Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: I.H.S. ACQUISITION NO. 103, INC., D/B/A HORIZON HEALTHCARE CENTER AT DAYTONA
Judges: SUZANNE F. HOOD
Agency: Agency for Health Care Administration
Locations: Daytona Beach, Florida
Filed: Feb. 07, 2007
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Friday, March 30, 2007.
Latest Update: Dec. 24, 2024
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
STATE OF FLORIDA,
AGENCY FOR HEALTH CARE O 7 . .) lo U 7
ADMINISTRATION,
Petitioner, . AHCANos. 2006010011 (Fine)
. 2006010012
vs. (Conditional License)
IHS ACQUISITION NO. 103, INC.,
D/B/A HORIZON HEALTHCARE CENTER AT DAYTONA,
Respondent.
ADMINISTRATIVE COMPLAINT
COMES NOW the Agency for Health Care Administration (hereinafter “Agency”), by
and through undersigned counsel, and files this administrative complaint against IHS
ACQUISITION NO.103, INC., D/B/A HORIZON HEALTHCARE CENTER AT DAYTONA,
(hereinafter “facility” or “Respondent”), pursuant to Chapter 400, Part II, and Sections 120.569
and 120.57, Florida Statutes (2006).
NATURE OF THE ACTION
1. This is an action to impose administrative fines in the amount of thirty-seven
thousand five hundred dollars ($37,500) and a survey fee in the amount of six thousand dollars
($6,000), based upon Respondent being cited for one isolated Class I deficiency, pursuant to
Section 400.022(1)(1), Florida Statutes (2006), one widespread Class I deficiency, pursuant to
Section 400.022(1)(0);, Florida Statutes (2006) and one patterned Class I deficiency, pursuant to
Section 400.102(1)(a), Florida Statutes (2006) (AHCA No. 2006010011). Additionally, this is
an action to impose a conditional licensure rating from October 14, 2006, through November 15,
2006, pursuant to Section 400.23(7)(b), Florida Statutes (2006) (AHCA No, 2006010012).
JURISDICTION AND VENUE
2. The Agency has jurisdiction pursuant to Sections 120.569, 120.57, 120.60, and
400.062, Florida Statutes (2006).
3. Venue lies in Volusia County, pursuant to Rule 28-106.207, Florida
Administrative Code (2006).
PARTIES
4. The Agency is the enforcing authority with regard to skilled nursing facilities
licensure pursuant to Chapter 400, Part IL, Florida Statutes (2006), and Chapter 59A-4, Florida
Administrative Code.
5. Respondent operates a skilled nursing facility located at 1350 S. Nova Road,
Daytona Beach, Florida 32114, having been issued license number 1164095. Respondent was at
all times material hereto a licensed nursing facility under the licensing authority of the Agency,
and was required to comply with all applicable rules and statutes.
COUNTI
RESPONDENT FAILED TO PROVIDE ADEQUATE AND APPROPRIATE CARE AND
SERVICES TO RESIDENTS
SECTION 400.022(1)(), FLORIDA STATUTES (2006)
ISOLATED CLASS I DEFICIENCY
6. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set
forth herein.
7. That on or about October 14, 2006, the Agency conducted an annual survey at
Respondent’s facility.
8. Based on resident and facility nursing staff interviews, observation, and record
review, Respondent failed to provide adequate and appropriate care and services to protect the
health and ensure no deterioration in condition for Residents #11, #10, and #6 (3 of 20 sampled
residents). Specifically, there was a failure to follow physician orders for insulin coverage and a
failure to notify the physician of blood sugars over 350, which is essential to diabetic
management, that poséd a direct threat to the health and safety for Resident #11. Also, the
Respondent provided documentation on 10/ 13/06 of missed accuchecks for Resident #3, as well
as four unsampled residents. There was also a failure to safely and correctly administer
necessary medications ordered by the physician for Resident #10, which posed a direct threat to
health and safety. The Respondent also failed to provide physician-ordered protection to the
ankles of Resident #6 as treatment for a Stage 4 pressure sore to the left ankle, a pressure ulcer
that developed in the facility. Additionally, the following findings were noted, including:
a. Resident #11 had a physician order for insulin coverage based on a sliding scale
dose dependent on the results of the Resident's accucheck, with the physician to be
notified of a result of 350 or above. A review of the Medication Record and Profiles of
August and September, 2006 for Resident #11 revealed the following entries:
8/2/06 Blood sugar 283- no coverage documented; 6 units ordered.
8/4/06 6 a.m. accucheck (blood sugar test) blood sugar signed as done with no results
recorded.
8/5/06 6 a.m. and 4 p.m. accucheck signed as done with no results recorded.
8/6/06 6 a.m. and 4 p.m. accucheck signed as done with no results recorded.
8/9/06 6 a.m. blood sugar 295; 9 units charted as given when 6 units was ordered for 295
results.
8/10/06 4 p.m. accucheck signed as done with no results recorded.
8/11/06 4 p.m. blood sugar 331-no Insulin coverage charted as given (8 units ordered).
8/12/06 4 p.m. blood sugar 367; documentation of 8 units Insulin given (the order of
716/06 states that blood sugars over 350 were to be called to the physician)
8/12/06 revealed no documentation of a call to the physician.
8/13/06 4 p.m. accucheck was done with no results charted.
8/14/06 4 p.m. accucheck was done with no results charted.
8/15/06 4 p.m. blood sugar 395-no Insulin coverage charted and no nurses’ notes
documented physician notification for blood sugar over 350.
8/20/06 6 a.m. accucheck signed as done with no results recorded.
8/21/06 6 a.m. accucheck not signed as done;
4 pan. blood sugar recorded was 334-no Insulin was recorded as given.
8/23/06 4 p.m. 351 blood sugar recorded with 15 units of Insulin coverage;
No physician order for the 15 units was noted in the clinical record.
8/24/06 6 a.m. accucheck signed as done with no results recorded.
8/25/06. 4 p.m. blood sugar recorded as 308; 6 units of Insulin charted as given with 8
units was ordered for blood sugars between 300 to 350.
8/26/06. 4 p.m. blood sugar 355 with 8 units of Insulin charted as given.
The physician order of 7/6/06 stated to call the physician for blood sugars over
350. No documentation of a physician call was noted in the nurses’ notes.
8/27/06 Accuchecks for 6 a.m. and 4 p.m. were not signed as done.
8/30/06 4 p.m. accuchecks were not signed as done.
8/31/06 6 a.m. accucheck was signed as done with no results documented;
4 p.m. results were not charted as done.
9/4/06 4 p.m. blood sugar of 350 with no Insulin administration recorded.
9/6/06 4 p.m. blood sugar documented at 218 with 1 unit administered in the LA (left
arm); there was no order for Insulin coverage below 250.
9/9/06 4 p.m. blood sugar 395; 8 units Insulin recorded as given when the physician was
to be notified.
9/12/06 4 p.m.-blood sugar 341; no coverage was charted when 8 units of Insulin were
ordered.
9/13/06 6 a.m. accucheck signed as done with no results documented.
9/18/06 4 p.m. blood sugar 426; 8 units of Insulin were given when the physician was to
be called.
9/19/06 4 p.m. blood sugar 344- no Insulin was charted as given when 8 units were
ordered.
9/20/06 4 p.m. blood sugar 318- no Insulin was charted as given when 8 units were
ordered.
9/23/06 4 p.m. blood sugar 330- documentation for administration of 10 units Insulin;
8 units of Insulin were ordered for blood sugars between 301-350.
9/24/06 6 a.m. accucheck was charted as done with no results documented.
A review of the clinical record revealed a physician progress note dated 9/20/06
documenting that the resident's Diabetes Mellitus was still out of control; a physician
otder was noted 9/20/06 expanding the sliding scale accucheck Insulin coverage for 351-
450 and notification of the physician with blood sugars over 450. History and physical
notes for Resident #11 dated 2/16/06 documented a diagnosis of Diabetes Type II
requiring Insulin. A review of the care plan for Resident #11 revealed the resident was at
tisk for hypo- and hyperglycemic reactions, and that accuchecks were to be done as
ordered in order that the resident's "blood sugars will become more WNL (within normal
limits) for him/her, thereby requiring minimal to no need for sliding scale coverage.”
‘An interview with the Assistant Director of Nursing on 10/14/06 at 11:25 a.m. revealed
that there was no nursing policy and procedure for emergency treatment of hypoglycemia
or hyperglycemia treatment with parameters for treatment or notification of the physician.
Resident #11 was observed in bed on 10/11/06 at 7:30 pm. When asked whether dinner
had been served, the resident stated "they have already given me my insulin shot and I
still have not been served dinner. I am feeling a little lightheaded and shaky." Resident
stated that the dinner hour has been changed and now her/his insulin regimen does not
coincide with her/his medications.
b. Resident #10 was observed on 10/12/06 at 8:10 am sitting on the edge of the bed
waiting for breakfast. Observation of the bed table revealed a 1-ounce plastic cup which
contained 7 different medications. The resident stated "the nurse leaves these here for me
and I take them when I get ready to." An interview with the Licensed Practical Nurse
(LPN) on 10/12/06 at 8:15 am revealed that she had given the medications to Resident
#10 together in a plastic cup, and she does that often so the resident can take them when
she/he wants to.
c. Resident #6 was admitted with a left hip dislocation and had current October 2006
physician orders for heel protectors to be worn when in bed. The resident also had a
stage IV pressure ulcer to the left ankle revealed by the 8/30/06 significant change
Minimum Data Set and 8/23/06 plan of care. The resident was observed lying in bed on
10/10/06 at 3:30 pm without the heel protector on the left foot. The day shift nurse
confirmed that they were not in place although it was a physician order. The resident's
current Kardex (used by the CNAs to direct care) did not indicate that the resident was to
have the heel protector on while in bed. The resident had a new order on 10/10/06 for a
sponge block to be on the resident's left lower extremity after each dressing change. The
resident was observed on 10/11/06 at 1:40 pm lying in bed without the sponge block in
place. The attending nurse verified that it was not in place and should be. This new
intervention was not on the resident's Kardex as care to be provided by CNA.
9. The above constitutes a violation of Section 400.022(1)(1), Florida Statutes
(2006), which includes residents’ rights to receive adequate and appropriate health care and
protective and support services. Failing to notify a physician as ordered when blood sugar spikes,
failing to administer medications properly, and failing to follow physician orders relating to
treatment of an area of the body near a stage IV pressure ulcer can have serious consequences for
residents. subjected to such neglect.
10. The above constitutes an isolated class J deficiency, for which a fine of $10,000 is
authorized pursuant to Section 400.23(8)(a), Florida Statutes (2006).
COUNT II
RESPONDENT FAILED TO PROVIDE A SAFE ENVIRONMENT, FREE OF
PHYSICAL, VERBAL AND MENTAL ABUSE
SECTION 400.022(1)(0), FLORIDA STATUTES (2006)
WIDESPREAD CLASS I DEFICIENCY
11. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set
forth herein.
12. That on or about October 14, 2006, the Agency conducted an annual survey at
Respondent’s facility.
13. Based on a family interview, staff and resident interviews, observations, and
review of the abuse investigation log and the grievance log, the Respondent failed to provide a
safe environment, free of physical, verbal, and mental abuse, and free of unprescribed physical
restraints for each of the facility residents, including sampled Residents #2, #4, #11, and seven
unsampled residents. The Respondent failed to thoroughly investigate all allegations of abuse,
report the allegations, protect residents from further abuse during investigations, and take
corrective actions to ensure the abuse did not continue or reoccur. These circumstances created
an environment that placed ail residents of the Respondent’s facility at risk for abuse, and
resulted in a direct threat to the health and safety of the residents. The findings include:
a. During the survey on 10/11/06 at 10:00 a.m., a family member for Resident #12
approached a surveyor regarding a witnessed incident. The incident involved Employee
#11. This family member alleged overhearing Employee #11 say to Resident #4 on
10/10/06, "[i]f you don't shut up about those glasses, I will push you out of that
wheelchair." The family member also stated that the incident was reported to the Director
of Nursing (DON), the Social Worker, and the Unit Manager on 10/10/06, and stated that
they were told by the DON and the Unit Manager to "keep it under wraps until we get to
it.”
At 9:55 am on 10/12/06, a CNA came to a surveyor to report that the family member for
Resident # 12 had wanted her to speak to the surveyors about the incident to be sure that
someone heard and responded to the concern. The CNA stated, "[mJany of [the] CNAs
don't want to go to the DON or the Unit Managers because they are friends with
Employee #11 and nothing gets done. I have personally heard this CNA (Employee #11)
abuse the residents, and she is still working here."
A teview of the Respondent's abuse investigation log, as well as the Respondent's abuse
investigations on 10/12/06 revealed no evidence that an allegation of abuse regarding this
incident had been reported or that an investigation had begun. Furthermore, the abuse
prevention coordinator stated she had no knowledge of this allegation. The incident of
alleged verbal abuse was not investigated or reported, and no measures were put in place
to protect residents, and the employee was observed to be working at the Respondent’s
facility with residents on 10/13/06 at 1:00 PM.
A review of Employee #11's personnel file on 10/12/06 revealed an allegation of abuse
alleging that the employee was observed choking a resident on 1/5/05 during breakfast.
Two different staff members documented the witnessed event and stated that the resident
was crying and repeating "help me, help me.” When the investigation for this incident
was requested by surveyors, the abuse prevention coordinator, who has held this position
for nine years, stated that she had never heard of this incident and that she had shredded
all the 2005 investigations.
Employee #11, who is alleged to have been physically and verbally abusive to residents,
continues to work at the facility even after the January 2005 witnessed incident of
choking. This employee is a CNA and has direct contact with the residents, placing them
at risk for abuse and mistreatment. On 10/13/06 at 1:00 pm, Employee #11 was observed
working with the residents of the facility.
b. A review of the facility's policy and procedures for abuse prevention was done on
10/12/06. The policy states that "[a]ll allegations of abuse, neglect, injuries of unknown
source, and misappropriation of resident property, are reported immediately to the
Administrator of the facility, the State Survey Agency and, to other officials in
accordance with State law.” The policy further states that "all allegations of abuse,
neglect, and exploitation/misappropriations, including injuries of unknown source, are
thoroughly investigated” and to "suspend suspected employee(s) pending outcome of the
investigation." The policy was not followed in that investigations were not done and the
"suspected employees were not suspended pending the outcome of the investigation".
A review of the Respondent’s records on 10/12/06 revealed the following:
01/23/06: An allegation of abuse stating a CNA "snatched the call bell out of the
resident's hand with one hand and twisted the wrist with the other hand."
02/1/06: An allegation stating a resident requested a bed pan for a bowel movement
and was told to "wait until his/her CNA came back from lunch." The
resident couldn't wait and was incontinent of bowel.
03/01/06: An allegation that "daughter came in facility at about 4:30 pm to take a
; resident to the dining room and the resident was still in [his/her]
nightgown. CNA's put a blue denim jumper and a sweater over the gown
and a yellow sweater." None of these items belonged to the resident.
03/20/06: An allegation by Resident #11 requesting a pain pill was told "[t]he nurse
stated you will get pain pill when I give it to you.”
03/21/06: Resident #11 made-an allegation of verbal abuse. When resident requested
assistance turning was told by CNA "[i]f you want to get the hell out of
here, you will do it yourself."
03/23/06: Resident #11 made an allegation that at 6:30 pm, a CNA said "[I’d] better
tell her everything I needed/wanted now because she wasn't coming back
in the room the rest of the night."
08/4/06: An allegation that the resident requested pain medicine at 8:30 pm on
8/3/06 and at different times throughout the night. The resident did not
receive any pain medication until the 7 am - 3 pm shift on 8/4/06.
08/10/06: An allegation that at 1:30 pm, the resident stated to staff "I have not had
my diaper changed since yesterday and I have been asking them to do it
since 2:30 thismorning.” Physical-Therapy staff found-his/her sheets
soaked from the knees to the neck.
08/23/06: An allegation that a resident requested a shower and the staff "just walked
out and didn't say anything.”
A review of the above allegations indicated no evidence of thorough investigation and
actions to prevent reoccurrences.
c. Resident #2 was observed lying in bed on 10/10/06 at 2:15 pm with full side rails
up on the bed. At lunch time, the left full side rail was lowered and the resident sat up at
the side of the bed and was observed eating the meal. Full side rails were again observed
to be up on Resident #2's bed while the resident was lying in it on 10/11/06 at 9:30am.
The resident was unable to lower the side rail by him- or herself when asked.
Resident #2 was admitted to the sub-acute unit on 7/19/06. The resident's Minimum Data
Set (MDS) assessment reference date of 7/26/06 revealed that no side rails were used by
the resident. A side rail data and collection assessment was partially completed on
7/19/06 indicating that the resident requests side rails to help the resident turn. It did not
indicate if quarter, half, or full side rails were to be used. The Unit Manager of the sub-
acute unit was interviewed on 10/10/06 at 2:15 pm and asked what type of side rail was
being used by the resident. The Unit Manager went to the resident's room and returned
and said that full side rails were up. She then checked full side rails on the 7/19/06 side
rail data collection and assessment form. The facility's side rail data collection and
assessment form had Full (Restraint only) under "Type of side rail to initiate."
A significant change MDS assessment reference date of 8/15/06 revealed that 1/2 side
rails were to be used daily. The resident was transferred to the nursing center unit on
September 12, 2006. When interviewed on 10/10/06 at 2:15 pm, the Restorative Nurse
stated that there were full side rails on the bed when the resident transferred from the
other unit. The Restorative Nurse stated that the full side rails were not considered a
restraint because the resident used it for bed mobility. The full side rails were not
assessed as a restraint or care-planned in the resident's medical record, although it
prevented the resident from sitting at the side of the bed and the resident could not lower
them. The Restorative Nurse had placed a work order for maintenance to replace 20 full
side rails with 1/2 side rails on 7/22/06. The MDS Coordinator stated that the resident
only had 1/2 side rails when she did the last assessment when the resident was on the sub-
acute unit. The MDS Coordinator stated on 10/11/06 at 9:30 am that the facility is
switching out full side rails for 1/2 side rails for the whole facility. It was not until
10/11/06 that 32 half side rails were ordered to replace any of the full side rails.
14. The above constitutes a violation of Section 400.022(1)(0), Florida Statutes
(2006), which ensures that facility residents have the right to be free from mental and physical
abuse, corporal punishment, extended involuntary seclusion, and from physical and chemical
restraints, except those restraints authorized on writing by a physician for a specified and limited
period of time or as are necessitated by an emergency. It is clear from the above findings that
residents of the Facility have been subjected to verbal and physical abuse, bullying, intimidation,
humiliation, neglect resulting in bowel/bladder incontinence incidents, and neglect in
administering pain medications resulting in resident(s) suffering needlessly. It is also clear that
policies and procedures designed to report, investigate, document, and respond appropriately to
allegations of abuse and neglect have not and do not function and are not followed at
Respondent’s facility.
15. The above constitutes a widespread class I deficiency, for which a fine of $15,000
is authorized pursuant to Section 400.23(8)(a), Florida Statutes (2006).
COUNT III
RESPONDENT FAILED TO PROVIDE AND MAINTAIN A SAFE AND SECURE
ENVIRONMENT AND TO MEET THE DAILY NEEDS OF ALL RESIDENTS,
MATERIALLY AFFECTING THE HEALTH OR SAFETY OF THE RESIDENTS
SECTION 400.102(1)(a), FLORIDA STATUTES (2006)
PATTERNED CLASS I DEFICIENCY
16. | The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set
forth herein.
17. That on or about October 14, 2006, the Agency conducted an annual survey at
Respondent’s facility.
18. Based on observations, record reviews, group interviews, staff and resident
interviews, the Respondent's facility failed to provide and maintain a safe and secure
environment and to meet the daily needs of all facility residents and specifically nine of twenty
sampled residents (#4, #7, #8, #10, #11, #12, #13, #18, and #19), and three unsampled residents
(#R8, #R10, and #R11). The facility failed to maintain a building that was secure and safe from
intruders. The facility also failed to provide the appropriate foods and supplements to ensure
nutritional health for the residents. Additionally, the facility failed to consult the residents before
changing their meal times, which resulted in dinner being served too late in the evening for
multiple residents, which resulted in not all residents having an evening meal prior to bedtime,
thus extending the time between meals from lunch until breakfast the next morning. The lack of
a safe environment and failure to provide adequate nutrition created a sense of anxiety, stress,
and fear of future harm for the residents, which constituted an immediate threat to the health and
safety of all residents. The findings include:
a. On 10/11/06 at 10:00 am, a group meeting was conducted with nine female
residents from the facility who were alert and oriented. All nine residents stated they
were fearful and anxious about strangers entering the building in the evenings and on
weekends. They stated, "the front doors are locked all weekend and in the evenings, but
people are in the facility that we do not know. They should at least wear name tags so -we
would know who they are.”
These residents also stated they were unhappy with the meal times and the menu. They
indicated that a new Certified Dietary Manager had just been hired at the facility and was
changing the menu and the meal times without consulting the residents.
They stated that their breakfast is always slow and late, and their dinner is now being
served between 6:30 pm and 7:00 pm. It was also stated that many nights in the past two
weeks, the evening meal was late and they did not receive their dinner until after 7:30
pm. They also voiced concer about not receiving a snack at bedtime.
b. During an evening visit to the facility on 10/11/06 at 6:30 PM, three surveyors
followed the instructions on the sub-acute entrance/exit door and were able to disarm and
reset the alarm and enter the building without any facility personnel observing them.
The instructions for disarming the alarm were attached in plain sight on the door of the
sub-acute unit, which presented an opportunity for unauthorized individuals to enter the
facility at any hour of the day or night without supervision.
The front doors of the facility were locked at night and weekends with a sign posted to
re-route people to the sub-acute door for entrance. A large printed sign in plain sight
advised individuals to enter the sub-acute door, then disarm and reset the alarm system by
pushing the yellow button three times.
The sub-acute door opened into a resident hallway with seven rooms that were not
observable from the nurse's station.
c. On 10/11/06 at 8:00 PM, the front door of the facility was observed to have a
folded newspaper between the doors which prevented the doors from locking and allowed
unmonitored access and egress to the front of the building.
d. A review of the medical record of Resident #8 on 10/11/06 revealed a form titled
"Food Preference Record" which was blank. An interview with this resident on 10/11/06
at 7:05 pm revealed "I don't like what they serve." There was nothing to indicate that
anyone had attempted to determine the resident's food preferences in order to allow the
resident to maintain a healthy nutrition status.
e. A review of Resident #19's diet card on 10/13/06 revealed the resident was to
receive fortified oatmeal with his/her breakfast. An observation on 10/14/06 at 8:17 am in
the restorative dining-room, revealed the resident did not eat the oatmeal. An interview
with the staff on 10/14/06 at 8:18 a.m. assisting Resident #19, stated the resident "Doesn't
eat oatmeal, doesn't like it." There was nothing to show that any other measures had been
tried to increase the resident's intake.
f. A review of Resident #18's diet card revealed the resident was to receive coffee
and juice as part of his/her breakfast. An observation of breakfast on 10/14/06 at 8:45
a.m. revealed the resident did not receive coffee or juice on the breakfast tray.
g During a breakfast observation on 10/12/06 at 8:40 am, unsampled resident #R8
was observed being served thickened liquids with the thickener settled to the bottom of
his/her juice and water. His/her diet card called for regular beverages. Resident R8 was
observed to have a staff feeding him/her. An observation on 10/13/06 at breakfast (8:45
am) revealed the resident's diet card called for the resident to receive 8 oz of skim milk, 1
cup of decaf coffee, and 6 oz of juice for the day. The resident was observed served with
2 glasses of water and no coffee, milk, or juice.
h. During meal observation on 10/10/06 at 12:30 PM, Resident #12 was observed
stating in a loud voice "Why am I sitting here? I want to sit at my regular table!" An
unidentified Certified Nursing Assistant (CNA) was heard replying, "[t]hey changed the
seating, you have to sit there.” During an interview with the Director of Nursing on
10/10/06 at 3:30 PM concerning the change in seating, she stated the change was so all
the "feeders" would be in one area so it would be easier for staff to assist with feeding.
i. In an interview with unsampled resident #R10 on 10/14/06 at 8:30 AM, it was
stated the resident did not feel well because she/he had to eat dinner the night before at
6:30 PM, which the resident felt was "ridiculous". The resident further stated, "We never
know when the meals are going to come and it feels awful to eat late in the evening.”
j. A review of resident records revealed that Residents #7 and #13 did not have their
food likes and dislikes form filled out. The facility-generated form was in each chart but
had not been filled out.
SECTIONS 400.19(3) AND 400.23(7)(b), FLORIDA STATUTES (2006)
21. The Agency re-alleges and incorporates paragraphs (1) through (20) as if fully set
forth herein.
22. Based upon Respondent’s three cited State Class I deficiencies, it was not in
substantial compliance at the time of the survey with criteria established under Part II of Florida
Statute 400, or with rules adopted by the Agency, a violation subjecting it to assignment of
conditional licensure status pursuant to Section 400.23(7)(b), Florida Statutes (2006). -
23. Due to the presence of three Class I deficiencies, a conditional license certificate
number 13950 was issued to Respondent with an effective date of October 14, 2006. Respondent
was issued a standard license certificate number 13951 with an effective date of November 15,
2006 (Exhibit 1 and 2).
24. Respondent has been cited for three Class I deficiencies and therefore is subject to
a six (6) month survey cycle for a period of two years and a survey fee of $6,000, pursuant to
Section 400.19(3), Florida Statutes (2006).
CLAIM FOR RELIEF
WHEREFORE, the State of Florida, Agency for Health Care Administration,
respectfully requests that this court:
(A) Make factual and legal findings in favor of the Agency on Count I, Count I, Count
II, and Count IV;
(B) Recommend administrative fines against Respondent in the amount of $10,000 for
Count I, $15,000 for Count II, $12,500 for Count II, and $6,000 as a survey fee pursuant to
Section 400.19(3), Florida Statutes (2006), for a total of $43,500;
(C) Assess attorney’s fees and costs; and
15
(D) Grant 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. Specific options for administrative action are set out in the
attached Election of Rights form. All requests for hearing shall be made to the attention of
Richard Shoop, Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, MS
#3, Tallahassee, Florida 32308, (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.
Respectfully submitted this 5 “day of January 2007.
orraine M. Novak, Esquire
Fla. Bar. No. 0023851
Agency for Health Care Admin.
2727 Mahan Drive, MS #3
Tallahassee, Florida 32308
850.922.5873 (office)
850.921.0158 (fax)
CERTIFICATE OF SERVICE
1 HEREBY CERTIFY that-a true and correct copy of the foregoing has been served by
US. Certified Mail, Return Receipt No. 7004 1160 0003 3739 3694 to: Registered Agent CT
Corporation System, 1200 South Pine Island Road, Plantation, FL 33324 and by U.S. Certified
Mail, Return Receipt No. 7004 1160 0003 3739 3700 to: Facility Admipistrator Susan L. Hein,
1350 S. Nova Road, Daytona Beach, FL 32114, on “© 2007:
Coraine M. Novak, Esquire
Copy furnished to: Nancy Marsh, FOM
Docket for Case No: 07-000647
Issue Date |
Proceedings |
Jun. 14, 2007 |
Final Order filed.
|
Mar. 30, 2007 |
Order Closing File. CASE CLOSED.
|
Mar. 28, 2007 |
Motion to Remand filed.
|
Feb. 14, 2007 |
Order of Pre-hearing Instructions.
|
Feb. 14, 2007 |
Notice of Hearing (hearing set for April 17, 2007; 10:00 a.m.; Daytona Beach, FL).
|
Feb. 13, 2007 |
Joint Response to Initial Order filed.
|
Feb. 09, 2007 |
Initial Order.
|
Feb. 07, 2007 |
Standard License filed.
|
Feb. 07, 2007 |
Conditional License filed.
|
Feb. 07, 2007 |
Administrative Complaint filed.
|
Feb. 07, 2007 |
Petition for Formal Administrative Hearing filed.
|
Feb. 07, 2007 |
Notice (of Agency referral) filed.
|