STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION OMNI HOME CARE AGENCY, INC, d/b/a OMNI HOME CARE AGENCY, INC., Petitioner, AHCA No.: 2008003503, DOAH No.: 08-1742... © vs. RENDITION NO.: AHCA-08-GRO¥ STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. FINAL ORDER Having reviewed the Notice of Intent to Deny Change of Ownership Application dated March 19, 2008, attached hereto and incorporated herein (Exhibit 1), and all other matters of record, the Agency for Health Care Administration (“Agency”) has entered into a Settlement Agreement (Exhibit 2) with the parties to these proceedings, and being otherwise well-advised in the premises, finds and concludes as follows: ORDERED: 1. The attached Settlement Agreement is approved and adopted as part of this Final Order, and the parties are directed to comply with the terms of the Settlement Agreement. 2. Upon full execution of this Agreement, the parties agree to the following: a. The Notice of Intent to Deny Change of Ownership Application is deemed superseded by this Agreement. b. The Petitioner’s request for a formal administrative proceeding is withdrawn. Cc. Upon 10 days of the full execution of this Agreement, Petitioner shall submit the first page of the CHOW application, but shall “change it to an Initial License Application. The Initial Application will be deemed submitted to the Agency once the Agency. has received the first page of the CHOW application with the changes discussed herein. d. Once the Agency has received the Initial Application, the Agency shall begin processing it. e. Nothing in this Agreement shall prohibit the Agency from denying Petitioner’s application for licensure based upon any statutory and/or regulatory provision, including, but not limited to, the failure of Petitioner to satisfactorily complete a survey reflecting compliance with all statutory and rule provisions as required by law. 3. Each party shall bear its own costs and attorney’s fees. 4. The above-styled case is hereby closed. DONE and ORDERED this SCcday of SALT BEL, 2008, in Tallahassee, Leon County, Florida. , Secretary Agency fer 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, 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: Gus Suarez, Esq. Attorney for Petitioner 5201 Blue Lagoon Drive Lourdes A. Naranjo, Esq. Assistant General Counsel Agency for Health Care Suite 270 Administration Miami, Florida 33126 8350 N. W. 52 Terrace - Suite 103 (U. S. Mail) Miami, Florida 33166 (Interoffice Mail) Jan Mills Elizabeth Dudek Agency for Health Care Administration 2727 Mahan Drive, Bldg #3, MS #3 Tallahassee, Florida 32308 (Interoffice Mail) Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive, Bldg #1, MS #9 Tallahassee, Florida 32308 (Interoffice Mail) Karen Rivera Supervisor Laboratory Unit Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) Stuart M Lerner Administrative Law Judge Division of Administrative Hearing 1230 Apalachee Parkway Tallahassee, Florida 32399 (U. S. Mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of this Final Order was served on the above-named person(s) and entities by U.S. Mail, or the E— method designated, on this the AY day of __ « —— 2008. Richard J- Shoop Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308 (850) 922-5873 - _ ©" HORDMAGENGNEORTEMTICANERIWNISTRATON CHARLIE GRIST : HOLLY BENSON GOVERNOR SECRETARY Mareh 19, 2008 Omni Home Care Agency Inc File Number: 26978828 13205 SW 137" Ave Ste 208 Miami, F1 33186 Case #: 2008003503 Dear Administrator ~ NOTICE OF INTENT DENY CHANGE OF OWNERSHIP APPLICATION It is the decision of the Agency for Health Care Administration that your request for Change of Ownership be DENIED, pursuant to section 408.815 (1)(c), Florida Statutes. The specific basis for this determination is the applicant failed to meet certain licensure requirements pursuant to Section 408.807(1) and 408.807(2), Florida Statutes. After reviewing your application, we determined the following: 1. The facitities application for Change of Ownership was received of December 6, 2007 but was duc to the Agency sixty (60) days priot to the change of ownership taking place. . 2. The facility has undergone a change of ownership without notifying the Agency. Applicable Statutes: Section 408.907(), Florida Statutes ; The transferor shail notify the agency in writing at least 60 days before the anticipated date of the change of ownership. Section 408,807(2), Florida Statutes ; The transferee shall make application to the agency for a license within the timeframes required in Section 408.806. Section 408.815(1)(c). Florida Statutes : The Agency may deny a change of ownership application for violation of this part. XPLANATION OF RIGHTS Pursuant to Section 120.569, F.S., you have the right to request an administrative hearing. In order to obtain a format proceeding bafore the Division of Administrative Hearings under Section 120.57(1), E.S., \, er 2727 Mahan Orive, MS# de Visit AHCA online at Tallahassee, Florida 32308 hitp Vahca.myflorida, com EXHIBIT i "CHARLIE GRIST HOLLY BENSON GOVERNOR ~ SECRETARY: your request for an administrative hearing must conform to the requirements in Section 28-106,201, Florida Administrative Code (F.A.C), and must state the material facts you dispute, Ifyou have any questions; please contact the laboratory unit at (850) 487-3109. SEE ATTACHED ELECTION AND EXPLANATION OF RIGHTS FORMS, Agency for-Health-Care Administration - pe By: Karen Rivera, Supervisor Laboratory Unit co: Agency Clerk, Mail Stop 3 Legal Intake Unit, Mai] Stop 3 nt Visit AHCA online at 2727 Mehan Drive, MS# http://ahea,myflorida,com Tallahassee, Florida 32308 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION OMNI HOME CARE AGENCY, INC. d/b/a OMNI HOME CARE AGENCY, INC., AHCA No.: 2008003503 DOAH No.: 08-1742 Petitioner, v. STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. SETTLEMENT AGREEMENT Respondent, State of Florida, Agency for Health Care Administration (hereinafter the “Agency”), through its undersigned representatives, and Petitioner, Omni Home. Care Agency, Inc. d/b/a omni Home Care Agency, Inc. (hereinafter “Petitioner”), pursuant to Section 120.57(4), Florida Statutes, a each individually, a “party,” collectively as “parties, “hereby enter into this Settlement Agreement (“Agreement”) and agree as follows: WHEREAS, the Petitioner is an applicant for a Certificate of Exemption for’a clinical laboratory pursuant to Chapter 483, Part I, Florida. Statutes (2007), Section 20.42, Florida Statutes, (2007), Chapter 408, Part II, Florida Statutes, (2007), and Chapter 59A-7 strative Code;. and EXHIBIT WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over licensure sought by Petitioner; and WHEREAS, the Agency served the Petitioner with a Notice of Intent to Deny Change of Ownership Application notifying the party of its intent to deny Petitioner’s application for licensure; and WHEREAS, the Petitioner requested a formal administrative hearing by filing an election of rights form or by petition; and WHEREAS, the parties have agreed that a fair, efficient, and cost effective resolution of this dispute would avoid the expenditure of substantial sums to litigate the dispute; and WHEREAS, the parties stipulate to the adequacy of considerations exchanged; and WHEREAS, the parties have negotiated in good faith and agreed that the best interest of all the parties will be served by a settlement of this proceeding; and NOW THEREFORE, in consideration of the mutual promises and recitals herein, the parties intending to be legally bound, agree as follows: 1. All recitals are true and correct and are expressly incorporated herein. : 2. ‘Both parties agree that the “whereas” ‘clauses incorporated herein are binding findings of the parties. Page 2 of 1 OF 3. Upon full execution of this Agreement, Petitioner agrees to a withdrawal of its request for an administrative proceeding; agrees to waive any and all proceedings and appeals to which it may be entitled including, but not limited to, an informal proceeding under Subsection 120.57(2), a formal proceeding under Subsection 120.57(1), appeals under Section 120.68, Florida Statutes; and declaratory and all writs of relief in any court or quasi-court (DOAH) of competent jurisdiction; and further agrees to waive compliance with the form of the Final Order (findings of fact and conclusions of law) to which it may be entitled. Provided, however, that no agreement herein, shall be deemed a waiver by either party of its right to judicial enforcement of this Agreement. 4, Upon full execution of this Agreement, the parties agree to the following: a. The Notice of Intent to Deny Change of Ownership Application is deemed superseded by this Agreement. . b. The Petitioner’s request for a formal administrative proceeding is withdrawn. c. Upon 10 days of the full execution of this Agreement, Petitioner shall submit the first page of the CHOW application, but shall change it to an Initial License Application. The Initial Application will be deemed submitted to the Agency once the Agency has received the first page of the CHOW application with the changes discussed herein. Page 3 of 7 a an whatsoever, arising out of or in any way related to this matter and the Agency’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 the Petitioner or related or resulting organizations. 10. The Respondent for itself and for its related or resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, does hereby discharge the Agency and its agents, representatives, and attorneys of 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 the Agency’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 the Respondent or related or resulting organizations. ll. This Agreement is binding upon all parties herein and those’ identified in the aforementioned paragraph of this Agreement. 12. In the event that Petitioner is or was a “Medicaid provider, this settlement does not prevent the Agency from seeking Medicaid overpayments or from imposing any sanctions pursuant to Rule 59G-9.070, Florida Administrative Code. This Page 5 of 7 —_— f agreement does not prohibit the Agency from taking action regarding Petitioner’s Medicaid provider status, conditions, requirements or contract. 13. The undersigned have read and understand this Agreement and have authority to bind their respective principals to it. 14. This Agreement contains the entire understandings and agreements of the parties. 15. This Agreement supersedes any prior oral or written agreements between the parties. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement shall be void. 16. All parties agree that a facsimile signature suffices for an original signature. THIS PORTION OF THE PAGE HAS BEEN LEFT BLANK DELIBERATELY Page 6 of 7 ROOF + The following representatives hereby acknowledge that they Elizabe&kh Dudek Deputy cretary Attorney for Petitioner Divisi of Health Quality 5201 Blue Lagoon Drive Assurance. Suite 270 Agency for Health Care Miami, Florida 33126 Administration 2727 Mahan Drive Tallahassee, Florida 32308 Dated: (a [2006 Dated: hh GE 2 OMNI HOME CARE AGENCY, INC. By Ce L Ex Luis L. Ferrer, Pres. patea: F Jn [ 2.208 ourdes A. Naranjo, Esq, General Counsel “Assistant General Counsel Agency for Health Care Agency for Health Care Administration Administration 2727 Mahan Drive 8350 N.W. 52 Terrace - #103 Tallahassee, Florida 32308 Miami, Florida 33166 Dated: az [or Dated: 3/14/08 Page 7 of 7

Docket for Case No: 08-001742