. STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION QUALITY CARE MANAGEMENT OF Ss NORTH CENTRAL FLORIDA,’ INC., Petitioner, DOAH Case No. 05-3842 v. " | AHCA NO. 2005006302 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / FINAL ORDER Having reviewed the Notice’ of. Intent to Deny: dated: July 21, 2005, attached hereto and incorporated herein (Ex. 1), and all other, matters of record, the Agency for Health Care Administration (“Agency”) finds: and concludes as’ follows: FINDINGS OF FACT 1. The Agency issued a Notice of Intent to Deny letter to Petitioner, Quality .Care Management of North Central Florida, Inc., a home health agency, for violation of Chapter 400, Part Iv, Fla. Stat. (2005), and Chapter 58A-8, Fla. Admin. Code (2005). 2. The Notice of Intent to Deny charged that the specific basis for the denial of Petitioner’s initial application was that Petitioner failed to demonstrate proof of financial ability to operate a home health agency pursuant to Sections 400.471(3), 400.474(2) (a), Fla. Stat. (2005), and Rule S9A-8.004(5)., Fla. Admin. Code (2005). ; 3. The Petitioner was served" the “Notice: of Intent to Deny on July 28, 2005, by U.S. Certified Mail, Return Receipt Requested (Receipt #7160 3901 9849 0223 7409). See: Exhibit 2. 4. Enclosed with the Notice of Intent was an Election of Rights form (Ex. 3), which advised Respondent of its right to a hearing pursuant to Section 120.57(1) or Section 120.57(2), Fla. Stat. (2005). ‘5. The Petitioner. selected Option (3) within the Election of Rights, disputing... the allegations» of. fact: contained: in the Notice of Intent to Deny, and: requesting a» formal. proceeding, pursuant to 120.57(1), Fla. Stat. (2005). 6. On January 05, 2006,, the. Agency: received the..required omitted’: items demonstrating. proof of financial. ability to Operate a home health agency and rescinded the Notice of Intent to Deny letter dated July 21, 2005. See Exhibit 4. CONCLUSIONS OF LAW 7. The Petitioner is a home health agency over which the Agency has jurisdiction pursuant to the provisions of Section 20.42, Fla. Stat. (2005), and Chapter 400, Part IV, Fla. Stat. (2005). 8. The January 05, 2006, rescission letter renders this matter moot. ’ Wy Based on the foregoing findings of fact and conclusions of ' , law, it is ORDERED: 1. Based on the Petitioner’s submission of the omitted items _ demonstrating proof"of financial ability to operate a home health ' . agency and the Agency’s rescission letter of January 05, 2006, this matter is moot, and this case is dismissed. DONE and ORDERED this 4D day of Aloluasep, 2006 in Tallahassee, Leon County, Florida, A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A SECOND COPY, ALONG WITH FILING FEE AS PRESCRIBED BY LAW, WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW OF PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE FLORIDA APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN 30 DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies furnished to: Michael 0. Mathis, Esq. Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive Bldg #3 Mail Stop Code #3 Tallahassee, Florida 32308 (Interoffice Mail) Elizabeth Dudek Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive Bldg #1 Mail Stop Code’ #9 Tallahassee, Florida:32308 (Interoffice Mail) wiiiiam F. Sutton, Jr., Esquire Ruden, McClosky, Smith, Schuster & Russell, P.A; 111 North Orange Avenue, Suite-1750. Orlando, Florida 32801 (U.S. Mail) Barbara J. Staros Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3030 (Inter-office Mail) Jan Millis ' (Interoffice Mail) CERTIFICATE: OF’ SERVICE I HEREBY CERTIFY that..a.truesand:correct« copy..of this Final order was served. on the. above-named: person(s) and entities by U.S. Mail, or by the method designated, on this LO aay of S Lacock , 2006. Richard Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 pew a-euus uasuspa Peomnuos MCLIasky Smith +4072448060, 7-255 = P.007/009 =F @ - . ETT | RGR; ASENDY POR HEADH CARE ADMINSTRATION J&B BUSH. GOVERNOR July 21, 2005 ' Administrator : Quality Care Management of North Central Florida 613 St. Johns Ave. Suite 209 RE: Initial Application for license Palatka, FL 3Zi77-4643 . ' Conmmlaine % 2005006302 ' NOTICE, OF INTENT TO.DENY The application ‘for licensnre-of the above named company asa home health, agency.is:being denied for failure to provide proof of financial ability to operate: A. letter with:items-that were omitted from your application: was sent Jupe.16, 2005: Responses:to the.omission letter. were receivéd Juty:8, 2005. The response. didnot meot the. requirements:in state law-and rulesand, your agency failed to demonstrate financial ability to.operate., The specific requirements-that were not met are: . 1. The appheant did-not demonstrate financial -ability:to operate: The following items fom the response ‘to the-first'omission Jener-were:the:basis' for the decision::: » The applicant has offered proof of insufficient company assets to mest their stated needs. A limited liability company is a legal construct limiting Hability to the assets held by the corporate body. As such, the only assets that can be’ considered. when assessing the financial stability and viability of a corporation are the assets that reside in the corporstion’s name. The applicant submitted a letter from the bank attesting to company assets consisting of $30,000 in a company account and a $12,000 line of credit, The applicant's federal tax ID number was attached to the company account but the line of credit was attached to the social security number of one of the owners, not the company. Personal assets of an owner may not be considered in judging the assets of a corporate entity. The pertinent statutes and rules that apply include: Section 400.471 (2) (c), F.S., “The applicant must file with the application satisfactory proof that the home health agency is in compliance with this part and applicable rules, including: (c) Proof of financial ability to operate.” cline &t 2727 Mahan Drive « Mail Srop #1 "i “be fi us Tallahassee, FL 32308 EXHIBIT 7-2 Sep-13-2005 03:05pm From-Ruden WeClosky th +4072445080 7-256 P.008/009 F-677 Quality Care Managen. - Central Florida. 9 nnn Section 400.471 @), F.S., “An applicant for initial licensure must demonstrate financial ability to operate by submitting a balance shest and income and expensé statement for the : first 2 years of operation which provide evidence of having sufficient assets, credit,-and projected revenues to cover lisbilities and expenses. The applicant shall have demonstrated: nancial ability to operate if the applicant's assets, credit, and projected revennes meet or exceed’ projected Habilities and expenses. All documents required under this subsection taustbe-——-—— prepared in accordance with generally accepted accounting principles, and the financial: Statement must be signed by e-certified public accountant,” | Section 400.474 (Z) (a), F.S., “Any of the following actions by a home health agency or its employee is grounds for disciplinary action by the agency: (a) Violation of this part or of applicable rales.” Section 59A-8:004 (5) Flotide Administrative Code (FAC), “For initial applications, including changes of ownership, the applicant must submit proof of financial ability io operate, pursuant to 5.400.471 (3), F.8.. The compliance is demonstrated by completion of schedules ] through 7 of the home health 2gency application, as referenced in subsection (1) above.” EXPHANATION-OF RIGHTS): Pursuant to Section 120.569, Florida Statutes, (F:S.) you-have thé right to request.an: administrative hearing. In order-to.obtain 2 formal: proceeding before the Division-of: Administrative Bearings under Section.120.57(1); F.8., your request for an administrative’ bearing must conform to. the requirements in Section’ 284106(111 Florida-Administrative:Code EAC), Section 28-106.201 Florida:Admi istrative Code:(F:A:C), and must state the material ‘facts you dispute. : oot : Tn onder to preserve the right toa hearing, the Election.of Rights'form, in this:matter; must be received by the Agency for Health Care Administration within twenty-one:(21) ‘days; from the gate the Notice of Intent to Deny is received by licensee. Tf the election of rights form with the sejected option is not received by the Ageacy for Health Care Administration within twenty-one . (21) days from the date of the receipt of Notice of Inteat to Deny, a final order will be issued finding the deficiencies and/or violations charged.and imposing the penalty sought. Apency for Health Care Administration py Bat Nintad Anne Menard as Unit Manager Home Care Unit Health Facility Regulation Copy: Agency Clerk, MS 3 Wendy Adams, MS 3 Enclosed: Election of Rights Form Explanation of Election of Rigbts Form lv Page 1 of 1 Vero 7 lah Oo NULLITY) ‘ oy UNITED STATES : BEd Postal SERVICE. Home | Help Track & Confirm Search Results F Label/Receipt Number: 7160 3901 9849 0223 7409 tts ; Track & Confirn SHES Status: Delivered : Enter Label/Receipt Number. Your item was delivered at 10:09 am on July 28, 2005 in PALATKA, FL 32177. A proof of delivery record may be available through your local Post Office for a fee, , ‘ Additional information for this item is stored in files offline. \ C Restore Offline Details > @ (Return to USPS.com Home > a site map contact us ' government services jobs National. & Premier Accounts POSTAL INSPECTORS -2004 USPS, All Rights Reserved. Terms of Use Privacy Policy Preserving the Trust Copyright © 1999. ' EXHIBIT _ #22 hitp://irkenfrm1 -smi.usps.com/PTSInternet Web/InterLabelInquiry.do 01/11/2006 "Sap-13-2005 03:06pn Fram-Rud . Sayin een Aine ariel Ld +407 2448080 T-258 P.009/009 F877 Sei th Aug-T7=2005 |0:38an — From-Rudan tell oc $40 72448080 ab. P.UDZ/O82.. Piga we . 3 . . os oe, ‘ t “a, Ts) Bo, wa. Ce ; . “a A ZB, an: < 3 | BTATEOF FLORIDA RS B ; AGENCY FOR HEALTH SARE ADMINISTRATION ioe oa ion Sf, - a ea ip RE: GASE NAME: Quality Care Managemant of Nori Central Florida. COMPLAINTZ es to, NG, 2005006202 om Cs ELECTION OF RIG § NOTIGE OF INTENT 4 ; . _ . ve . PEEABE SELECT our Br ZOPTIONS: 0D 5 - ayy pa Kn Explanation of Rignis ic atinched, -- OPTION ONE (1) 1 de ant widsute tind altsgations of fact contained in the Notice of Intan! and waiva mrHghtbredke urir das hearts a mudenstaret that p acceler lip ighiay sintecater tL ar tosame st . meen the Notice of Infartt and Imposne the sanctions aoughtt DPTION TWO} ido nol dloputs aad J acmit tho aflegnGans of fact In the Noise ef Intent, boil elo wish to bes edfordad ar inorrat proceeding, pursuant fo Section 12257(2), Frankie Sotufes, st whch dae | , WRB perma i suai cre, pndiiar wrnnstt ewstense to 778 AgeHsy In, Amgetien ate pereaty Inpoasdds OPTION THREE (3) Kar ‘do elfepinfis the allegations of fact contained i the Notice of Inteunt andl request a formal hearing, pursuant 7 Sector qen.57t), Florida Statutes, before en “Acrainigthadive Law Juda appodrted by rp Ciliobor ot Admnlaletreties Hewrinse: - . F.you choose OPTION: THREE, (3), in order. to gbisin.a Yonmalpreceeding..befare the-Division of Administrative Hearings-tmdar Section 420:57¢4}, FS. your request for-en:adminisretive-heering: must donfocn £3 the raquraments in Section 26e109,204;, Florida Administrative: Code (FAC), end must alate fhe mmutoria! facte you cirputas * . {n ordor 40 preserve:your right fo any hearing, ‘your Election oF Rights:in this matter. must ba dinacad the Agency by fling within fventy-ome (at) clays fror tha data you rere the Nati of Infant. If you tics nat rarpand at ah within bwentyont (21) clays fram receipt of: a Notes of. Intent a final eeder: will ba issued finding yau guiby ot-me. vejanan crrargag era mpesing me penalty SOUENE IN Te TAT OF inant if you have: elected either OPTION WO (2) or THREE 18) above-and: you ars. intarastadt:tn. flxeuesing a potlement of this mation with ta Agency, please diss mark this bissk. 9 . yet Mediatian unser Reston 120.573, Florida Statutes, 1s not avalile In this: matier, (Plsasesiga anediin your gumentyeddteese,) dy AAP as Managing Member dohns Avenue, Suite 209 ‘ Addreses vt - ' ; Baath tL A B2 TT ee Lconep. No. pr facil tec PENDING /Nome Health Agency Phere Wa 407-BS4-1117 PLEASE RIETURH YOUR COMPLEVED FORM TD: : Booney Clerk, DiGerof. the. General Counsel, Agency far Health Care Adminixtmion, 2727 Rishon Brive ~ Mell Stop 3, Tallarmsnt, FLE2308, . of at EXHIBIT 73 DAE 2*RCVD AT SH7I2005 {4:48:05 AM [Eastem Daylight Time)’ SVR:F TLWEBAI9 * DNIS:B402° SiO: 4078341907 * DURATION (mm-ss}-044 , FLORIDA AGENCY FOR HEATH CARE ADMINISTRATION . JEB BUSH, GOVERNOR ALAN LEVINE, SECRETARY Jamaary 5, 2006" ' . ' Administrator Quality.Care Management. of Norttt: Central Florida 613 St. Johns Ave., ’ Palatka, FL 32177 " ' "RE: ~— Complaint # 2005006302 Dear Administrator: The purpose of this letter is to rescind the Notice of Intent to Deny, complaint #2005006302, issued on July 21, 2005 for Quality Care Management of North Central Florida. located in Palatka, FL. Since you have provided the omitted items to demonstrate proof of financial ability to operate, the reason for the denial of the application for a home health agency license is eliminated. The application is now considered complete and an initial licensure survey has been requested from the field office. If you have any questions about this letter, please cc contact Jan Benesh:at:(850):414- 6010 or by email, beneshj@ahca.myflorida.com. ‘ , ’ ' Sincerely, Orne Viner Anne Menard Supervisor Licensed Home Health Programs Unit Copy: Agency Clerk, General Counsel’s office Janice K. Mills, General Counsel’s office exuipit 7% 7 Visit AHCA online at 2727 Mahan Drive « Mail Stop #734 www fdhe.statefl.us Tallahassee, FL 32308 a, aa STATE OF FLORIDA ~~~ pIVISION OF ADMINISTRATIVE HEARINGS ——-—- QUALITY -CARE_MANAGEMENT OF NORTH CENTRAL FLORIDA, INC., a petitioner, Case No. 05-3542 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. ) ) ) ) . ) vs. ) ) } ) . ) ORDER’ CLOSING. FILE re: the-undersigned® on : hich’ informed’ the- undersigned s»been rescinded, and..the this: cause having: come: befo ts Motion to, Dismiss: w otice of Intent to. Deny -ha fully advised, itis; therefore, Respondent that the’N ; undersigned being ORDERED that: 1.. The final. hearing in this cause. scheduled: for February 2, 2006, is hereby cancelled. 2. The file of the Division of Administrative Hearings in the above-captioned matter is hereby closed, DONE AND ORDERED this 12th day of January, 2006, in ~-“ysqyahassee, Leon County, Florida. a BARBARA J. STAROS Administrative Law Judge : Division of Administrative Hearings The DeSoto Building 1230° Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division-of Administrative Hearings ' this 12th day of January, 2006. t COPIES FURNISHED: William F.” Sutt6n, or. , Esquire: Ruden, McClosky, Smith, Schuster «. ’ Russell, P,A: 111.North Orange Avenue, Suite 1750 Orlando, Florida 32801 Michael O. Mathis, Esmtire \ Agency for Health Care Administration. Fort Knox Building III, Suite 3431 2727 Mahan Drive Tallahassee, Florida 32308

Docket for Case No: 05-003542