STATE OF FLORIDA me Ty EY AGENCY FOR HEALTH CARE ADMINISTRATION oo fom OSAPR-7 PM 4: 18 STATE OF FLORIDA AGENCY FOR a HEALTH CARE ADMINISTRATION, Paha OF ‘A IVE Petitioner, YS. Case No. 2004010800 PATHWAYS TO CARE, INC., _ . Respondent. 0 5 ~ J aS | ADMINISTRATIVE COMPLAINT COMES NOW the Agency For Health Care Administration (hereinafter “Agency”), by and through the undersigned counsel, and files this Administrative Complaint against PATHWAYS TO CARE, INC. (hereinafter “Respondent”), pursuant to Section 120.569, and 120.57, Florida Statutes, (2004), and alleges: NATURE OF THE ACTION This is an action to impose an administrative fine in the amount of $1000.00 pursuant to § 400.419(2)(b) Fla. Stat. (2004), and survey fee in the amount of $500.00 pursuant to § 400.419(10), based upon the existence of one (1) cited Class II violation. JURISDICTION AND VENUE 1. The Agency has jurisdiction pursuant to §§ 20.42, 120.60 and 400.407, Fla. Stat. (2004). 2. Venue lies pursuant to Fla. Admin. Code R. 28-106.207. PARTIES 3. The Agency is the regulatory authority responsible for licensure of assisted living facilities and enforcement of all applicable statutes and rules governing assisted living facilities oo Exhibit pursuant to the Chapter 400, Part II, Florida Statutes, and Chapter 58A-5 Fla. Admin. Code, respectively. 4. Respondent operates a licensed 40-bed assisted living facility located at 430 Plumrosa Avenue, Casselberry, Florida 32707 (License #10343), 5. Atall times material hereto, Respondent’ s assisted living facility was licensed under the authority of the Agency, and Respondent was required to comply with all applicable rules and statutes. COUNT I 6. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. . 7. Pursuant to § 400.428(1), Fla. Stat. (2004), the Respondent is required to comply with all provisions of the Resident Bill of Rights. 8. Pursuant to § 400.428(1)(a), Fla. Stat. (2004), every resident of an assisted living facility shall have the right to live in a safe and decent living environment, free from abuse and/or neglect. 9. Pursuant to § 400.428(1)(b), Fla. Stat. (2004), every resident of an assisted living facility shall have the right to be treated with consideration and respect and with due recognition of personal dignity, individuality and the need for privacy. 10. Pursuant to § 400.428(1)(d), Fla. Stat. (2004), every resident of an assisted living facility shall have the right to unrestricted private communication, including visiting with any person of his her choice, at any time between the hours of 9 a.m, and 9 p.m. 11. Pursuant to § 400.428(1)(h), Fla. Stat. (2004), every resident of an assisted living facility shall have the right to a reasonable opportunity to be outdoors at regular and frequent intervals except when prevented by inclement weather. 12. On or about October 18, 2004, the Agency conducted a complaint investigation (CCR #2004009327) of the Respondent’s assisted living facility (hereinafter “Facility”). 13. Based on interview, observation, and record review conducted during the October 18, 2004, complaint investigation, the Agency determined that the Respondent failed to ensure that each Facility resident: (1), live in a safe and decent living environment, free from abuse and/or neglect; (2), is treated with consideration and respect and with due recognition of personal dignity, individuality and the need for privacy; (3), is permitted to visit with any person of his/her choice, at any time between the hours of 9 a.m. and 9 p.m.; and (4), has a reasonable opportunity to be outdoors at regular and frequent intervals except when prevented by inclement weather. | 14. During a tour of the Facility on or about 10/18/04, an Agency surveyor observed 11 rooms in which residents were sleeping, with the doors opened to the hallway. 15. In interviews conducted on or about 10/18/04, four (4) residents indicated that Facility rules require them to keep the doors to their respective rooms open from 7:00 a.m. until 7:00 p.m. each day. The interviewed residents expressed that they "were not happy" with such rules because those rules result in a lack of privacy. 16. In an interview conducted on or about 10/18/04 at approximately 1:45 p.m., the Facility’s acting administrator (hereinafter “Administrator’) confirmed that Facility rules require that resident room doors are kept open at all times during the day. 17. In interviews conducted on or about 10/1 8/04, Facility residents indicated that Facility rules restrict them from exiting Facility unless they are going to an appointment or are supervised by Facility staff. 18. ‘In interviews conducted on or about 10/18/04, Facility residents indicated they are only allowed to sit in the smoking area of the screened in porch. ° 19, Ih interviews conducted on or about 10/18/04, some Facility residents stated that they felt like they were in a prison. 20. ‘In an interview conducted on or about 10/18/04 at approximately 1:45 p.m., the Administrator confirmed that Facility residents were not allowed to leave the facility unless accompanied by facility staff or to go to scheduled appointments. The Administrator indicated that the reason for this was agreement with the City of Casselberry that in order for the Facility to operate from that address the residents would not be allowed to wander around the community. 21. In interviews conducted on or about 10/18/04, two (2) Facility residents revealed that a Facility staff member was verbally abusive to them. The residents explained that the staff member yelled at and talked down to them. The two (2) residents expressed that this behavior was inappropriate and made them feel uncomfortable. 22. In interviews conducted on or about 10/18/04, a Facility resident indicated that the staff member yelled at him/her to not drink water from an area where that resident was not permitted. That resident stated he/she was new to the Facility and did not realize he/she could not get water from that location. 23. In an interview conducted on or about 10/18/04 at approximately 1:00 p.m., another resident revealed that the staff member speaks to residents "like they are alcoholics and drug addicts," stating "do this, do that,” in a yelling tone. 24. Review of the conditions of residency form, included in the admission packet given to new residents, revealed that the visiting hours were between 9:00 a.m. and 5:00 p.m., and were allowed only in the designated visiting areas. 25. Review of the house rules, also included in the admission packet, revealed that visiting hours are between 9:00 a.m. and 5:00 p.m., seven days a week, and that residents are instructed to "Please schedule known visits during free-time." 26. In an interview conducted on or about 10/18/04 at approximately 1:00 p.m., a resident confirmed that the visiting hours are between 9:00 a.m. and 5:00 p.m. and that he/she has never observed any visitors in the Facility other than between the hours of 9:00 a.m. and 5:00 p.m. 27. In an interview conducted on or about 10/18/04 at approximately 1:45 p.m., the Administrator confirmed that the Facility visiting hours were between the hours of 9:00 a.m. and 5:00 p.m. 28. Based on the above, the Agency determined that the Respondent failed to comply with all provisions of the Resident Bill of Rights, in violation of § 400.428(1), Fla. Stat. (2004). 29. Based on the above, the-Agency determined that the Respondent failed to ensure that each Facility resident live in a safe and decent living environment, free from abuse and/or neglect, in violation of § 400.428(1)(a), Fla. Stat. (2004). 30. Based on the above, the Agency determined that the Respondent failed to ensure that each Facility resident be treated with consideration and respect and with due recognition of personal dignity, individuality and the need for privacy, in violation § 400.428(1)(b), Fla. Stat. (2004). 31. Based on the above, the Agency determined that the Respondent failed to ensure that each Facility resident has the right to unrestricted private communication, including visiting with any person of his her choice, at any time between the hours of 9 a.m. and 9 p.m., in violation of § 400.428(1)(d), Fla. Stat. (2004). 32. Based on the above, the Agency determined that the Respondent failed to ensure that each Facility resident has a reasonable opportunity to be outdoors at regular and frequent intervals except when prevented by inclement weather, in violation of § 400.428(1)(h), Fla. Stat. (2004). , 33. The Agency determined that these deficient practices were related to operation and maintenance of the Facility or to the personal care of Facility residents and directly threatened the health, safety, or security of Facility residents. Accordingly, the Agency cited the Respondent for a Class II deficiency pursuant to § 400.419(2)(b), Fla. Stat. (2004). 34. The Agency provided Respondent with a mandatory correction date of October 19, 2004. WHEREFORE, the Agency intends to impose an administrative fine in the amount of $1,000.00 against Respondent, an assisted living facility in the State of Florida, pursuant to § 400.419(2)(b), Fla. Stat. (2004). COUNT 11 35. The Agency re-alleges and incorporates Paragraphs (1) through (5) and (7) through (34) as if fully set forth herein. 36. As aresult of the Agency’s complaint investigation conducted on or about October 18, 2004, the Respondent was cited for one (1) Class Il deficiency. 37. Pursuant to § 400.428(3)(c), Fla. Stat. (2004), due to the existence of the Class II deficiency described in Count I of this Administrative Complaint, the Agency must conduct a monitoring survey of Respondent’s facility (hereinafter “Facility”). The survey fee assessed should equal the lesser of one half of the Facility’s biennial license and bed fee or $500.00. 38. The Facility’s biennial license and bed fee is $2300.00. 39. Pursuant to § 400.419(10), Fla. Stat. (2004), the Agency is authorized to assess a survey fee to cover the cost of monitoring visits conducted under § 400.428(3)(c), Fla. Stat. (2004). That survey fee must be assessed though the survey will occur in the future. See, Agency for Health Care Administration v. Luz Home for the Elderly, Inc., d/b/a/ Luz Home for the Elderly, Case No. 02-263PH (Agency for Health Care Administration). WHEREFORE, the Agency intends to impose a survey fee of $500.00 against Respondent, an assisted living facility in the State of Florida, pursuant to § 400.419(10), Fla. Stat. (2004). Respectfully submitted this _2 O™day of January, 2005. rian T, Muili Fla. Bar. No. 0676543 Counsel for Petitioner Agency for Health Care Administration 525 Mirror Lake Drive, 330L St. Petersburg, FL 33701 Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes. 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 Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, Bldg #3,MS #3, Tallahassee, FL 32308; Telephone (850) 922-5873. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO REQUEST 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. CERTIFICATE OF SERVICE THEREBY CERTIFY that a true and correct copy of the foregoing has been served by USS. Certified Mail, Return Receipt No. 7003 1010 0003 0298 4824 on J; anuary 2.0™ 2005 to John J. Bluett, Registered Agent, Pathway to Care, Inc., 1201 Trotwood Bivd., Winter Springs, Florida 32708, and by U.S. Mail to Jeffrey Pickering, Administrator, Pathways to Care, Inc., 430 Plumrosa Avenue, Casselberry, Florida, 32707. Brian T. Mulligan Senior Attomey Copies furnished to: John J. Bluett Jeffrey Pickering Brian T. Mulligan Registered Agent Administrator Agency for Health Care Pathways to Care, Inc. Pathways to Care, Inc. Administration 1201 Trotwood Blvd. 430 Plumrosa Avenue 525 Mirror Lake Drive, 330L Winter Springs, FL 32708 Casselberry, FL 32707 St. Petersburg, Florida 33701 (U.S. Certified Mail) (U.S. Mail) (Interoffice) “iP Ei Ke Basae hares OSAPR-7 PM 4: 18 seat ee ee NA RE, SENDER: COMPLETE la q SECTION COMPLETE THIS SECTION DELIVERY ® Complete Items 1, 2, @ a. Also complete : iter 4 If Restricted Delivery fs desired. 3" ue 1 Print your name and address on the reverse 25. . 80 that we can retum the card to you. 3 " mi Attach this card to the back of the mal oF on the front If apace permits. ‘ER con Exhibit B

Docket for Case No: 05-001257