STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION DEVONSHIRE ASSOCIATES, LTD., Ls ee d/b/a CHATSWORTH AT PGA, DOAH No. 06-1271CON Petitioner, AHCA No. 2006002612 vs. CON No. 9904 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. FINAL ORDER The Agency for Health Care Administration (“AHCA”), having entered into a Stipulation and Settlement Agreement with Devonshire associates, LTD., d/b/a Chatsworth at PGA (“Chatsworth at PGA”), and being otherwise well- advised in the premises, finds as follows: It is ORDERED that: 1. The Stipulation and Settlement Agreement is attached hereto and made a part hereof. The parties are directed to comply with the terms of the Stipulation and Settlement Agreement. 2. AHCA hereby approves the issuance of CON Application No. 9904 to Chatsworth at PGA to establish an additional 40 bed skilled nursing facility, through the delicensure of 40 active community skilled nursing home beds from Palm Beach Shores Rehabilitation and Subacute Center. 3. The above referenced case is hereby closed. 1 - DONE and ORDERED this 32 day of JU , 2006, in Tallahassee, Leon County, Florida. Alah Levine, Secretary Agency for Health Care Administration 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, IN THE DISTRICT COURT OF APPEAL 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 THIRTY (30) DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies furnished to: Elizabeth Dudek,Deputy Secretary Alfred W. Clark, Esq. Managed Care and Health Quality Assurance Attorney for Petitioner Agency for Health Care Administration Post Office Box 623 (32302) 2727 Mahan Drive, Bidg.3, MS 9 215 East Fifth Avenue Tallahassee, Florida 32308 Tallahassee, Florida 32303 (Interoffice Mail) Michael O. Mathis, Senior Attorney Janice Mills Agency for Health Care Administration Intake Unit, Bldg. 3 MS 3 2727 Mahan Drive, Bldg. 3, MS 3 (Inter-office Mail) Tallahassee, Florida 32308 (Interoffice Mail) Charles A, Stampelos Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399 CERTIFICATE OF SERVICE I hereby certify that a true copy of the foregoing Final Order was served on the above-named person(s) and entities: by U.S. Mail or the method designated on this Lv bay of DX , 2006. ee Richard J. Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Bldg. 3, MS 3 Tallahassee, Florida 32308 oth BEFORE THE STATE OF FLORIDA S te AGENCY FOR HEALTH CARE ADMINISTRATION 20 | << wat OO ¢ DEVONSHIRE ASSOCIATES, es, 3 ‘23 LTD., d/b/a CHATSWORTH AT Ep e ~ PGA, Bees * a a S Petitioner, vs. CON No.: 9904 DOAH Case No.: 06-1271CON STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent . STIPULATION AND SETTLEMENT AGREEMENT This Stipulation and Settlement Agreement ("Agreement") is entered into effective the date of execution hereof between Petitioner and the Agency for Health Care Administration ("AHCA") pursuant to Sections 120.569 and 120.57(1), Florida Statutes, and Rule 59C-1.0105, Florida Administrative Code. WHEREAS, Petitioner timely submitted an application to AHCA for CON number 9904 to transfer and add 40 skilled nursing beds to Petitioner's skilled nursing facility located in Palm Beach County; and WHEREAS, AHCA initially reviewed application for CON number 9904 and issued a preliminary notice of intent to deny the application and published notice of its intent to deny the application in the Florida Administrative Weekly dated March 10, 2006; and WHEREAS, Petitioner timely filed a Petition for Formal Administrative Proceeding which AHCA referred to the Division of Administrative Hearings, resulting in this above-styled case; and WHEREAS, subsequent to initiation of this proceeding, representatives from Petitioner and AHCA met to seek an amicable resolution of the issues and applicant provided clarification regarding application for CON number 9904; and WHEREAS, the parties wish to resolve their differences in an amicable manner and in a manner which reduces costs and litigation while promoting the goals and objectives of the Florida Certificate of Need law. IT IS, THEREFORE, agreed, in consideration of the mutual promises and covenants set forth herein, and other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, as follows: 1. The above recitals are true and correct and are incorporated herein by reference. 2. The parties shall file with the ALJ a Joint Motion for Relinquishment of Jurisdiction, pending finalization of settlement of this case and entry of a Final Order, with leave of either party to seek to reinstate jurisdiction if AHCA's Final Order is not entered within 90 days of relinquishment by the ALJ. 3. After jurisdiction is relinquished to AHCA by the ALJ, AHCA shall promptly enter a Final Order which approves CON number -2- 9904, adopts and incorporates this Agreement, and dismisses this pending proceeding. 4. When issued, CON number 9904 shall provide for the addition of 40 skilled community nursing home beds to Chatsworth at PGA National through the delicensure of 40 active community skilled nursing home beds from Palm Beach Shores Rehabilitation and Subacute Center. 5. Petitioner hereby waives the right to any further administrative, judicial, or similar proceeding it may be entitled to in this matter, including any requirement of any formal final order (findings of fact and conclusions of law) and including, but not limited to, any informal proceeding under Subsection 120.57(2), any formal proceeding under Subsection 120.57(1), appeals under Section 120.68, Florida Statutes, and declaratory or other writ of relief in any court or quasi-court (e.g., DOAH) of competent jurisdiction. Provided, however, that no agreement herein shall be deemed a waiver by either party of its right to judicial or administrative enforcement of this Agreement. 6. The parties agree that this Agreement is a legal and binding document and is enforceable in any court of competent jurisdiction. Should litigation be required to enforce the terms of this Agreement, said litigation shall be filed in the Circuit Court of the Second Judicial Circuit in and for Leon County, Florida. 7. Petitioner, for itself and for its related or resulting organizations, its successors or transferees, agents, attorneys, heirs and representatives, does hereby discharge AHCA and its agents, representatives and attorneys of and from all claims, demands, actions, causes of action, suits, damages, losses and expenses of any and every nature whatsoever arising out of or in any way related to this matter and AHCA's actions, including, but not limited to, any claims that were or may be asserted in any federal or state court or administrative forum, including any claims arising out of this Agreement, by or on behalf of Petitioner or related entities. 8. This Agreement contains all understandings and agreements (whether oral, written, or otherwise) of the parties and supersedes any prior oral or written agreements, understandings, or representations. 9. This Agreement may not be amended except in writing signed by all parties hereto. 10. This Agreement shall be binding upon and enure to the benefit of the parties' successors and permitted assigns. No assignment of this agreement shall be valid unless approved by AHCA in writing. 11. The parties agree to fully cooperate and execute any supplemental documents and take all additional acts necessary to give full force and effect to the terms and conditions of this Agreement. 12. Each party shall bear its own costs and attorneys fees with respect to this Agreement and the matters referenced herein. 13. This Agreement shall be governed by the laws of the State of Florida. 14. This Agreement may be executed in as many counterparts as may be required and it shall not be necessary that the signature of each party or the signatures of the persons required to bind any party appear on more than one counterpart. All counterparts shall collectively constitute a single agreement. Facsimile signatures may be used in place of original signatures for this Agreement. All parties waive any defenses to the enforcement of the terms of this Agreement based on the form of signature. 15. Each party agrees that it enters into this Agreement voluntarily and knowingly. 46. The undersigned have read and understand this Agreement and hereby represent and warrant that they have authority to bind their respective principals to it. IN WITNESS WHEREOF, the parties have set their hands and seals effective the dates entered. AGENCY FOR HEALTH CARE ADMINISTRATION: 2727 Mahan Drive Tallahassee, FL 32308-5403 Charite Gbewsad wu [4a ob CHRISTA CALAMAS © (Date) General Counsel Florida Bar No. 0142123 BHCA 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308 MV wed b -5- MICHAEL O. MATHIS (Date) Senior Attorney AHCA 2727 Mahan Drive Tallahassee, FL 32308-5403 DEVONSHIRE ASSOCIATES, LTD, d/b/a CHATSWORTH AT PGA: SV EZLO 2 : (Date) Attorney at Law Post Office Box 623 (32302) 215 Hast Fifth Avenue Tallahassee, FL 32303

Docket for Case No: 06-001271CON