Og STATE OF FLORIDA # uy , AGENCY FOR HEALTH CARE ADMINISTRATION bin, ° py AOje ete et AGENCY FOR HEALTH CARE _ WBSTo ADMINISTRATION, O4-20 09 Anne De Petitioner, vs. Case No. 2004004120 WUESTHOFF MEMORIAL HOSPITAL, INC., d/b/a/ WUESTHOFF MEDICAL CENTER-ROCKLEDGE, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the AGENCY FOR HEALTH CARE ADMINISTRATION (hereinafter “Agency”), by and through the undersigned counsel, and files this Administrative Complaint against Wuesthoff Health System, Inc. d/b/a/ Wuesthoff Medical Center- Rockledge hereinafter “Respondent”), pursuant to Section 120.569 and 120.57, Florida Statutes (2003), and alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine pursuant to Rules 59E- 2.024(1), (3)(b) and (5), and 59E-2.025(1)(a), Fla. Aamin. Code (2003); and Section 408.08(2) Florida Statutes (2003), and as a result of a violations of Section 408.061(4), Florida Statutes (2003); and Rule 59E-5.201, Fla. Admin. Code. (2003). JURISDICTION 2. The Agency has jurisdiction over licensure and fines of the hospital pursuant to Chapter 395, Florida Statutes (2003); and Chapter 59A-3, Fla. Admin. Code. (2003). VENUE 3. Venue shall be determined pursuant to Rule 28-106.207, Fla. Admin. Code. (2003). PARTIES 4. The Agency is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing hospitals pursuant to Chapter 395, Florida Statutes (2003); and Chapter 59A-3 Fla. Admin. Code. (2003). 5. The Agency is the regulatory authority responsible for collecting and enforcing the hospital reporting requirements as required in Chapter 408, Florida Statutes (2003), and Chapter S9A-3 Fla. Admin. Code. (2003). 6. Respondent is licensed as a hospital pursuant to Section 395.002(13), , Florida Statutes (2003). COUNT 1 Respondent failed to file a complete and/or accurate prior year report in a timely manner violating. § 408.061(4), Fla. Stat. (2003) Fla. Admin. Code R. 59E-5.201 (2003) 7. The Agency realleges and incorporates by reference paragraphs (1) through (6) as if fully set forth herein. 8. The Respondent failed to submit a complete and accurate Prior Year Report for its 2003 fiscal year within 120 days subsequent to the end of the facilities fiscal year pursuant to Section 408.061(4), Florida Statutes (2003); and Rule 59E-5.201, Fla. Admin. Code. (2003). 9. The Respondent failed to file a corrected Prior Year Report on the extended due date of February 27, 2004, to meet statutory requirements. 10. The Agency sent a deemed-not-filed notice of violation to the Respondent on April 8, 2004, which specified the corrections needed to bring the report into compliance with statutory and rule requirements, allowed ten (10) working days to provide the Agency with the requested information, and gave notice that Respondent would be subject to imposition of an administrative fine if the requested information was not timely filed pursuant to Rule 59E-2.024(5), Fla. Admin. Code (2003), Violation of Chapter 408, Florida Statutes (2003); or Board Rules, which states in part: (5) Prior to seeking to impose an administrative fine against an entity for the violations described ... the Agency will send a notice of violation to the entity by certified mail, return receipt requested. If the entity corrects the violation within 10 working days of receipt of the notice, no violation will be deemed to have occurred and no administrative fine will be sought or imposed. If the entity does not correct the violation within that time, it shall be subject to imposition of an administrative fine which will be calculated from the original due date of the report or document. 11. The Respondent received the deemed-not-filed notice of violation on April 13, 2004. 12. A copy of the deemed-not-filed notice of violation is attached hereto as Exhibit “A” and incorporated herein by reference. 13. The Respondent failed to provide the Agency with the requested information specified in the April 8, 2004 notice of violation within ten (10) working days of receipt of the notice. 14. As of the date of this Administrative Complaint, Respondent has failed to appropriately file the report, resulting in a total of 97 days late, calculated pursuant to Rule 59E-2.024(5), Fla. Adm. Code. (2003). a @ @ 15. Failure to provide an accurate and/or complete Prior Year Report in a timely manner is a violation of Section 408.061(4), Florida Statutes (2003), and Rule 59E-5.201, Fla. Admin. Code (2003), which requires Respondent to file the Prior Year Report with the Agency within 120 days subsequent to the end of its fiscal year. 16. Section 408.08(2), Florida Statutes (2003), provides that any hospital which refuses to file a report, fails to timely file a report, files a false report, or files an incomplete report shall be punished by a fine not to exceed $1,000 per day for each day in violation, to be fixed, imposed, and collected by the Agency. Each day in violation shall be considered a separate offense. 17. Respondent's violations constitute a First Occurrence as defined in Rule 59E-2.025(1)(a), Fla. Admin. Code (2003), which results in fine of $24.50 perday —_, starting on the original filing due date of January 28, 2004. This violation constitutes the grounds for which the Agency imposes a fine in the minimum amount of $2,377.00 as of the date of this Administrative Complaint pursuant to Sections Rule 59E-2.025 (1)(a), Fla. Admin. Code. (2003). 18. The Agency may impose additional fines due to continued failure to provide the report pursuant to Rule 59E-2.025 (1)(a), Fla. Admin. Code (2003) and Section 408.08(2), Florida Statutes (2003), which states each day is a separate violation. CLAIM FOR RELIEF WHEREFORE, State of Florida, Agency for Health Care Administration (Agency requests the Court to order the following relief against the Respondent for continued violation of Section 408.061(4), Florida Statutes (2003), and Rule 59E-5.201, Fla. Admin. Code. (2003), pursuant to Rule 59E-2.024(3)(b) and (5), Fla. Admin. Code. (2003), and 59E-2.025(1){a), Fla. Admin. Code (2003), and Section 408.08(2), Florida Statutes (2003), finding: (A) Make factual and legal findings in favor of the Agency on Counts 1; (B) Recommend administrative fines and fees to be imposed against the Respondent as follows: 1. In the minimum amount of $2,377.00; and 2. Additional fines due to continued failure to file the 2003 Report as provided in Rule 59E-2.025(1)(a), Fla. Admin. Code (2003); and (C) All other general and equitable relief allowed by law. Dated on this j | day of M ay , 2004. Cs. Pall Eric R. Bredemeyer, Esquire Assistant General Counsel Florida Bar 1.D. 318442 Agency for Health Care Administration Bldg. 3, MSC#3 2727 Mahan Drive Tallahassee, FL 32308 (850) 922-5873 (office) @ , @ NOTICE 0 ; ; gig. Respondent is notified that it has a right to request an administrative hearing purs' ue sy ‘2, Section 120.569, Florida Statutes (2003). specific options for administrative action ay Woe Fore. set out in the attached Election of Rights (one page) 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 Clerk, Agency for Health Care Administration, Building 3, MSC #3, 2727 Mahan Drive, Tallahassee, Florida, 32308. THE RESPONDENT IS FURTHER NOTIFIED, IF THE REQUEST FOR HEARING IS NOT RECEIVED BY THE AGENCY FOR HEALTH CARE ADMINISTRATION WITHIN TWENTY-ONE (21) DAYS OF RECEIPT OF THIS ADMINISTRATIVE COMPLAINT, A FINAL ORDER WILL BE ENTERED. CERTIFICATE OF SERVICE LtNRISS SoS 1 HEREBY CERTIFY that a true and correct copy of the foregoing has been served by U. S. Certified Mail, return receipt requested (receipt# 7001 0360 0003 3804 3820) to: Wuesthoff Medical Center- Rockledge, Attention: Emil P. Miller, Chief Executive Officer, 110 Longwood Avenue, Rockledge, Florida, 32955. Dated on this day of Mar , 2004. Eric a Bre eyer, “Assistant ‘General Counsel a A I = JEB BUSH, GOVERNOR MARY PAT MOORE, INTERIM SECRETARY U.S. Postal! Service CERTIFIED MAIL RECEIPT (Domestic Mail Only: No Insurance Coverage Provided) CERTIFIED MAIL aay bt A April 8, 2004 Emil P. Miller Chief Executive Officer Wuesthoff Medical Center- Rockledge 110 Longwood Avenue Rockledge, Florida 32955 Retum Recelpt Fee {Endorsement Required) Restricted Delivery Fee RE: 2003 Prior Year Report FYE 09/30/03 Endorsement Restie AHCA #: 10-0092 Deemed-not Filed _ Notice of Violation 7000 L530 G000 1483 8318 Dear Mr. Miller: 0, May 2 Pursuant to Rules 59E-2.024, 59E-5.102, 59E-5.103, 59E-5.201, 59E-5.204 and 59E-5.206, Florida Administrative Code, the above referenced report has been found incomplete and deemed not filed for the following reason(s): ‘0v0 See Reverse for Instructions oO Prior Year Actual Report Pursuant to Rule 59E-5.201 and 59E-5.206, Florida Administrative Code, your hospital is required to submit to the Agency its actual report in electronic format. Your submission was received using an obsolete and unacceptable version of the FADES software. FADES version 4.0 software should now be used. Information Letter # 60, dated April 28, 2003, notified all hospitals of this change in reporting requirements. Acopy of the notification is attached. Please submit the proper (1) 3.5 inch diskette pursuant to the new requirements as discussed in Information Letter # 60. aw Audited financial statements Pursuant to Rule 59E-5.101 and 59E-5.201, Florida Administrative Code, your hospital is required to submit the hospital’s audited financial statements. The audited financial statements filed by the hospital are consolidated. Please re-submit audited financial statements with an opinion for Wuesthoff Medical Center- Rockledge only. Draft copies are not accepted. oO Medicare Cost Report Pursuant to Rule 59E-5.201, Florida Administrative Code, your hospital is required to submit (1) copy of the Medicare Cost Report. Please submit (1) copy of the Medicare Cost Report. Visit AHCA online at 2727 Mahan Drive © Mail Stop #28 www.fdhe.statefl.us Tallahassee, FL 32308 Pursuant to Rule 59E-2.024(5), please submit the required information within 10 working days from the date you receive this letter. Any subsequent administrative fines will be imposed from the due date of the report. Section 408.08 of the Florida Statutes provides that any hospital which refuses to file on a timely basis reports or other information required to be filed with the Agency, shall be punished by a fine not to exceed $1,000 per day for each day in violation. Failure to provide these corrections will result in the matter being forwarded to our legal counsel for appropriate action. Thank you very much for your cooperation. If you have any questions, please contact me at (850) 922-7750. 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Docket for Case No: 04-002065