STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, AHCA No.: 2003006059 AHCA No.: 2003005568 Vv. Return Receipt Requested: 7002 2410 0001 4236 2809 FT. LAUDERDALE HEALTH & 7002 2410 0001 4236 2816 REHABILITATION CENTER, INC., @/b/a FT. LAUDERDALE HEALTH & REHABILITATION CENTER, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (hereinafter referred to as “AHCA”), by and through the undersigned counsel, and files this Administrative Complaint against Ft. Lauderdale Health & Rehabilitation Center, Inc., d/b/a Ft, Lauderdale Health & Rehabilitation Center (hereinafter “Ft. Lauderdale Health & Rehabilitation Center”), pursuant to Chapter 400, Part II, and Section 120.60, Fla. Stat., and alleges: NATURE OF THE ACTIONS 1. This is an action to impose an administrative fine of $12,500.00 pursuant to Section 400.23(8), Fla. Stat. (2002), for the protection of the public health, safety and welfare. 2. This is an action to impose a Conditional Licensure status to Ft. Lauderdale Health & Rehabilitation Center pursuant to Section 400.23(7) (b), Fla. Stat. 3. This is an action to impose a $6,000.00 survey fee pursuant to Section 400.19(3), Fla. Stat. JURISDICTION AND VENUE 4. This Court has jurisdiction pursuant to Sections 120.569 and 120.57, Fla. Stat., and Chapter 28-106, F.A.C. 5. Venue lies in Broward County, pursuant to Section 400.121(1)(e), Fla. Stat., and Rule 28-106.207, Florida Administrative Code. PARTIES 6. AHCA is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing nursing homes, pursuant to Chapter 400, Part II, Fla. Stat., (2002), and Chapter 59A-4 Florida Administrative Code. 7. Ft. Lauderdale Health & Rehabilitation Center operates a 169-bed skilled nursing facility located at 2000 East Commercial Boulevard, Ft. Lauderdale, Florida 33308. Ft. Lauderdale Health & Rehabilitation Center is licensed as a skilled nursing facility; license number SNF13630951; certificate number 10479, effective 07/24/2003 through 09/30/2003. Ft. Lauderdale Health & Rehabilitation Center was all times material hereto a licensed facility under the licensing authority of AHCA and was required to comply with all applicable rules and statutes. 8. Ft. Lauderdale Health & Rehabilitation Center participates in Title XVIII or XIX, it must follow the certification rules and regulations found in Title 42 C.F.R. 483, as incorporated by Rule 59A-4.1288, F.A.C. COUNT I FT. LAUDERDALE HEALTH & REHABILITATION CENTER FAILED TO ENSURE THAT THE RESIDENTS’ ENVIRONMENT WAS FREE OF HAZARDS TITLE 42, SECTION 483.25(h) (1), CODE OF FEDERAL REGULATIONS, RULE 59A-4.1288, FLORIDA ADMINISTRATIVE CODE, (QUALITY OF CARE) CLASS I DEFICIENCY 9. AHCA re-alleges and incorporates paragraphs (1) through (8) as if fully set forth herein. 10. During the Licensure survey conducted on 7/21- 24/2003 and based on observation and interview, it was determined that the facility failed to ensure that the resident's environment remained free from hazards, in that, water temperatures in resident bathroom sinks were at or above 120 degrees Fahrenheit in 18 of 28 resident occupied rooms in the second and third floor of the facility. The findings include: (a) Observation of resident occupied rooms 202 through 203 and 214 through 219 on 07/22/03 between 11:45 a.m. and 1:00 p.m. revealed that after running the hot water in the bathroom sinks of the resident's rooms, for 3 to 5 minutes that the temperatures of the water were at Or exceeded 120 degrees Fahrenheit (F) as follows: Room 202- 130 degrees Room 203- 132 degrees Room 214- 120 degrees Room 215- 120 degrees Room 216- 121 degrees Room 217- 125 degrees Room 218- 130 degrees Room 219- 121 degrees RY Ry RY ry ny ny ny ry ll. Observation of resident occupied rooms, Alzheimer's unit, 301 through 304, 306 through 308 and 314 through 317 on 07/22/03 between 11:20 a.m. and 1:00 p.m. revealed that after running the hot water in the bathroom sinks of the resident's rooms, for 3 to 5 minutes that the temperatures of the water were at or exceeded 120 degrees Fahrenheit (F) as follows: Room 301- 122 degrees Room 302- 120 degrees Room 303- 120 degrees Room 304- 120 degrees Room 306- 120 degrees Room 307- 120 degrees Room 308- 122 degrees Room 314- 121 degrees Room 316- 121 degrees Room 317- 122 degrees BY RY Ay yy ay Ry yoy 12. The maintenance director stated in an interview on 07/21/03 at 10:00 a.m. that," ..did not have any logs for water temperatures. Thought the water was hot in the 3rd floor (resident) shower yesterday but I didn't check the temperature." 13. During an interview with the administrator on 07/22/03 at 12:42 p.m., the administrator stated," I checked the water temperatures and they are 120 degrees. I will shut the hot water in the building now. The repairman for the hot water is coming at 2:00 p.m." 14. Interview on 07/22/03 at 3:45 p.m. with the "boiler repair man" who stated, "Problem with the mixing valve, not the boiler." Interview with the administrator on 07/22/03 at 3:45 p.m. who stated," The plumber will be here tonight." 15. Interview with the plumber in the presence of the administrator on 07/23/03 at 10:00 a.m. who stated," cause (of the high hot water temperature) was the mixing valve. The old one was not efficient. The mixing valve and the pump has been replaced." 16. On 07/24/03 at approximately 9:00 a.m., the administrator provided a log of resident bathroom sink water temperatures, which ranged between 108 degrees F and 116 degrees F. The administrator stated during an interview on 07/23/03 at approximately 3:00 p.m.," I will monitor the water temperatures every day for the next 2 weeks and then every week for the next couple of months to assure that we are maintaining acceptable water temperatures. If they remain stable, we will check 1 time a month for quality assurance." 17. Based on the foregoing, Ft. Lauderdale Health «& Rehabilitation Center violated Title 42, Section 483.25(h) (1), Code of Federal Regulations as incorporated by Rule 59A- 4.1288, Florida Administrative Code, herein classified as a Class I deficiency pursuant to Section 400.23(8) (a), Fla. Stat., which carries, in this case, an assessed fine of $12,500.00 This violation also gives rise to a conditional licensure status pursuant to Section 400.23(7) (b). COUNT II ADDITIONAL FINE UNDER SECTION 400.19(3), Fla. Stat. 18. The Agency, in addition to any administrative fines imposed, may assess a survey fee. The fine for the 2-year period shall be $6,000, one half to be paid at the completion of each survey. DISPLAY OF LICENSE Pursuant to Section 400.23(7)(e), Florida Statutes, Ft. Lauderdale Health & Rehabilitation Center shall post the license in a prominent place that is in clear and unobstructed public view at or near the place where residents are being admitted to the facility. The Conditional License is attached hereto as Exhibit “A” CLAIM FOR RELIEF WHEREFORE, the Petitioner, State of Florida Agency for Health Care Administration requests the following relief: A. Make factual and legal findings in favor of the Agency on Count I. B. Assess an administrative fine of $12,500.00 against Ft. Lauderdale Health & Rehabilitation Center, and assess a $6,000 survey fee pursuant to Section 400.19(3), Fla. Stat. on Count I Cc. Assess and assign a conditional license status to Ft. Lauderdale Health & Rehabilitation Center in accordance with Section 400.23(7) (b), Florida Statutes. D. Grant such other relief as this Court deems is just and proper. Respondent is notified that it has a 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, Lealand McCharen, Agency Clerk, 2727 Mahan Drive, Building #3, Mail Stop #3, Tallahassee, Florida 32308. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO RECEIVE A REQUEST FOR A HEARING WITHIN 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. E.