBERT SHARPE Deputy Secretary of Medicaid Dated: , 2003. ANTHONY L. CONTICELLO, ESQ, Assistant General Counsel

Docket for Case No: 02-003633