STATE OF FLORIDA PLiED AGENCY FOR HEALTH CARE ADMINISTRATION yer 9 pay 4: 99 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, vs. . Case No. 2006007241 LOMONICO MANAGEMENT CORPORATION, a) by A] J4 d/b/a HIGHLANDS VILLAGE, SEBRING, 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 Lomonico Management Corporation, d/b/a Highlands Village, Sebring (hereinafter Respondent), pursuant to Sections 120.569 and 120.57, Florida s:xiuies : POOS3, aml ccactes: ai aa! ££ OF THE ACTION T’ is is an action to impose an administrative fine in the amount of one wiv. ind Collare ($1,00u.U0) based upon one cited State Class II deficiency pursuant to § 429.19(2)(b), Fla. Sta. (2006). JURISDICTION AND VENUE 1. The Agency has jurisdiction pursuant to §§ 20.42, 120.60 and 429.07, Fla. Stat. (2006). two 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 federal regulations, state statutes and rules governing assisted living facilities pursuant to the Chapter 429, Part I, Florida Statutes, and Chapter SBA-5 Fla, Admin. Code, respectively. 4, Respondent operates a forty-five (45) bed assisted living facility located at 2301 U.S. 27 South, Sebring, Florida 33870, and is licensed as an assisted living facility, license number 9069. 5. Respondent was at all times material hereto a licensed facility under the licensing authority of the Agency, and 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. That pursuant to Florida law, an assisted living facility shall contact the resident’s health care provider and other appropriate party such as the resident’s family, guardian, health care surrogate, or case manager if the resident exhibits a significant change; contacting the resident’s family, guardian, health care surrogate, or case manager if the resident is discharged or moves out. R. 58A-5.0182(1)(d) Fla. Admin. Code. . 8. Every facility shall be under the supervision of an Administrator who is responsible for the operation and maintenance of the facility including the management of all staff and the provision of adequate care to all residents as required by Part I of Chapter 429, F.S. and this rule chapter, Rule 58A-5.019(1), Florida Administrative Code (2006). 9. Any person, including ... assisted living facility staff...who knows, or has reasonable cause to suspect , that a vulnerable adult has been or is being abused, neglected, or exploited shall immediately report such knowledge or suspicion to the central abuse hotline. Section 415.1034(1), Fla. Stat. (2006). hw 10. “Abuse” means any willful act or threatened act by a caregiver that causes or is likely to cause significant impairment to a vulnerable adult’s physical, mental, or emotional health. Abuse includes acts and omissions. Section 415.102(1), Fla. Stat. (2006). ll. . "Neglect” means the failure or omission on the part of the caregiver to provide the care, supervision, and services necessary to maintain the physical and mental health of the vulnerable adult, including but not limited to, food, clothing, medicine, shelter, supervision, and medical services, that a prudent person would consider essential for the well-being of a vulnerable adult. The term “neglect” also means the failure of a caregiver to make a reasonable effort to protect a vulnerable adult from abuse, neglect, or exploitation by others. “Neglect” is repeated conduct or a single incident of carelessness which produces or could reasonably be expected to result in serious physical or psychological injury or a substantial risk of death. Section 415.102(15), Fla. Stat. (2006). 12.‘ That on August 13, 2006, the Agency conducted a monitoring survey of the Respondent facility. 13 That based upon interview and the review of records, the Respondent facility failed to immediately report to appropriate parties, including but not limited to family, law enforcement, and the central abuse hotline, the potential abuse of a resident. 14 That the Petitioner’s representative reviewed the records of resident number one (1) at approximately 6:00 PM on August 13, 2006, and noted the following: 2) That at 12:30 AM on August 13, 2006, facility staff, while providing incontinence care, noted that the resident had developed bruising at the resident’s hairline and beneath the left eye; b) That the resident is a vulnerable adult suffering from advanced dementia; c) That there was no known cause for the bruising; d) That the Administrator was made aware of the noted unexplained bruising; e) That the unexplained bruising of the resident had not been reported to the resident’s family or other responsible party, had not been reported to law enforcement, and had not been reported to the central abuse registry. 15. That the Petitioner’s representative interviewed the Respondent’s Administrator on August 13, 2006, at approximately 7:30 PM who indicated and confirmed that the resident?s family, law enforcement, and the central abuse registry had not been contacted by the facility. 16. That only upon the behest of the Petitioner’s representative did the Respondent’s Administrator make such contacts. 17. That the Administrator is responsible for ensuring that operation and management of the facility, including the responsibility for ensuring that facility staff, and the Administrator, comply with provisions of Florida’s regulatory and statutory law. . 18. . That the failure of the Respondent to contact the family, law enforcement, and the central abuse registry until in éxcess of nineteen (19) hours after injuries from an unknown source, individually and collectively, are in violation of Florida law. 19. That the Agency determined that this deficient practice was related to the personal care of the resident that directly threatened the health, safety, or security of the resident and cited Respondent for a State Class II deficiency. 20. The Agency provided Respondent with a mandatory correction date of August 16, 2006. 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 § 429.19(2)(b), Fla. Stat. (2006). Respectfully subpaitted this ar day of August 2006. Tho: . (Walsh I Fla, . No. 566365 Counsel for Petitioner Agency for Health Care Administration 525 Mirror Lake Drive, 330G St. Petersburg, Florida 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. 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, Florida 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 I HEREBY CERTIFY that a true and correct copy of the foregoing has been served by DHL Express Overnight Delivery and by U.S. Certified Mail, Return Receipt No. 7005 1160 0002 2254 8764 on August £7, 2006 to Shelia Gilley, Administrator, Highlands Village, Sebring, 2301 U.S. 27 South/ Sebring, Florida 33870. Fa as J, Walsh II Sevor Attorney Copies furnished to: Shelia Gilley Thomas J. Walsh, IT Administrator Agency for Health Care Adminisiration Highlands Village, Sebring 525 Muror Lake Drive, 330G 2301 U.S. 27 South St. Petersburg, Florida 33701 Sebring, Florida 33870 (Interoffice) (U.S. Certified Mail & DHL Express)

Docket for Case No: 06-003729