STATE OF FLORIDA + be ACENCY FOR HEALTH CARE ADMINISTRATION 03 MAY 28 Pit 0: 3 0 AGENCY FOR HEALTH CARE ADMINISTRATION, ive Petitioner, AHCA No.: 2003001705 Return Receipt Requested: Vv. 7000 1670 0011 4849 5979 7000 1670 0011 4849 5986 H & C RETIREMENT CENTER d/b/a BEST 7000 1670 0011 4849 5993 RETIREMENT CENTER, OD- M003 Respondent. ~ ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (hereinafter “AHCA” or the “Agency”), by and through the undersigned counsel, and files this administrative complaint against H & C Retirement Center d/b/a Best Retirement Center (hereinafter “Best Retirement Center”), pursuant to Chapter 400, Part III, and Section 120.60, Florida Statutes, (2002) (hereinafter “Fla. Stat.”), and alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine of $10,400.00 pursuant to Section 400.419, Fla. Stat., for the protection of the public health, safety and welfare, and 2. This is an action to revoke the license of Best Retirement Center pursuant to Section 400.414(1), Fla. Stat. JURISDICTION AND VENUE 2. This Court has jurisdiction pursuant to Sections 120.569 and 120.57 Fla. Stat. and Chapter 28-106, Florida Administrative Code. 3. Venue lies in Broward County, pursuant to Section 120.57 Fla. Stat, Rule 28-106.207, Florida Administrative Code. PARTIES 4. AHCA is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing assisted living facilities pursuant to Chapter 400, Part III, Florida Statutes (2002) and Chapter 58A-5 Florida Administrative Code. 5. Best Retirement Center operates a J0-bed assisted living facility located at 5605 N. W. 27 Court, Lauderhill, Florida 33313. Best Retirement Center is licensed as an assisted living facility under license number 4915. Best Retirement Center was at all times material hereto a licensed facility under the licensing authority of AHCA and was required to comply with all applicable rules and statutes. COUNT I BEST RETIREMENT CENTER FAILED TO COMPLY WITH THE RESIDENT BILL OF RIGHTS, AS EVIDENCED BY DEPRIVING A RESIDENT OF THE RIGHT TO LIVE IN A SAFE AND DECENT LIVING ENVIRONMENT, FREE FROM ABUSE AND NEGLECT, AND/OR THE RIGHT TO BE TREATED WITH CONSIDERATION AND RESPECT AND WITH DUE RECOGNITION OF PERSONAL DIGNITY. SECTIONS 400.428(1),(4), FLORIDA STATUTES, (RESIDENT RIGHTS) CLASS I VIOLATION 6. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. Best Retirement Center was cited with one (1) Class I violation pursuant to the complaint investigation conducted by the Agency on February 14, 2003 and February 21, 2003. 8. Based on the complaint investigation conducted on February 14, 2003 and February 21, 2003 and based on interview and record review, the Agency’s surveyor found that the facility failed to comply with the Resident Bill of Rights, as evidenced by depriving a resident of the right to live in a safe and decent living environment, free from abuse and neglect, and/or the right to be treated with consideration and respect and with due recognition of personal dignity. For confidentiality purposes, the resident who was the subject of the complaint investigation and resulting violation has been identified as “E.Q.”, and is hereinafter referred to as “the resident.” The findings include the following, to wit: 9. During an interview with the resident named in Complaint Investigation #2003-001083 conducted on 02/14/03 by John W. Sanders, HFE I, it was reported that the owner of the facility struck the resident in the face with an open beer can on February 7, 2003. According to the resident, the incident occurred at approximately 2:30 AM. The resident was in the yard of the facility following a false fire alarm when the owner noticed the resident with an open beer can in hand. Following a demand for the beer can by the owner, a struggle ensued between the resident and the owner for the beer can. After taking the beer can from the resident, the owner struck the resident on the left side of the face with the can. The resident’ went to the entrance of the facility where a police officer was finishing paperwork following the false fire alarm, and alerted the officer to the incident with the owner, which had just occurred. 10. The Police Report documents that the resident's head was completely soaked and that the resident had a superficial laceration approximately two (2) inches in length on his/her left cheek and that there was raised swelling on and around the facial area. The report further documents that the officer had personally observed the resident five (5) minutes prior to the incident and that the resident did not have any marks on his/her face at that time. The resident informed the officer that he/she was in extreme fear for his/her safety due to the owner's actions. 11. The Police Report further documents that there were two (2) witnesses to the incident from beginning to end and that their account of the incident did not contradict the resident's. The witnesses and the resident were separated and interviewed in private by the police. The resident and one (1) witness provided the police with sworn taped statements. According to the Police Report, the other witness was afraid of retaliation from the owner if he/she provided the: police with a sworn taped statement. Photographs of the resident's injury was taken by the police and submitted into evidence along with the taped statements. 12. The witness who gave a sworn taped statement to the police was interviewed by 2 surveyors on a subsequent visit to the facility on 02/21/03 and confirmed the events as documented by the resident named in the complaint and the Police Report. The other witness was not present at the facility during both visits (02/14/03 & 02/21/03) and was not interviewed. 13. The Department of Children and Families conducted an independent investigation. The Investigator was interviewed and their findings of the incident are consistent with the Police report. Copies of both reports were obtained as part of the complaint investigation. 14. Based on the foregoing, Best Retirement Center violated Sections 400.428(1), (4), Fla. Stat., herein classified as a Class I violation, pursuant to Section 400.419(1) (a), Fla. Stat., which carries an assessed fine of $10,000.00. This and the foregoing facts give rise to the Agency’s revocation of the facility’s license, pursuant to Section 400.414(1), Fla. Stat. SURVEY FEE 15. Pursuant to Section 400.419(9), Fla. Stat., AHCA may assess a survey fee to cover the cost of initial complaint investigations that result in the finding of a violation. AHCA assessed a survey fee of $400.00 in this instance. CLAIM FOR RELIEF WHEREFORE, the Agency requests the Court to order the following relief: 1. Enter a judgment in favor of the Agency for Health Care Administration against Best Retirement Center on Count I. 2. Assess and maintain the Agency’s administrative fine of $10,000.00 for a Class I violation, against Best Retirement Center on Count I, pursuant to Section 400.419(1) (a), Fla. Stat. 3. Assess and maintain the Agency’s revocation of Best Retirement Center’s license, pursuant to Section a00.414(1), Fla. Stat. 4. Assess and maintain the Agency’s survey fee of $400.00 against Best Retirement Center, pursuant to Section 400.419(9), Fla. Stat. 5. Assess costs related to the investigation and prosecution of this matter, if the Court finds costs applicable. 6. Grant such other relief as this Court deems is just and proper. Respondent ig notified that it has 4 right to request an administrative hearing pursuant to Sections 120.569 and 120.57, Florida Statutes (2001). specific options for administrative action are set out in the attached Election of Rights and explained in the attached Explanation of Rights. All requests for hearing shall be made to the Agency for Health Care Administration, and delivered to the Agency for Health Care Administration, Manchester Building, First Floor, 8355 N. W.- 53rd Street, Miami, Florida, 33166; Attn: Kathryn F. Fenske. RESPONDENT [5S FURTHER NOTIFIED THAT THE FAILURE TO RECEIVE A REQUEST FOR 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. Kathryn F. Fenske, ESq- Assistant General Counsel Agency for Health Care Administration Florida Bar No. 0142832 8355 N. W. 53 Street Miami, Florida 33166 Copies furnished to: Diane Reiland Field Office Manager Agency for Health Care Administration 1710 E. Tiffany Drive - Suite 100 West Palm Beach, Florida 33407 (U.S. Mail) Jean Lombardi Finance and Accounting Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) Assisted Living Facility Unit Program Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) 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 Ramchand Ramrup Administrator, Best Retirement Center, 5605 N. W. 27 Court, Lauderhill, Florida 33313; H & C, Retirement Center, Inc., 5605 N. W. 27 court, Lauderhill, Florida 333123; Hansram Ramrup, 2834 N. W. 55 Avenue - 1-B, Lauderhill, Florida 33313 on this 2 Saay of \prouuch_ 2003. Kathryn’ F. Kénske, Esq.

Docket for Case No: 03-002003