STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION Foyt, oY AGENCY FOR HEALTH CARE certified mail # here 76 E 9 tos #3 ADMINISTRATION, Fes 10100000 i Petitioner, vs. Case No. 2004008222 GULF COAST TREATMENT CENTER, INC., p ( | _ Ky y+ d/b/a GULF COAST TREATMENT CENTER, 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 Gulf Coast Treatment Center, Inc., d/b/a/ Gulf Coast Treatment Center hereinafter “Respondent”), pursuant to Section 120.569, and 120.57, Florida Statutes, (2004), and alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine pursuant to Rule 59E- 2.024(1), (3)(a) and (5), and 59E-2.025(1)(a), Fla. Admin. Code, and Section 408.08(2) Florida Statutes, (2004) and as a result of a violations of Section 408.061(4), Florida Statutes, (2004) and Rule 59E-5.201, Fla. Admin. Code. JURISDICTION 2. The Agency has jurisdiction over licensure and fines of the hospital pursuant to Chapter 395, Florida Statutes, (2004) and Chapter 59A-3, Fla. Admin. Code. VENUE 3. Venue shall be determined pursuant to Rule 28-106.207, Fla. Admin. Code. 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, (2004), and Chapter 59A-3 Fla. Admin. Code. 5. The Agency is the regulatory authority responsible for collecting and enforcing the hospital reporting requirements as required in Chapter 408, Florida Statutes, (2004), and Chapter 59A-3 Fla. Admin. Code. 6. Respondent is licensed as a hospital pursuant to Section 395.002(13), Florida Statutes. COUNTI RESPONDENT FAILED TO FILE A COMPLETE AND/OR ACCURATE PRIOR YEAR REPORT IN A TIMELY MANNER VIOLATING § 408.061(4), F.S. AND RULE 59E-5.201 F.A.C. 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 2004 fiscal year within 120 days subsequent to the end of the facilities fiscal year pursuant to Section 408.061(4), Florida Statutes and Rule 59E-5.201, Fla. Admin. Code. 9. The Respondent failed to file a Prior Year Report on the due date of April 29, 2004, to meet statutory requirements. 10. The Agency sent a deemed-not-filed notice of violation to the Respondent on August 17, 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, Violation of Chapter 408 Florida Statutes 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 viclation on August 19, 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 August 17, 2004 notice of violation within ten (10) working days of receipt of the notice. 14. Asof the date of this Administrative Complaint, Respondent has failed to appropriately file the report, resulting in a total of 124 days late, calculated pursuant to Rule 59B-2.024(5), Fla. Adm. Code. 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, and Rule 59E-5.201, Fla. Admin. Code, 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, 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, which results in fine of $20.00 per day starting on the original filing due date of April 29, 2004. This violation constitutes the grounds for which the Agency imposes a fine in the minimum amount of $2,480.00 as of the date of this Administrative Complaint pursuant to Sections Rule 59E-2.025 (1)(a), Fla. Admin. Code. 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 and Section 408.08(2), Florida Statutes which states each day is a separate violation. CLAIM FOR RELIEF WHEREFORE, 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, (2004) and Rule 59E-5.201, Fla. Admin. Code. pursuant to Rule 59E-2.024(3)(b) and (5), and 59E-2.025(1)(a), Fla. Admin. Code, and Section 408.08(2) Florida Statutes, (2004) finding: (A) Make factual and legal findings in favor of the Agency on Counts I; (B) Recommend administrative fines and fees to be imposed against the Respondent as follows: 1. In the minimum amount of $2,480.00; 2. Additional fines due to continued failure to file the 2004 Report as provided in Rule 59E-2.025(1)(a), Fla. Admin. Code; and (C) All other general and equitable relief allowed by law. Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes (2004). Specific options for administrative action are 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; RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO REQUEST A HEARING WITHIN 21 DAYS OF RECEIPT OF THIS COMPLAINT N ADMISSION OF THE FACTS ALLEGED IN THE WILL RESULT IN A COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. te Dated on this [#~ day of Sgt «_, 2004. Assistant General Counsel Florida Bar LD. 318442 Agency for Health Care Administration Bldg. 3, MSC#3 2727 Mahan Drive Tallahassee, FL 32308 (850) 922-5873 (office) CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that a true and correct copy of the foregoing has been served a by U. S. certified mail/return receipt requested on the l tay of September 2004 to: Jeffrey M. Kaplan, Chief Executive Officer, 1015 Mar Walt Drive, Fort Walton Beach, Florida, 32547. SES - 4 Zz Eric R. Bredemeyer, Assistant Geferal 2s /

Docket for Case No: 04-003852