STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, O 3 - (ey AHCA No: 2003000271 vs. Return Receipt Requested CENTRAL MEDICAL EQUIPMENT 7000 1670 0011 4849 4101 RENTALS, INC., d/b/a CENTRAL 7000 1670 0011 4849 4095 MEDICAL: EQUIPMENT RENTALS, Raspondent ee, ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (hereinafter “AHCA”), and files this Administrative Complaint against Central Medical Equipment Rentals, Inc., d/b/a Central Medical Equipment Rentals, Inc. (hereinafter “Central Medical Equipment Rentals”) pursuant to 28-106.111, Florida Administration Code (2001) (F.A.C.), and Chapter 120, Florida Statutes (“Fla. Stat. 2001”) hereinafter alleges: NATURE OF ACTION l. This is an action to impose an administrative fine in the amount of Five Hundred ($500) dollars pursuant to Section 400.932, Fla. Stat. (2001). EXHIBIT A JURISDICTION AND VENUE 2. This Court nas jurisdiction pursuant to Sections 120.569 and 120.57, Fla. Stat., and Chapter 28-106, F.A.C. 3. Venue lies in Miami~Dade County, pursuant to Section 120.57, Florida Statutes, and Chapter 28, F.A.C. PARTIES 4.° AHCA is the enforcing authority with regard to home medical equipment licensure law pursuant to Chapter 400, Part X, Fla. Stat. (2001), and Chapter 59A-25, F.A.C. 5. Central Medical Equipment Rentals” is a home medical equipment located at 28590 Douglas Road, Coral Gables, Florida 33134, and is licensed under Chapter 400, Part X, Fla. Stat. (2001), and Chapter 59A-25. F.A.C., license # 11233. COUNT I CENTRAL MEDICAL EQUIPMENT RENTALS FAILED TO FOLLOW THE ESTABLISHED SYSTEM FOR THE RESOLUTION OF THE COMPLA-NTS. 400.934(8), Fla. Stat. (2001) 59A-25(1) (1)7., F.A.C. (RESOLUTIONS OF COMPLAINTS) UNCORRECTED DEFICIENCY 6. AHCA re-alleges and incorporates (1) through (5) as if fully set forth herein. 7. During the complaint investigation conducted on 9/18/01 and based on the finding as determined by review of available policies and procedures, Concern/Complaint Communication Logs and interview with the Directcr of Operations on the day of survey visit was that the provider was inconsistent in completing the column on the Concern/Complaint Communication Log form which is titled Comment/Resolution. The policy on Client Concerns/Complaints specifically calls for this information to be determined and documented on the form. There was a lack of documentation to € be able to determine that this had been done in three (3) of three(3) calls requiring a resolution out of fourteen (14) sampled calls received by the provider and reviewed during complaint investigation. Correction Date: 10/18/01 8. During another complaint investigations conducted on 10/21/02 and based on policy review, record review and interview the agency did not maintain a system for investigating and resolving patient and/or family complaints in l of 5 records reviewed, The findings include: 9, Review of the grievance policy revealed that "after receiving the complaint, the Director of Operations or designee shall; document the information in the complaint log, investigate the matter and document the resolution." 10. Review of the complaint log and the record of sample patient #5 revealed there was no evidence of documentation of a patient and/or family complaint in the records. Interview with the Director of Operations and the Supervisor Customer Service at 4:00 pm on 10-21-02 reveal that they nave no knowledge of any patient and/or family complaint having been voiced. Interview with the complainant, at 6:00 pm on 10-21- 02, confirmed that he/she has called the medical equipment company on numerous occasions and spoken with the Supervisor of Customer Service. The complainant also called the Director of Operations who has not returned the calls. 11. Based on the foregoing, “Central Medical Equipment Rentals” violated Chapter 400.934(8), Fla. Stat., herein classified as a repeated and uncorrected deficiency, which carries, in this case, an assessed fine of $500.00, CLAIM FOR RELIEF WHEREFORE, the Agency requests that the Court grant the following relief: BR. Make factual and legal findings in favor of the Agency on Count I. B. Assess an administrative fine of $500.00 against “Central Medical Equipment Rentals” for the repeat violation as described in Counts I, in accordance with Section 400.432, Fla. Stat. C. Award the Agency for Health Care Administration any other such relief as this Court deems just and proper. Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Filia. Stat. Specific options for administrative action are set out and explained in the attached Explanation to Rights (one page) and Election of Rights (one page). All request for hearing shall be made to the Agency for Health Care Administration, and delivered to the Agency for the Health Care Administration, Manchester Building, 8355 NW 53** Street, Miami, FL 33166; Nelson E. Rodney, Assistant General Counsel. RESPONDENT IS FURTHER NOTIFIED THAT FAILURE TO REQUEST A HEARING WITHIN TWENTY -ONE (21) DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. Respectfully submitted, Nelson E. Rodney Assistant General Counsel Agency for Health Cate Administration Florida Bar #178081 8355 NW 53 Street Miami, Florida 33166 Telephone (305) 499-2165 Fax (305) 499-2195 while 2 , 2003. wa CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail, Return Receipt Requested to Osvaldo de la Pedraja, General Manager, Central Medical Equipment Rentals, Inc. 2850 Douglas Road, Coral Gables, Florida 33134, and to Raul E. Garcia, Jr., Esquire, Registered Agent, 9200 S. Dadeland Blvd., Suite 316, Miami, Florida 33156 on EQu 3, 2003. Nelson E. Rodney Copies to: Elizabeth Dudek, Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Inter-office mail) Gloria Collins, Finance and Accounting Agency for Health Care Administration 2727 Mahan Drive, mail Stop #14 Tallahassee, Florida 32308 {Inter-office mail) Diane Lopez Castillo Field Office Manager Agency for Health Care Administration 8355 NW 5379 Street Miami, Florida 33166 (Inter-office mail)

Docket for Case No: 03-001164