STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, O s - lo 0d4 AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, Vv. Case No. 2008009808 ALTERRA HEALTHCARE CORPORATION d/b/a STERLING HOUSE OF CAPE CORAL, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the Petitioner, State of Florida, Agency for Health Care Administration, (hereinafter “the Agency”), by and through the undersigned counsel, and files this administrative complaint against the Respondent, ALTERRA HEALTHCARE CORPORATION d/b/a STERLING HOUSE OF CAPE CORAL (hereinafter “the Respondent”), pursuant to Sections 120.569 and 120.57, Florida Statutes (2008), and alleges: NATURE OF THE ACTION This is an action to impose an administrative fine against an assisted living facility in the amount of TWO THOUSAND DOLLARS ($2,000.00) based upon four (4) uncorrected Class III violations pursuant to Section 429.19(2)(c), Florida Statutes (2008) and to assess a survey fee in the amount of FIVE HUNDRED DOLLARS ($500.00) pursuant to Section 429.19(7), Florida Statutes (2008). JURISDICTION AND VENUE 1. The Court has jurisdiction over the subject matter pursuant to Sections 120.569 and 120.57, Florida Statutes (2008). 2. The Agency has jurisdiction over the Respondent pursuant to Sections 20.42 and 120.60, and Chapters 408, Part II, and 429, Part I, Florida Statutes (2008). 3. Venue lies pursuant to Rule 28-106.207, Florida Administrative Code. PARTIES 4. The Agency is the licensing and regulatory authority that oversees assisted living facilities in Florida and enforces the applicable federal and state regulations, statutes and rules, governing assisted living facilities. Chapter 408, Part II, and Chapter 429, Part I, Florida Statutes (2008); Chapter 58A-5, Florida Administrative Code. The Agency may deny, revoke, or suspend any license issued to an assisted living facility, or impose an administrative fine for violations. Sections 408.813, 408.815 and 429.14, Florida Statutes (2008). 5. The Respondent was issued a license by the Agency (License Number 9358) to operate a 50-bed assisted living facility located at 1416 Country Club Road, Cape Coral, Florida 33990, and was at all times material required to comply with the applicable federal and state regulations, statutes and rules governing assisted living facilities. COUNTI The Respondent Failed To Maintain An Accurate And Up-To-Date Admission And Discharge Log In Violation Of Rule 58A-5.024(1)(b), Florida Administrative Code 6. The Agency re-alleges and incorporates by reference paragraphs one (1) through five (5). 7. Pursuant to Florida law, the facility shall maintain the following written records in a form, place and system ordinarily employed in good business practice and accessible to Department of Elder Affairs and Agency staff. Facility records shall include: The facility’s license which shall be displayed in a conspicuous and public place within the facility. An up-to- date admission and discharge log listing the names of all residents and each resident’s date of admission, the place from which the resident was admitted, and if applicable, a notation the resident was admitted with a stage two (2) pressure sore; and date of discharge, the reason for discharge, and the identification of the facility to which the resident is discharged or home address, or if the person is deceased, the date of death. Readmission of a resident to the facility after discharge requires a new entry. Discharge of a resident is not required if the facility is holding a bed for a resident who is out of the facility but intends to return pursuant to Rule 58A- 5.025, Florida Administrative Code. Rule 58A-5.024(1)(b), Florida Administrative Code. 8. On or about June 10, 2008 through June 11, 2008 the Agency conducted a Biennial Survey of the Respondent’s facility. 9. Based on review of records and interviews with staff, the facility failed to maintain an up-to-date admission and discharge log for thirty-three (33) of thirty-five (35) residents admitted since September 7, 2007. 10. A review of the facility's admission and discharge log on June 10, 2008, revealed multiple missing or incomplete entries including: a. Thirty-two (32) missing or incomplete entries for place from which admitted; b. Three (3) missing entries for reason for discharge; and c. Five (5) missing entries for place to which discharged or transferred. 11. During interviews with staff members on June 10, 2008 at 3:35 p.m., one staff member stated the log had not been kept up-to-date. Another staff member stated they would try to get the log up-to-date by the following day. 12. The Respondent’s deficient practice was related to the operation and maintenance of the facility or to the personal care of residents which indirectly or potentially threatens the physical or emotional health; safety, or security of the facility residents, other than Class I or Class II violations, in violation of Section 429.19(2)(c), Florida Statutes (2008). 13. The Agency cited the Respondent for a Class III violation in accordance with Section 429.19(2)(c), Florida Statutes (2008). 14. The Respondent was given a mandatory correction date of July 11, 2008. 15. On or about July 14, 2008 the Agency conducted a Follow-Up Survey to the Biennial Survey of Respondent’s facility. 16. Based on record and interview, the facility failed to maintain an accurate and up- to-date admission and discharge log. 17. The admission discharge log was reviewed. The log listed forty-four (44) current residents. The resident roster provided by the administrator on July 14, 2008 at 9:45 a.m., listed a current census of forty-seven (47). The health care coordinator stated on July 14, 2008 at 2:00 p-m. that a resident's admission date was listed on the resident information/emergency contact sheet under "Move in Date." The "Move in Date" found on Resident number three’s (3) sheet is October 7, 2007. The "Move in Date" for Resident number four (4) is January 18, 2006. The "Move in Date" for Resident number seven (7) is January 7, 2008. Resident number three (3), Resident number four (4) and Resident number seven (7) were not found on the facility's admission discharge log. 18. OnJuly 14, 2008 at 2:00 p.m., the health care coordinator stated she was unaware the admission discharge log did not list Resident number three (3), Resident number four (4) and Resident number seven (7). 19. This remains an uncorrected deficiency. 20. The Respondent’s deficient practice was related to the operation and maintenance of the facility or to the personal care of residents which indirectly or potentially threatens the physical or emotional health, safety, or security of the facility residents, other than Class I or Class II violations, and constituted a Class II deficiency as provided for in Section 429.19(2)(c), Florida Statutes (2008). 21. The Respondent’s deficiency constituted an uncorrected Class III violation. 22. | The Agency shall impose an administrative fine for a cited Class III violation in an amount not less than five hundred dollars ($500.00) and not exceeding one thousand dollars ($1,000.00) for each violation. 23. The Respondent was given a mandatory correction date of August 14, 2008. WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, intends to impose an administrative fine against the Respondent in the amount of FIVE HUNDRED DOLLARS ($500.00) pursuant to Section 429.19(2)(c), Florida Statutes (2008). COUNT IH The Respondent Failed To Ensure All Resident’s Rooms Open Directly Into A Corridor In Violation Of Rule 584-5.023(4)(d), Florida Administrative Code 24. The Agency re-alleges and incorporates by reference paragraphs one (1) through five (5). . 25. Pursuant to Florida law, residents shall be given the option of choosing their own roommate or roommates if possible. All resident bedrooms shall open directly into a corridor, common use area or to the outside. A resident must be able to exit his bedroom without having to pass through another bedroom unless the two (2) rooms have been licensed as one (1) bedroom. Rule 58A-5.023(4)(d), Florida Administrative Code. 26. On or about June 10, 2008 through June 11, 2008 the Agency conducted a Biennial Survey of the Respondent’s facility. 27. Based on observation, a review of floor plans and interviews with staff, the facility failed to ensure all resident bedrooms open directly into a corridor, Room number 113, Room number 122, and Room number 125 are being shared by unrelated residents each using one space as a bedroom, the resident sharing the back bedroom has to walk into the other resident's bedroom to exit the sleeping space. 28. Anobservation during a tour of the facility revealed in Room number 113, Room number 122 and Room number 125 there were two (2) unrelated residents sharing the space. There is one entrance into the living space, the entry room is being used as a bedroom and there is another bedroom to the back of the space. The resident in the back bedroom has to walk through the other resident's bedroom in order to exit the space. 29. A review of the facility's model apartments revealed there are three (3) models that are considered one (1) bedroom apartments. The models show a living room and a bedroom anda bathroom. The facility did not have any models for semi-private rooms. 30. An interview with the previous executive director revealed the facility was using the rooms as “companion rooms." She stated since it was a one (1) bedroom apartment they could put two (2) people in the same apartment even if they are unrelated and let each have their own bedroom. 31. The Respondent’s deficient practice was related to the operation and maintenance of the facility or to the personal care of residents which indirectly or potentially threatens the physical or emotional health, safety, or security of the facility residents, other than Class I or Class II violations, in violation of Section 429.19(2)(c), Florida Statutes (2008). 32. The Agency cited the Respondent for a Class II violation in accordance with Section 429.19(2)(c), Florida Statutes (2008). 33. The Respondent was given a mandatory correction date of J uly 11, 2008. 34. On or about July 14, 2008 the Agency conducted a Follow-Up Survey to the Biennial Survey of Respondent's facility. 35. Based on observation, record review and interviews, the facility failed to ensure all resident's bedrooms open directly into a corridor for two (2) of seven (7) sampled residents, Resident number two (2) and Resident number six (6). On July 14, 2008 at 9:30 a.m., during the initial tour of the facility it was observed that Resident number one (1) and Resident number two (2) both reside in Unit number 105. Resident number one (1) and Resident number two (2) are not related. Resident number five (5) and Resident number six (6) reside in Unit number 125 and are not related. Unit number 105 and Unit number 125 consist of a bedroom area, a bathroom with a toilet, and a living area with a small kitchen area. The bedroom is separated from the living area by a wall. The access to the bathroom is from the bedroom area. 36. Resident number two’s (2) bed and personal items are located in the bedroom area of Unit number 105. Resident number one’s (1) bed and personal items are located in the living room area of Unit number 105. Resident number two (2) must past through Resident number one’s (1) area to leave the Unit. 37. Resident number sixes (6) bed and personal items are located in the bedroom area of Unit number 125. Resident number five’s (5) bed and personal items are located in the living room area of Unit number 125. Resident number six (6) must past through Resident number five’s (5) area to leave the Unit. 38. The resident roster provided by the facility indicates Resident number one (1) resides in Unit number 105A and Resident number two (2) resides in Unit number 105B. The roster indicates Resident number five (5) resides in Unit number 125A and Resident number six (6) resides in Unit number 125B. 39. On July 14, 2008 at 11:15 am., the administrator stated the facility has forty-two (42) one (1) bedroom units. The administrator stated the facility was originally licensed as forty- two (42) one (1) bedroom units. He stated the facility is licensed for fifty (50) residents. In order to facilitate fifty (50) residents some units must have more than one (1) resident. The administrator provided a copy of a brochure that lists the "Living Accommodations and Monthly Fees." All units are described as "Suite Style/Service." There are no fees posted for two (2) bedroom units. 40. This remains an uncorrected deficiency. 41. The Respondent’s deficient practice was related to the operation and maintenance of the facility or to the personal care of residents which indirectly or potentially threatens the physical or emotional health, safety, or security of the facility residents, other than Class I or Class II violations, and constituted a Class III deficiency as provided for in Section 429.19(2)(c), Florida Statutes (2008). 42. The Respondent’s deficiency constituted an uncorrected Class III violation. 43. The Agency shall impose an administrative fine for a cited Class II violation in ‘an amount not less than five hundred dollars ($500.00) and not exceeding one thousand dollars ($1,000.00) for each violation. 44, The Respondent was given a mandatory correction date of August 14, 2008. WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, intends to impose an administrative fine against the Respondent in the amount of FIVE HUNDRED DOLLARS ($500.00) pursuant to Section 429.19(2)(c), Florida Statutes (2008). COUNT III The Respondent Failed To Ensure Sole Access To A Bathroom Is Not Through Another Resident’s Bedroom In Violation Of Rule 58A-5.023(5)(d), Florida Administrative Code 45. The Agency re-alleges and incorporates by reference paragraphs one (1) through five (5). 46, Pursuant to Florida law, sole access to a toilet or bathtub or shower shall not be through another resident’s bedroom, except in apartments within a facility. Rule S8A- 5.023(5)(d), Florida Administrative Code. 47. On or about June 10, 2008 through June 11, 2008 the Agency conducted a Biennial Survey of the Respondent’s facility. 48. Based on observation, review of floor plans and interviews with staff, the facility failed to ensure residents do not have to go through another resident's bedroom to have access to the bathroom. 49, An observation of Room number 113, Room number 122 and Room number 125 during the tour of the facility on June 10, 2008, revealed these rooms were being occupied by unrelated residents. One resident had the back bedroom with access to the bathroom; the other resident has the front room as a bedroom and had to enter the back bedroom to access the bathroom. 50. A review of the facility's model apartments revealed there are three (3) models that are considered one (1) bedroom apartments. The models show a living room and a bedroom and abathroom. The facility did not have any models for semi-private rooms. 51. An interview with the previous executive director on June 10, 2008 at 10:30 am. revealed the facility was using the rooms as “companion rooms." She stated since it was a one (1) bedroom apartment they could put two (2) people in the same apartment even if they are unrelated and let each have their own bedroom and share the bathroom. 52. The Respondent’s deficient practice was related to the operation and maintenance of the facility or to the personal care of residents which indirectly or potentially threatens the physical or emotional health, safety, or security of the facility residents, other than Class I or Class II violations, in violation of Section 429.19(2)(c), Florida Statutes (2008). 53. The Agency cited the Respondent for a Class III violation in accordance with Section 429.19(2)(c), Florida Statutes (2008). 54, The Respondent was given a mandatory correction date of July 11, 2008. 55. On or about July 14, 2008 the Agency conducted a Follow-Up Survey to the Biennial Survey of Respondent's facility. 56. Based on observation, record review and interviews, the facility failed to ensure the sole access to the bath/toilet room for two (2) of seven (7) sampled residents is not through another resident's bedroom, Resident number one (1) and Resident number five (5). 57. On July 14, 2008 at 9:30 a.m., during the initial tour of the facility it was observed that Resident number one (1) and Resident number two (2) both reside in Unit number 105. Resident number one (1) and Resident number two (2) are not related. Resident number five (5) and Resident number six (6) reside in Unit number 125 and are not related. Unit number 105 and Unit number 125 consist of a bedroom area, a bathroom with a toilet, and a living area with a small kitchen area. The bedroom is separated from the living area by a wall. The access to the bathroom is from the bedroom area. 58. Resident number two’s (2) bed and personal items are located in the bedroom area of Unit number 105. Resident number one’s (1) bed and personal items are located in the living room area of Unit number 105. Resident number one (1) must past through Resident number two’s (2) area to access the bathroom. 59. Resident number sixes (6) bed and personal items are located in the bedroom area of Unit number 125. Resident number five’s (5) bed and personal items are located in the living room area of Unit number 125. Resident number five (5) must past through Resident number sixes (6) area to access the bathroom. 60. The resident roster provided by the facility indicates Resident number one (1) resides in Unit number 105A and Resident number two (2) resides in Unit number 105B. The roster indicates Resident number five (5) resides in Unit number 125A and Resident number six (6) resides in Unit number 125B. 61. On July 14, 2008 at 11:15 a.m., the administrator stated the facility has forty-two (42) one (1) bedroom units. The administrator stated the facility was originally licensed as forty- two (42) one (1) bedroom units. He stated the facility is licensed for fifty (50) residents. In order to facilitate fifty (50) residents some units must have more than’ one resident. The administrator provided a copy of a brochure that lists the "Living Accommodations and Monthly Fees." All units are described as "Suite Style/Service." There are no fees posted for two (2) bedroom units. 62. This remains an uncorrected deficiency. 63. The Respondent’s deficient practice was related to the operation and maintenance of the facility or to the personal care of residents which indirectly or potentially threatens the physical or emotional health, safety, or security of the facility residents, other than Class I or Class II violations, and constituted a Class III deficiency as provided for in Section 429.19(2)(c), Florida Statutes (2008). 64. The Respondent’s deficiency constituted an uncorrected Class II violation. 65. | The Agency shall impose an administrative fine for a cited Class Il violation in an amount not less than five hundred dollars ($500.00) and not exceeding one thousand dollars ($1,000.00) for each violation. 66. | The Respondent was given a mandatory correction date of August 14, 2008. WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, intends to impose an administrative fine against the Respondent in the amount of FIVE HUNDRED DOLLARS ($500.00) pursuant to Section 429.19(2)(c), Florida Statutes (2008). COUNTIV The Respondent Failed To Ensure That Employees Had Annual Statements Of Freedom From Tuberculosis Signed By A Healthcare Provider In Violation Of Rule 58A-5.019(2)(a), Florida Administrative Code 67. The Agency re-alleges and incorporates by reference paragraphs one (1) through five (5). 68. Pursuant to Florida law, newly hired staff shall have thirty (30) days to submit a i statement from a health care provider, based on an examination conducted within the last six (6) months, that the person does not have any signs or symptoms of a communicable disease including tuberculosis. Freedom from tuberculosis must be documented on an annual basis. A person with a positive tuberculosis test must submit a health care provider’s statement that the person does not constitute a risk of communicating tuberculosis. Newly hired staff does not include an employee transferring from one facility to another that is under the same management or ownership, without a break in service. If any staff member is later found to have, or is suspected of having, a communicable disease, he/she shall be removed from duties until the administrator determines that such condition no longer exists.. Rule 58A-5.019(2)(a), Florida Administrative Code. . 69. On or about June 10, 2008 through June 11, 2008 the Agency conducted a Biennial Survey of the Respondent’s facility. 70, Based on employee record review and interviews with staff, the facility failed to ensure two (2) of five (5) employees reviewed had proof of freedom from tuberculosis on an | annual basis, (Employees number three (3) and Employee number five (5). 71. | Employee number three (3) was hired on April 22, 2007 and Employee number five (5) was hired on December 20; 2006. There was no documentation in the employees’ records of an annual proof of freedom from tuberculosis. 72. An interview with the assistant to the administrator on June 11, 2008 at 10:00 a.m. revealed she was not aware the employees did not have the annual proof of freedom from tuberculosis. 73. The Respondent’s deficient practice was related to the operation and maintenance of the facility or to the personal care of residents which indirectly or potentially threatens the physical or emotional health, safety, or security of the facility residents, other than Class I or Class II violations, in violation of Section 429.19(2)(c), Florida Statutes (2008). 74. The Agency cited the Respondent for a Class III violation in accordance with Section 429.19(2)(c), Florida Statutes (2008). 75. The Respondent was given a mandatory correction date of July 11, 2008. 76. On or about July 14, 2008 the Agency conducted a Follow-Up Survey to the Biennial Survey of Respondent’s facility. 77. Based on record review and interviews, the facility failed to ensure that three (3) of three (3) sampled employees had annual statements of freedom from tuberculosis signed by a health care provider, Employee number one (1), Employee number two (2) and Employee number three (3). 78. | Employee number one (1) had a statement of freedom from tuberculosis dated November 21, 2007; it was signed by a Licensed Practicing Nurse. The only statement provided by the facility of freedom from tuberculosis was signed by a Registered Nurse for Employee number two (2) whose hire date is June 6, 2008. The last statement of freedom from tuberculosis for Employee number three (3) was dated July 11, 2007. 79. OnJuly 14, 2008 at 1:50 p.m., the administrator stated he was unaware the annual freedom from tuberculosis statement had to be signed by a health care provider which is defined as a physician, or a Registered Nurse Practitioner. He also stated he thought that as Employee number three (3) had a chest x-ray that it was good for two (2) years. 80. This remains an uncorrected deficiency. 81. The Respondent’s deficient practice was related to the operation and maintenance of the facility or to the personal care of residents which indirectly or potentially threatens the physical or emotional health, safety, or security of the facility residents, other than Class I or Class II violations, and constituted a Class II deficiency as provided for in Section 429.19(2)(c), Florida Statutes (2008). 82. The Respondent’s deficiency constituted an uncorrected Class Ii violation. 83. The Agency shall impose an administrative fine for a cited Class III violation in an amount not less than five hundred dollars ($500.00) and not exceeding one thousand dollars ($1,000.00) for each violation. 84. The Respondent was given a mandatory correction date of August 14, 2008. WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, intends to impose an administrative fine against’ the Respondent in the amount of FIVE HUNDRED DOLLARS ($500.00) pursuant to Section 429.19(2)(c), Florida Statutes (2008). COUNT V (Assessment of Survey Fee) 85. The Agency re-alleges and incorporates by reference paragraphs one (1) through five (5) and the allegations in Counts I, Il, IIL, and IV. . 86. The Agency conducted a Biennial Survey of the Respondent’s facility on June 10, 2008 through June 11, 2008 and a Follow-Up Survey on July 14, 2008 to the Biennial Survey of Respondent’s facility. 87. As a result of the Agency’s Surveys, the Respondent was cited with four (4) uncorrected Class Ill deficiencies. . . 88. Pursuant to Section 429.19(7), Florida Statutes (2008), the Agency is authorized to, in addition to any administrative fines imposed, assess a survey fee equal to the lesser of one- half of the facility’s. biennial license and bed fee or five hundred dollars ($500.00), to cover the cost of monitoring visits conducted under Section 429.28(3)(c), Florida Statutes (2008), to verify the correction of the violations. 89. In this case, the Agency is authorized to seek a survey fee of five hundred dollars ($500.00). WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, intends to assess a survey fee against the Respondent in the amount of FIVE HUNDRED DOLLARS ($500.00) pursuant to Section 429.19(7), Florida Statutes (2008). CLAIM FOR RELIEF WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, respectfully requests the Court to enter a final order granting the following relief: 1, Make findings of fact and conclusions of law in favor of the Agency. 2. Impose an administrative fine against the Respondent in the total amount of TWO THOUSAND DOLLARS ($2,000.00). 3. Assess a survey fee in the amount of FIVE HUNDRED DOLLARS ($500.00). 4. Enter any other relief that this Court deems just and appropriate. Respectfully submitted this aFbay of VNovemWer , 2008. Wn . Andrea M. Lang, Assistant General sel Florida Bar No. 0364568 Agency for Health Care Administration Office of the General Counsel 2295 Victoria Avenue, Room 346C Fort Myers, Florida 33901 Telephone: (239) 338-3203 NOTICE THE RESPONDENT IS NOTIFIED THAT IT/HE/SHE HAS THE RIGHT TO REQUEST AN ADMINISTRATIVE HEARING PURSUANT TO SECTIONS 120.569 AND 120.57, FLORIDA STATUTES. IF THE RESPONDENT WANTS TO HIRE AN ATTORNEY, IT/HE/SHE HAS THE RIGHT TO BE REPRESENTED BY AN ATTORNEY IN THIS MATTER. SPECIFIC OPTIONS FOR ADMINISTRATIVE ACTION ARE SET OUT IN THE ATTACHED ELECTION OF RIGHTS FORM. THE RESPONDENT IS FURTHER NOTIFIED IF THE ELECTION OF RIGHTS FORM IS NOT RECEIVED BY THE AGENCY FOR HEALTH CARE ADMINISTRATION WITHIN TWENTY-ONE (21) DAYS OF THE RECEIPT OF THIS ADMINISTRATIVE COMPLAINT, A FINAL ORDER WILL BE ENTERED. THE ELECTION OF RIGHTS FORM SHALL BE MADE TO THE AGENCY FOR HEALTH CARE ADMINISTRATION AND DELIVERED TO: AGENCY CLERK, AGENCY FOR HEALTH CARE ADMINISTRATION, 2727 MAHAN DRIVE, BUILDING 3, MAIL STOP 3, TALLAHASSEE, FLORIDA 32308; TELEPHONE (850) 922-5873. CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that a true and correct copy of the Administrative Complaint and Election of Rights form have been served to: William Lindmar, Administrator, Alterra Healthcare Corporation d/b/a Sterling House of Cape Coral, 1416 Country Chub Road, Cape Coral, Florida 33990, by U.S. Certified Mail, Return Receipt No. 7007 1490 0004 1620 7305, and to CT Corporation System, Registered Agent for Alterra Healthcare Corporation d/b/a Sterling House of Cape Coral, 1200 South Pine Island Road, Plantation, Florida 33324, by US. Certified Mail, Return Receipt No. 7007 1490 0004 1620 7312 on this 3c a day of No Jew 242008. Qs Vrer On, cloves ‘Andrea M. Lang, Assistant General C sel Florida Bar No. 0364568 Agency for Health Care Administration Office of the General Counsel 2295 Victoria Avenue, Room 346C Fort Myers, Florida 33901 Telephone: (239) 338-3203 Copies furnished to: William Lindmar, Administrator Alterra Healthcare Corporation d/b/a Sterling House of Cape Coral 1416 Country Club Road Cape Coral, Florida 33990 Andrea M. Lang, Assistant General Counsel | Agency for Health Care Administration Office of the General Counsel 2295 Victoria Avenue, Room 346C Fort Myers, Florida 33901 (U.S. Certified Mail) (Interoffice Mail) —_—-_| | CT Corporation System, Registered Agent for | Harold Williams Alterra Healthcare Corporation Field Office Manager d/b/a Sterling House of Cape Coral Agency for Health Care Administration 1200 South Pine Island Road 2295 Victoria Avenue, Room 340A Plantation, Florida 33324 Fort Myers, Florida 33901 (U. S. Certified Mai!) (Interoffice Mail) | 7

Docket for Case No: 08-006024