STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, vs. Case Nos. 2003000349 2003000711 HANNA OAKS ALF, INC., D/B/A 6 ys - 1) 7 HANNA OAKS RETIREMENT COMMUNITY, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA”), by and through its undersigned counsel, and files this Administrative Complaint against HANNA OAKS ALF, INC., d/b/a HANNA OAKS RETIREMENT COMMUNITY hereinafter referred to as “Respondent,” pursuant to Sections 120.569, and 120.57, Florida Statutes, (2002), and alleges: NATURE OF THE ACTION 1. This is an action to impose upon the Respondent an administrative fine in the amount of $1,500 and a $500 survey fee pursuant to Sections 400.419 and 400.414, Florida Statutes (2002). JURISDICTION AND VENUE 2. This Tribunal has jurisdiction pursuant to Sections 120.569 and 120.57, Florida Statutes (2002). 3. Venue shall be determined pursuant to Rule 28-106.207, Florida Administrative Code (2002). PARTIES 4. Pursuant to Chapter 400, Part III, Florida Statutes, and Chapter 58A-5, Florida Administrative Code, AHCA is the licensing and enforcing authority with regard to assisted living facility laws and rules. 5. The Respondent is an assisted living facility located at 2425 East Hanna Avenue, Tampa, Florida 33610. The Respondent is and was at all times material hereto a licensed facility under Chapter 400, Part III, Florida Statutes (2002), and Chapter 58A-5, Florida Administrative Code (2002), having been issued license number 61. COUNT I RESPONDENT FAILED TO ENSURE THAT RESIDENTS WHO HAVE INDIVIDUALLY CONTROLLED THERMOSTATS IN THEIR BEDROOMS OR APARTMENTS SHALL BE PERMITTED TO CONTROL TEMPERATURES IN THOSE AREAS. Fla. Admin. Code R. 58A-5.023(2)(c) (2002) § 400.414, Fla. Stat. (2002) § 400.419, Fla. Stat. (2002) § 400.428, Fla. Stat. (2002) UNCORRECTED CLASS II] DEFICIENCY 6. AHCA repeats, re-alleges, and incorporates paragraphs one (1) through five (5) above as if fully set forth herein. 7. On or about August 20, 2002, AHCA conducted a complaint investigation at the Respondent’s facility. AHCA cited the Respondent for a class III deficiency based on the findings below, to wit: a) Based on observations by an AHCA surveyor, although all resident rooms in the facility’s Personal Care Unit have individual air conditioners, the thermostats of which are controlled by the respective room resident, several air conditioners were found to be malfunctioning. b) During the tour conducted on 8/20/02 at 11:35 a.m., the wall unit air conditioner in room #205, #211 and #209, respectively, were not working. Based on the foregoing, the residents were unable to control the temperatures in their rooms. 8. For this class III deficiency, AHCA provided Respondent with a mandated correction date of 8/30/02. 9. On or about December 10, 2002, AHCA conducted a re-visit survey at the Respondent’s facility and made the findings below, to wit: a) Based on observations by an AHCA surveyor, each room in the facility’s Personal Care Unit had a wall unit for heating/cooling the resident’s room. The heating/cooling unit in one room was found to be non-operational. b) During a tour of the facility on 12/10/02 at 1:00 p.m. by an AHCA surveyor, the wall heating/cooling unit in room #104 was found to be non-operational. The front panel/grill of the unit was off the unit and the unit was completely non-functioning. The AHCA surveyor was unable to get the unit working by manipulating the heating, cooling and fan settings. Based on the foregoing, the residents of room #104 were unable to control the temperature in the room. 10. The Respondent failed to correct the cited deficiency by the mandated correction date. 11. Based on all of the foregoing, the Respondent violated Rule 58A- 5.023(2)(c), Florida Administrative Code, by failing to ensure that the residents who have individually controlled thermostats in their bedrooms or apartments shall be permitted to contro] temperatures in those areas. 12. The foregoing deficiency constitutes a Class III deficiency, and warrants a fine of $500, to wit: ...(b) Class ‘III’ violations are those conditions or occurrences related to the operation and maintenance of a facility or the personal care of residents which the agency determines indirectly or potentially threaten the physical or emotional health, safety, or security of facility residents, other than class I or class II violations. A class III violation is subject to an administrative fine of not less than $500 and not exceeding $1,000 for each violation. § 400.419(1)(c), Fla. Stat. (2002) COUNT RESPONDENT FAILED TO ENSURE THAT RESIDENTS WHO RESIDED IN THE FACILITY WERE APPROPRIATELY PLACED IN AN ASSISTED LIVING FACILITY. Fla. Admin. Code R. 58A-5.0181(4)(d), (2002) § 400.426(1), Fla. Stat. (2002) § 400.414, Fla. Stat. (2002) § 400.419, Fla. Stat. (2002) § 400.428, Fla. Stat. (2002) UNCORRECTED CLASS ITI DEFICIENCY 13. AHCA repeats, re-alleges, and incorporates paragraphs one (1) through five (5) above as if fully set forth herein. 14, On or about October 23, 2002, AHCA conducted a survey at the Respondent's facility. AHCA cited the Respondent for a class III deficiency based on the findings below, to wit: a) According to the Administrator in a 10/22/02 interview at 10:00 a.m., this program was a pilot project, begun May 2, and so long as residents who required total assistance with some ADL’s “could direct their care, they were permitted to be here (in Respondent’s facility).” This was the understanding of the Administrator, from his Corporation. These residents were spinal cord/brain injury residents, and some of them (resident #3, resident #4, resident 5, and resident #6) were quadriplegic. b) c) d) e) Respondent’s Extended Congregate Care (ECC) license was not being used, even though the entire facility was licensed for ECC. The Administrator believed the corporation obtained permission to admit these residents at some higher level, from the various agencies involved, but he did not know if AHCA was involved or not. The Administrator did not know if special permission or a waiver had been obtained for these residents to live in an assisted living facility (“ALF”), in spite of the fact that, according to ALF rules, they were inappropriately placed. The Administrator was unable to provide answers to these questions during the survey. According to Resident #1’s Health Assessment (“HA”) dated 7/2/02, the resident require 24-hour nursing or psychiatric care. Based on the foregoing, Resident #1 was inappropriately placed in the facility. According to Resident #3’s HA dated 8/30/02, the resident was a quadriplegic and required total help in ambulation, bathing, dressing, grooming, and ___ transferring. Additionally, the HA indicated that the resident received nutrition via tube feeding. Based on the foregoing, Resident #3 was inappropriately placed in the facility. Resident #4 was admitted to the facility on 9/12/02. According to Resident #4’s undated/unsigned HA, the resident was a quadriplegic and required total help in bathing, dressing, grooming, and transferring. On or about 10/22/02 an AHCA surveyor interviewed Resident #4 at about 12:30 p.m. The interview confirmed that Resident #4 needed total help in these areas. On or about 10/22/02 at about 12:20 p.m. an AHCA surveyor observed unlicensed staff administer medication to Resident #4. Based on the foregoing, Resident #4 was inappropriately placed in the facility. According to Resident #5’s HA dated 9/5/02, the resident was bedridden and required total assistance with bathing, dressing, and transferring. Resident #5 also required 24- hour nursing or psychiatric care. Respondent’s staff confirmed during an interview on 10/22/02 at about 10:55 a.m. with the AHCA surveyor that Resident #5 required total help with those areas as well as with grooming and toileting due to his quadriplegia. Based on the foregoing, Resident #5 was inappropriately placed in the facility. g) According to Resident #6’s HA dated 8/5/02, the resident was a quadriplegic and required total help with bathing, dressing, grooming, and transferring. The resident confirmed the foregoing in an interview with the AHCA surveyor on or about 10/23/02 at approximately 12:00 p.m. Resident #6 further stated that staff administer medication, although the HA noted assistance. The AHCA surveyor interviewed the unlicensed staff during the survey. The staff said they administered Resident #6’s medication on or about 10/22/02 at approximately 12:10 p.m. Based on the foregoing, Resident #6 was inappropriately placed in the facility. 15. For this class III deficiency, AHCA provided the Respondent with a mandated correction date of 11/22/02. 16. On or about December 17, 2002, AHCA conducted a re-visit survey at the Respondent’s facility and made the findings below, to wit: a) According to Resident #6’s health assessments dated 8/5/02 and 10/25/02, respectively, the resident was a quadriplegic and required total help with ambulating, bathing, dressing, grooming, and transferring. During an interview with the AHCA surveyor, Resident #6 said staff administer medication, although the HA noted assistance. During an interview with unlicensed staff, the staff said the administered medication to Resident #6 on or about 12/17/02 at approximately 12:10 p.m. Bsed Resident #6 was inappropriately placed in the facility because he/she required the administration of medication bv licensed staff. b) Resident #9, a quadriplegic, had an undated health assessment, which noted he/she required total help with bathing, dressing, grooming, and transfer. The resident stated that staff must administer medications, although the health assessment noted assistance, and unlicensed staff stated they had to administer the medications on 12/17/02 at 12:10 p.m. (c) Interview with the Administrator on 12/17/02 at 2:20 p.m. revealed that staff used a hoyer lift transferred both resident #6 and resident #9. 17. The Respondent failed to correct the deficiency by the mandated correction date. 18. Based on the foregoing, the Respondent violated Section 400.426(1), Florida Statutes, and Rule 58A-5.0181(4)(d), Florida Administrative Code, by failing to ensure that residents who resided in the facility were appropriately placed. 19. The foregoing deficiency constitutes an uncorrected Class III deficiency, and warrants a fine of $1,000, to wit: “...(b) Class III violations are those conditions or occurrences related to the operation and maintenance of a facility or the personal care of residents which the agency determines indirectly or potentially threaten the physical or emotional health, safety, or security of facility residents, other than class I or class II violations. A class III violation is subject to an administrative fine of not less than $500 and not exceeding $1,000 for each violation. § 400.419(1)(c), Fla. Stat. (2002) COUNT Ill RESPONDENT IS SUBJECT TO A $500 SURVEY FEE § 400.419 (9), Fla. Stat. (2002) 20. | AHCA repeats, re-alleges, and incorporates paragraphs one (1) through twelve (12) as if fully set forth herein. 21. The $500 survey fee is imposed pursuant to Section 400.419(9), Florida Statutes, which provides the following: ---(9) In addition to any administrative fines imposed, the agency may assess a survey fee, equal to the lesser of one half of the facility's biennial license and bed fee or $500, to cover the cost of conducting initial complaint investigations that result in the finding of a violation that was the subject of the complaint or monitoring visits conducted under s. 400.428(3)(c) to verify the correction of the violations...” (§ 400.419 (9), Fla. Stat. 2002) 22. On or about August 20, 2002 AHCA conducted a complaint investigation at Respondent which investigation resulted in a violation cited against the facility that was the subject of the complaint. See Count I supra. 22. Respondent’s biennial license and bed fee is equal to $8,373. 23. Based on all of the foregoing, Respondent is subject to a $500 survey fee. WHEREFORE, AHCA demands the following relief: 1. Enter factual and legal findings as set forth in the allegations of Counts I, I, and III; 2. Impose a $1,500 fine against Respondent; and 3. Impose a $500 survey fee against Respondent. NOTICE The Respondent hereby is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes (2002). Specific options for administrative action are set out in the attached Election of Rights (two pages) 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 Agency for Health Care Administration, Building 3, MSC #3, 2727 Mahan Drive, Tallahassee, Florida, 32308; Attention: Lori C. Desnick - Senior Attorney. THE RESPONDENT IS FURTHER NOTIFIED THAT if the request for hearing is not RECEIVED by AHCA within twenty-one (21) days of receipt of this Administrative Complaint by Respondent, a Final Order will be rendered by AHCA finding the deficiencies and/or violations charged and imposing the penalties sought in the Administrative Complaint. Respectfully submitted, he © Qyprwct Lori C. Desnick, Senior Attorney Fla. Bar. No. 0129542 Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 (850) 922-8854 (office) (850) 413-9313 (fax) CERTIFICATE OF SERVICE I HEREBY CERTIFY that the original Administrative Complaint, Explanation of Rights form, and Election of Rights form, have been sent by U.S. Certified Mail, Return Receipt Requested (return receipt #7160 4575 1294 2050 0354) to John Perkins, Hanna Oaks ALF, Inc., d/b/a Hanna Oaks Retirement Community, 2425 East Hanna Avenue, Tampa, Florida 33610 on this 3rd day of March 2003. de C Dowd LORI C. DESNICK, ESQ. 10 STATE OF FLORIDA rn AGENCY FOR HEALTH CARE ADMINISTRATION APp ae a /? AGENCY FOR HEALTH CARE Appt ER, ADMINISTRATION, Oh % Petitioner, OS vs. Case No. 2003000349 2003000711 HANNA OAKS ALF, INC., d/b/a HANNA OAKS RETIREMENT COMMUNITY, INC., Respondent. / ELECTION OF RIGHTS FOR ADMINISTRATIVE HEARING PLEASE SELECT ONLY 1 OF THE 3 OPTIONS (An Explanation of Rights form is attached) OPTION ONE (1) 1) Respondent does not dispute the allegations of fact contained in the Administrative Complaint and waives Respondent’s right to object or to be heard. Respondent understands that by waiving Respondent’s rights, a final order will be issued that adopts the Administrative Complaint and imposes the sanctions sought. OPTION TWO (2) (] Respondent does not dispute and Respondent admits the allegations of fact in the Administrative Complaint, but Respondent does wish to be afforded an informal proceeding, pursuant to Section 120.57(2), Florida Statutes, at which time Respondent will be permitted to submit oral and/or written evidence to the Agency in mitigation of the penalty imposed. OPTION THREE (3) 1) Respondent does dispute the allegations of fact contained in the Administrative Complaint and Respondent requests a formal hearing, pursuant to Section 120.57(1), Florida Statutes, before an Administrative Law Judge appointed by the Division of Administrative Hearings. If Respondent chooses OPTION THREE (3), in order to obtain a formal proceeding before the Division of Administrative Hearings under Section 120.57(1), Florida Statutes. Respondent’s request for an administrative hearing must conform to the requirements in Section 28-106.201, Florida Administrative Code (F.A.C), and must state the material facts you dispute. In order to preserve Respondent’s right to a hearing, Respondent’s Election of Rights in this matter must be received by AHCA within twenty-one (21) days from the date Respondent receives the Administrative Complaint. If the election of rights form with Respondent’s selected option is not received by AHCA within twenty-one (21) days from the date of the Respondent’s receipt of the Administrative Complaint, a final order will be issued finding the deficiencies and/or violations charged and imposing the penalty sought in the Complaint. If Respondent _has elected_either OPTION TWO (2) or THREE (3) above and if Respondent is interested in discussing a settlement of this matter with the Agency, please also mark and check this block. OJ Mediation under Section 120.573, Florida Statutes, is not available in this matter, SEND NO PAYMENT NOW -- REGARDLESS OF THE OPTION SELECTED, PLEASE WAIT UNTIL RESPONDENT RECEIVES A COPY OF A FINAL ORDER FOR INSTRUCTIONS ON PAYMENT OF ANY FINES. (Please sign and fill in your current address.) Respondent (Licensee) Address: License. No. and facility type: Phone No. PLEASE RETURN YOUR COMPLETED FORM TO: Agency for Health Care Administration, GENERAL COUNSEL’S OFFICE, Attention: Lori C. Desnick, Senior Attorney, 2727 Mahan Drive, Mail Stop #3, Tallahassee, Florida 32308. Telephone Number: 850-922-8854; FAX 850-921-0158; TDD 1-800-955-8771. EXPLANATION OF RIGHTS : UNDER SEC. 120.569, FLORIDA STATUTES 03 oo fd APR | (To be used with the attached Election of Rights form) 7 if Pig a: 3 4 ORAS! In response to the allegations set forth in the Administrative Complaint ile by n the Agency for Health Care Administration (“(AHCA” or “Agency”), Responden Thust/3.¢ make one of the following elections within twenty-one (21) days from the date of receipt of the Administrative Complaint and your Election of Rights in this matter must be received by AHCA within twenty-one (21) days from the date you receive the Administrative Complaint. Please make your election on the attached Election of Ri ghts form and return it fully executed to the address listed on the form. OPTION 1. If Respondent does not dispute the allegations in the Administrative Complaint and Respondent elects to waive the right to be heard, Respondent should select OPTION 1 on the election of rights form. A Final Order will be entered finding you guilty of the violations charged and imposing the penalty sought in the Complaint. You will be provided a copy of the Final Order. OPTION 2. If Respondent does not dispute any material fact alleged in the Administrative Complaint (Respondent admits all the material facts alleged in the Administrative Complaint.), Respondent may request an informal hearing pursuant to Section 120.57(2), Florida Statutes before the Agency. At the informal hearing, Respondent will be given an opportunity to present both written and oral evidence to reduce the penalty being imposed for the violations set out in the Complaint. For an informal hearing, Respondent should select OPTION 2 on the Election of Rights form. OPTION 3. _ If the Respondent disputes the allegations set forth in the Administrative Complaint (you do not admit them) you may request a formal hearing pursuant to Section 120.57(1), Florida Statutes. To obtain a formal hearing, Respondent should select OPTION 3 on the Election of Rights form. In order to obtain a formal proceeding before the Division of Administrative Hearings under Section 120.57(1), F.S., Respondent’s request for an administrative hearing must conform to the requirements in Section 28-106.201, Florida Administrative Code (F.A.C), and must state the material facts disputed. IF YOU SELECT OPTION 3, PLEASE CAREFULLY READ THE FOLLOWING a LE ARE PML WING PARAGRAPH: In order to preserve the right to a hearing, Respondent’s Election of Rights in this matter must be RECEIVED by AHCA within twenty-one (21) days from the date Respondent receives the Administrative Complaint. If the election of rights form with Respondent’s selected option is not received by AHCA within twenty-one (21) days from the date of Respondents receipt of the Administrative Complaint, a final order will be issued finding the deficiencies and/or violations charged and imposing the penalty sought in the Complaint.

Docket for Case No: 03-001367