Sep-09-04 = 11:25am = From-HCA Inc, #615 344 2596 T7081 =P.004/019 = F-938 STATE OF FLORIDA “ey AGENCY FOR HEALTH CARE ADMINISTRATION © sent SS eee STATE OF FLORIDA a . . AGENCY FOR HEALTH CARE a a ADMINISTRATION, Q ah Petitioner, Jo ee BEE. 6 eo) FO ig: vs. AHCA NO.200400745¢,7 %, Return Receipt Requeste Ba, ? COLUMBIA/JFK MEDICAL CENTER, 7002 2410 0001 4237 1895 ~~ LIMITED PARTNERSHIP, d/b/a, 7002 2410 0001 4237 1901 a¥K MEDICAL CENTER, 7002 2410 0001 4237 1918 Respondent. O Uf. . Y ) / SYTC ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (hereinafter “AHCA”), by and through the undersigned counsel, files this Administrative Complaint against Columbia/JFK Medical Center Limited Partnership, d/b/a JFK Medical Center (hereinafter ‘JFK Medical Center”) pursuant to 28-106.111 Florida Administrative Code (F.A.c.) and Chapter 120, Florida Statutes ("Fla. Stat.") hereinafter alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine in the amount of two thousand ($2,000.00) dollars pursuant to Section 395.1065(2) (a) Fla. Stat. JURISDICTION AND VENUE EXHIBIT i A Sep-00-04 «= 11:28am = From-HCA Inc, +615 344 2598 T-081 © P.005/013 2. This court has jurisdiction pursuant to Section 120.569 and 120.57 Fla. Stat. and Chapter 28-106 F.A.C. 3. Venue lies in Palm Beach County, pursuant to 120.57 Fla. Stat. and Chapter 28, F.A.C. PARTIES 4. AHCA is the enforcing authority with regard to Hospital licensure law pursuant to Chapter 395, Part I, Fla. Stat. and Rules 59A~-3 F.A.C. 5. UFK Medical Center is a hospital facility located at 5301 S. Congress Avenue, Atlantis, Florida 33462 and is licensed under Chapter 395, Part I, Fla. Stat. and Chapter S9A-3. F.A.C. COUNT I JFK MEDICAL CENTER DID NOT HAVE PROTOCOLS OR POLICY AND PROCEDURES FOR RECEIVING TRANSFERS. IN ADDITION, STAFF DID NOT CONTACT THE EMERGENCY DEPARTMENT PHYSICIAN OR ON CALL PHYSICIAN REGARDING A TRANSFER 59A-3.255(6) (ec) (3) (4)a-d, Florida Administrative Code (EMERGENCY CARE) 6. AHCA re-alleges and incorporates (1) through (5) as if fully set forth herein. 7. During a complaint investigation conducted on June 15, 2004 and Based on staff interview and record review, it was determined that the facility did not have protocols or policy and procedures for receiving transfers. In addition, staff did not contact the emergency department physician or on call physician regarding a transfer. 2 F-835 Sep-08-04 «= 11:26am = From-HCA Inc, +615 344 2598 T-081 P.006/013 F835 ; 8. The facility received a call from the transferring facility on February 02, 2004, requesting to have a patient transferred for neurosurgical services, which is listed as provided by the recipient facility. The facility's Risk Manager (RM) was asked if a transfer log was kept. It was provided to the surveyor. Documentation of the call from the transferring facility to transfer a patient to the recipient hospital was ‘not found in the leg kept by the recipient hospital. The RM was asked why there was no documentation. The RM stated there was no specific policy and procedure for the documentation of transfers in and out of the facility, but that they started logging transfer ealls in and out recently. The nursing supervisor from the recipient facility, who was on duty February 02, 2004, when the transferring facility attempted to transfer the patient was interviewed at 11:15 A.M. It was stated he/she did not remember the call. It was also stated he/she did not know the policy for the documentation of incoming requests for transfer, although he/she stated they started doing that recently. The RM stated that a call would go to the nursing supervisor, who would call the ED physician, who would then eall the on-call physician. There was na decumentation to substantiate that this was done, Documentation from the transferring facility revealed documentation that the nursing supervisor was called at 10:00 A.M., and he/she told Sep-08-04 11:26am From-HCA Inc, +615 344 2508 T-081 © P.007/013 the caller at the transferring facility that Dr. ____s (the neurosurgeon on call) doas not do aneurysms. There was no documentation to substantiate that the nursing superviser contacted the ED physician or the on-call physician to inform him/her that a transfer was requested by another facility. The recipient facility does not haye specific policies or procedures to address transferring of patients to the facility. 9. During a revisit conducted on June 22, 2004 and based on record review and interview with staff, it was determined that the facility did not consistently implement policies and procedures relating to incoming transfers, and refused to accept a transfer from a requesting facility for 1 of 6 patients sampled fer medical record review. 10. During a revisit survey to the facility on July 22, 2004, the transfer log was requested. Review of the log revealed a transfer request from a facility fer patient RR#7. The request for transfer was made on July 21, 2004, at 12:45 A.M. ‘The service needed was decumented as "neurologist". It is documented on the form the nursing supervisor contacted the emergency department physician at 1:05 A.M. Under action taken, documentation reveals "No Neurologist on call". Further documentation revealed "Call placed to __ (transferring facility) after call list checked and confirm no neurologist on call". F835 Sep-08-04 11:26am From-HCA Inc, +615 344 2598 T-081 P.008/013 11. The facilities "Hospital Emergency Services" form, submitted to the Agency for Health Care Administration on May 20, 2004, documents that the service of neurology is provided 24 hours per day, seven days per week. A tour of the emergency department was conducted with the Chief Nursing Officer. The service capability sign in the waiting room indicated that the only services not available at the facility are obstetrics, pediatrics, neonatal, psychiatric, trauma, and burn. It was stated by the officer that the sign meant the facility does provide. neurology. 12. Amn interview was conducted with the Chief Nursing Officer on July 22, 2004, at 11:00 A.M. It was Stated by the officer that neurology is a subspecialty. The process was described as follows: if a patient needs the services of neurology, he/she would be admitted to medicine. The physician would then call neurology on a consultant basis. It was asked what happens if a facility calls requesting to transfer a patient to their facility, because the transferring facility dees not have neurology as a service. The reply was, the process would be for the nursing supervisor to call the emergency department physician, who would call the on call medical physician to accept the patient, who would then call a neurologist to see the patient as a consult. F-935 Sep-00-04 11:26am = From-HCA Inc, +615 344 2598 T-08) © P.008/013 13. While in the emergency department on tour, the on call physician list was requested. On July 22, 2004, neurology was listed as having no coverage. It was stated by the Chief Nursing Officer, the problem is that staff are not fully aware of the procedure that internal medicine should be called when a patient needs a neurologist, SO he/she can admit and consult with the neurologist. Supervisory and Medical staff did not follow the policy and procedure for the xeferrale of patients to internal medicine, to acoess/obtain consultation with a neurologist to examine the patient. On 7/21/04 staff refused to accept a patient needing the services of a neurologist, which the facility is documented as providing, by failing to follow facility protocol. 14. Based on the foregoing, JFK Medical Center violated 59A-3.255 (6) (c) (3) (4)a-d, FPlorida Administrative Cede on two different occasions. The fine assessed is $1,000.00 for each occurrence for a total of $2,000.00 PRAYER FOR RELIEF WHEREFORE, AHCA intends to: A. Assess against JFK Medical Center an administrative fine of $2 ,000.00 for the violations deseribed in Count I in accordance with Section 395.1065 Plorida Statutes. P8365 a Sep-09-04 tf: 26am From-HCA Inc, +615 344 2588 T-08) P.010/013 B. Award the Agency’ for Health Care Administration reasonable attorney’s fees, expenses, and costs. Respondent is notified that it has a right to request an administrative hearing pursuant to Sections 120.569 and 120.57, Florida Statues (2003) . Specific options for administrative action are set eut in the attached Election ef Rights and explained in the attached Explanation of Rights. All requests for. hearing shall be made to the Agency for Health Care Administration, attention Agency Clerk, 2727 Mahan Drive, Mail Stop #3, Tallahassee, Florida 32308. Telephone (250) 922-5873. RESPONDENT IS FURTHER NOTIFIED THAT FAILURE TO RECEIVE A REQUEST FOR A HEARING WITHIN TWENTY-ONE (21) DAYS OF RECEIPT OF THIS COMPLAINT, PURSUANT TO THE ATTACHED ELECTION OF RIGHTS, WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. Respectfully submitted. sen Counsel for Petitioner Agency for Health Care Adm nistration Spokane Building, Suite 103 8350 N.W. 52™ Terrace Miami, Florida 33166 . (305) 470-6802 7 F935 Sep-08-04 = 11:27am = From-HCA Inc, +15 344 2588 T-081 P.O11/013 Copies furnished te: Diane Reiland Pield office Manager Agency for Health Care Administration 1710 Bast Tiffany Drive, Suite 100 West Palm Beach, Florida 33407 Elizabeth Dudek Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 Jean Lombardi Finance and Accounting Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Plerida 32308 CERTIFICATE OF SERVICE Xt HEREBY CERTIFY that a true and correct copy of the foregoing was mailed (Return Receipt Requested) to George E. Asbell, CEO, JFK Medical Center, 5301 S. Congress Avenue, Atlantis, Florida 33462; Columbia/JFK Medical Center Limited Partnership, P.O. Box 750, Legal Department, Nashville, Termessee, 37202, and to CT Corporation System, Registered Agent, 1200 South Pine Island Road, Plantation, Florida 33324 on thus ft 3 , 2004, Nelsoy BE. Rodney F-835 Sep-09-04 = 11:27am = From-HCA Inc, +615 344 2598 T-0B1 = P.012/013 F938 ° STATE OF FLORIDA Ko : AGENCY FOR HEALTH CARE ADMINISTRATION . Oy by EXPLANATION OF RIGHTS UNDER SEC. 120,569. FLORIDA STATUTES hy ey UMS yy (To be used with Election of Rights for Administrative Complaint form — attached) Vinge In respanse to the allegations set forth in the Administrative Complaint issued by the Agency for Health Care Administration (“AHCA” or “Agency”), Respondent must 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 of the attached Election of Rights form and retum it fully executed to the address listed on the form. OPTION 4, 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 setting forth the allegations as being deemed admitted and imposing the penalty sought in the Administrative 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. ' OPTION3. 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 8, mediation may be available in this case pursuant to Section 120.573, Florida Statutes, If all parties agree to it : PLEASE CAREFULLY READ THE FOLLOWING PARAGRAPH: In order to preserve the right to a hearing, Respondent’s original 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 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. a

Docket for Case No: 04-003470