FILED HAR 2 03 Qe Tn AGENCY FOR HEALTH CARE ADMINISTRATION Wp (9 o> té es STATE OF FLORIDA EPARTMENT CLERK, 9 4, AGENCY FOR HEALTH CARE a one Ns 5 ADMINISTRATION, ‘ _ “ Me Petitioner, Cr - clear ase vs. DOAH No: 02-3857 _ AHCA Ng: 2002046645 C SARA HOME CARE, INC, Rendrhon Ady HCA -OR Br D-OWG Respondent / FINAL ORDER The Agency for Health Care Administration, having received an Order Closing File from the Division of Administrative Hearings and a Stipulation and Settlement Agreement entered into by the parties to these proceedings, and being otherwise well advised in the premises, decides as follows: 1. The attached Stipulation and Settlement Agreement is approved and adopted as part of this Final Order. 2. The Order Closing File entered by Claude B. Arrington, Administrative Law Judge, dated December 4, 2002 closing the file that was opened in this matter by the Division of Administrative Hearings is attached and made a part of this Final Order. THEREFORE, it is ORDERED and ADJUDGED that the parties have to comply with the terms of the Joint Stipulation. DONE and ORDERED this _/7% day of Pack, » 2003, in Tallahassee, Leon County, Florida. Rhonda M. Medows, MD, Secretary Agency for 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 AND A SECOND COPY, ALONG WITH FILING FEE AS PRESCRIBED BY LAW, WITH THE DISTRICT COURT OF APPEAL 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 THIRTY (30) DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies furnished to: Nelson E. Rodney, Esquire Assistant General Counsel Agency for Health Care Administration Manchester Building, 1st Floor 8355 NW 53rd Street Miami, Florida 33166 (Interoffice mail) Hon. Claude B. Arrington Administrative Law Judge Division of Administrative Hearings The'DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (U.S. Mail) Elizabeth Dudek Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 CInteréffice mail) Wendy Adams Intake (Interoffice mail) Jean Lombardi Finance and Accounting PAYMENT SHOULD BE SENT TO {Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #14 Tallahassee, Florida 32308 (Interoffice mail) Clutilde DaCosta, Owner Sara Home Care 29100 S.W. 1727 Avenue Homestead, FL 33030 (U.S. Certified mail) Jennifer N. Lucy, Esquire Attorney for Respondent Cole, Scott and Kissane Pacific National Bank Bldg. 1390 Brickell Avenue, Third Floor Miami, Florida 33166 (U.S, Certified mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true copy of the foregoing was furnished to the above named addresses on this kK Sh day of +{ a CLIN , 2003. Chaciore Taps cpa ‘SeLealand McCharen, Agéncy Clerk Agency for Health Care Administration 2727 Mahan Drive Building #3 Tallahassee, Florida 32303 (850) 922-5873 we STATE OF FLORIDA baa Se AGENCY FOR HEALTH CARE ADMINISTRATION OSMAR 26 AMI 53 pos Ur AGENCY FOR HEALTH CARE 7 ADMINISTRATION, Petitioner, Case No. 02-3857 AHCA No. 2002046645 vs. SARA HOME CARE, INC., Respondent. ee STIPULATION AND SETTLEMENT AGREEMENT Petitioner, State of Florida, Agency for Health Care Administration (hereinafter the “Agency”) through their ' undersigned representatives, and Sara Home Care, Inc.,. (hereinafter “Sara Home Care”) pursuant to Sec, 120.57(4), Florida Statutes (2001) each individually, a “party”, collectively as “parties,” hereby enter into this Stipulation and Settlement Agreement (“Agreement”) and agree as¥ follows: WHEREAS, Sara Home Care is an Assisted Living Facility licensed pursuant to Chapter 400, Part III, Florida Statutes (2001), and Chapter 58A-5, Florida Administrative Code, (2001); and WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over Sara Home Care pursuant to Chapter 400, Florida Statutes; and WHEREAS, the Agency served Sara Home Care with a Notice of Intent to Deny on August 30, 2002, and an Administrative Complaint on October 2, 2002 notifying the party of its intent to impose a fine of $51,500 and revoke Sara Home Care’s Assisted Living Facility license, and; WHEREAS, Sara Home Care requested a formal administrative hearing in a petition to the Agency dated September 24, 2002; and WHEREAS, the parties have negotiated and agreed that the best interest of all the parties will be served by a settlement of this proceeding; and 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, Sara Home Care agrees to a withdrawal of its Petition for Formal Administrative Proceedings; agrees to waive any and all appeals and proceedings in the above captioned matter and in Case number 2001004021; 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, Sara Home Care agrees to surrender its license to operate an Assisted Living Facility (License # AL6630) to the Agency within ninety (90) days of the entry of the Final Order and cease operations on or before that date. Sara Home Care will not admit any new residents under license # AL6630. Sara Home Gare is responsible for the appropriate placement of the residents currently residing in Sara Home Care. Sara Home Care further agrees that the principals of Sara Home Care, including the Administrator, shall not apply for a new ligense to operate an Assisted Living Facility in the State of Florida for a period of five (5) years from the date of the Final Order. Venue for any action brought to enforce the terms of this Agreement or the Final Order entered pursuant hereto shall lie in the Circuit Court in Leon County, Florida. 5. Sara Home Care neither admits nor denies the allegations raised in the administrative complaint number 2002046645. The Agency agrees that it will not impose any further penalty against Sara Home Care as a result of the August 23, 2002 survey, and will not execute on the $30,000 fine due from Sara Home Care on case number 2001004021, however, no agreement made herein shall preclude the Agency from imposing a penalty against Sara Home Care for any deficiency identified in a future survey of Sara Home Care, which constitutes a “repeat” deficiency from the August 23, 2002 survey. In addition, Sara Home Care agrees that after the five year period in paragraph 4 above, should Sara Home Care or any principal of Sara Home Care apply for a license in the State of Florida to operate an Assisted Living | ; Facility, the fine amount of $81,500 shall be due and owing prior to such license being granted. 6. Upon full execution of this Agreement, the Agency shall enter a Final Order adopting and incorporating the terms of this Agreement and dismissing the above-styled case. 7. Each party shall bear its own costs and attorney fees. 8. This Agreement shall become effective on the date upon which it is fully executed by all the parties, 9, Sara Home Care for itself and for its related or resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, does hereby discharge the Agency for Health Care Administration, and its agents, representatives, and attorneys 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 and the Agency’s actions, 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 Sara Home Care or related facilities. 10. This Agreement is binding upon all party’s herein and those identified in the aforementioned paragraph (9) of i) this Agreement. \ 11. The undersigned have read and understand this Agreement and have authority to bind their respective principals to it. 12. This Agreement contains the entire understandings ang agreements of the parties. 13. This Agreement supercedes any prior oral or written agreements between the parties. 14. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement shall be void. The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement. Elizabeth Dudek Secretary, Managefl Care and Quality Assurance Agency for Health Care Administration DATED: ¥/7/ 03— pele LUGE Valda Clark Christian General Counsel, Agency for Health Care Admin. 2727 Mahan Drive Tallahassee, FL 32308 (Audia, €. bdeleal For Sara Home Care, Inc. 29100 SW 17254 Avenue Homestead, Florida patep: 3 / Y [63

Docket for Case No: 02-003857