STATE OF FLORIDA 2008 HAD 10 Sp >: 2307 AGENCY FOR HEALTH CARE ADMINISTRATION ty gis e, OE, . 4 Oo VILLAGE WOMEN’S HEALTHCARE KBE: ‘ SE, 4, ae gta On "op Petitioner, ey v4 AHCA Nos. 2008013586 < Vv. 2008013587 DOAH Nos: 09-0045 STATE OF FLORIDA, 09-0046 AGENCY FOR HEALTH CARE ; . “e. ADMINISTRATION, RENDITION NO.: AHCA-09- (24 -s-oLc Respondent. / FINAL ORDER Having reviewed the Notice of Intent to Impose a Late Fee, and a Notice of Intent to Deny dated on December 5, 2008, attached hereto and incorporated herein (Ex. 1 and Ex. 1A), and all other matters of record, the Agency for Health Care Administration (“Agency”) has entered into a Settlement Agreement (Ex. 2) with the other party 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. Petitioner shall pay administrative fines in the amount of $200.00 on Case #2008013586 and $200.00 in Case #2008013587. The administrative fines are due and payable within thirty (30) days of the date of rendition of this Order. 3. Checks should be made payable to the “Agency for Health Care Administration.” The check for $400.00, along with a reference to these case numbers should be sent directly to: Agency for Health Care Administration Office of Finance and Accounting Revenue Management Unit 2727 Mahan Drive, MS# 14 Tallahassee, Florida 32308 4. Unpaid fines pursuant to this Order will be subject to statutory interest and may be collected by all methods legally available. 5. Petitioner’s petition for formal administrative proceedings is hereby dismissed. 6. Each party shall bear its own costs and attorney’s fees. 7. The above-styled cases are hereby closed. DONE and ORDERED this @_day of hnatch— 1 2 in Tallahassee, Leon County, Florida. Holly Benson) Secretary Agency for Héalth 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: Katia T. Laremont, M.D. Village Women’s Healthcare 2247 Palm Beach Lakes Blvd. Suite #206 West Palm Beach, Florida 33409 (U. S. Mail) Finance & Accounting Agency for Health Care Administration Revenue Management Unit 2727 Mahan Drive, MS #14 Tallahassee, Florida 32308 (Interoffice Mail) Jan Mills Agency for Health Care Admi: ation ; 2727 Maran Drive, Bldg #3, MS #3 Tallahassee, Florida 32308 (Interoffice Mail) Nelson E. Rodney Assistant General Counsel Agency for Health Care Administration 8350 NW 52™ Terrace, Suite 103 Miami, Florida 33166 (Interoffice Mai!) Hon. Patricia M. Hart Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (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 Merck, , 200% method designated, on this the /0F fay of Richard Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 901 9845 6792 3495 ez ‘CARE ADMINISTRATION FLORIDA AGENCY FOR HEALTH oS Soe Better Health Care for all Floridians. reece No DECEMBER 5, 2008 CERTIFIED MAIL / RETURN RECEIPT REQUESTED AFA FP EAREMONTE EEE VILLAGE WOMENS HEALTHCARE 2247 PALM BEACH LAKES BLVD STE 206: WEST PALM BEACH, FL 33409 LICENSE NUMBER: 800018496 CASE #; 2008013587 NOTICE OF INTENT T0 DEEM'APPLIGATION INCOMPLETE AND WITHDRAWN FROM FURTHER REVIEW Your application for Clinical Laboratory Licensure is deemed incomplete and withdrawn from further consideration pursuant to Section 408.806(3)(b), Florida Statutes, Section 408.806(3)(b), F.S. contains the following language: Requested information omitted from an application for licensure, license renewal, or change of ownership, other than an inspection, must be filed with the agency within 21 days after the agency's request for omitted information or the application shall be deemed incomplete and shall be withdrawn from further consideration and the fees shall be forfeited. : You were notified by correspondence dated December 27, 2007 to provide further information addressing identified apparent errors or omissions within twenty-one days from the receipt of the Agency’s correspondence. Our records indicate you received this correspondence by certified mail on January 02, 2008. As the following information was not received, your application is deemed incomplete and withdrawn from further consideration: 1. Affidavit of Compliance with Background Screening Requirements for laboratory director 2. Health Care Licensing Application 3. Health Care Licensing Application Addendum EXPLANATION OF RIGHTS Pursuant to Section 120.569, F.S., you have the right to request an administrative hearing, In order to obtain a formal proceeding before the Division of Administrative Hearings under Section 120,57(1), F.S., 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. EXHIBIT 2727 Mahan Drive, MS# 32 4 f : Visit AHCA online at Tallahassee, Florida 32308 http://ahca myflorida.com SEE ATTACHED ELECTION AND EXPLANATION OF RIGHTS FORMS. Agency for HealthCare Adthinistration By: Karen Rivera, Manager Laboratory Unit ce: Agency Clerk, Mail Stop 3 Legal Intake Unit, Mail Stop 3 Certified Article Number 7LG0 390% 9845 b74e 3495 SENDERS RECORD FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION } CSOVERNOR Better Health Care for all Floridians Age BeNeoN DECEMBER 5, 2008 : CERTIFIED MAIL / RETURN RECEIPT REQUESTED KATIA T LAREMONT VILLAGE WOMENS HEALTHCARE LICENSE NUMBER: 800018496 2247 PALM BEACH LAKES BLVD STE 206 WEST PALM BEACH, FI 33409 CASE #: 2008013587 NOTICE OF INTENT T0 DEEM APPLICATION INCOMPLETE AND WITHDRAWN FROM FURTHER REVIEW : ‘ Your application: for Clinical sthargtory Licensure is deemed incomplete and withdrawn from further consideration pursuant to Section 408,806(3)(b), Florida Statutes. Section 408.806(3)(b), F.S. contains the following language: Requested information omitted from an application for licensure, license renewal, or change of ownership, other than an inspection, must be filed with the agency within 21 days after the agency's request for omitted information or the application shall be deemed incomplete and shall be withdrawn from further consideration and the fees shall be forfeited, You were notified by correspondence dated December 27, 2007 to provide further information addressing identified apparent errors or omissions within twenty-one days from the receipt of the Agency’s correspondence, Our records indicate you received this correspondence by certified mail on January 02, 2008. As the following information was not received, your application is deemed incomplete and withdrawn from further consideration: 1. Affidavit of Compliance with Background Screening Requirements for laboratory director 2, Health Care Licensing Application, 3. Health Care Licensing Application Addendum EXPLANATION OF RIGHTS Pursuant to Section 120.569, F.S., you have the right to request an administrative hearing. In order to obtain « formal proceeding before the Division of Administrative Hearings under Section 120.57(1), F.S., 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. EXHIBIT 2727 Manen Drive, MS# 32 mt . Visit ANCA online at Tallahassee, Fiorlda 32308 : A A http://ahca.myflorida.com 99 “d bT:0 ©8002 Se seq LNOWSaET A SEE ATTACHED ELECTION AND EXPLANATION OF RIGHTS FORMS, Agency for Healt) inistration By: Karen Rivera, Manager Laboratory Unit ce: Agency Clerk, Mail Stop 3- Legal Intake Unit, Mail Stop 3 60°d ST:0 ©8007 $2 39 ANOWIES) ad STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION VILLAGE WOMEN’S HEALTHCARE, Petitioner, vs. Case Nos: 2008013586 2008013587 STATE OF FLORIDA, DOAH Nos.09-0046 AGENCY FOR HEALTH 09-0045 CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT Respondent, State of Florida, Agency for Health Care Administration (hereinafter the “Agency”), through its undersigned representatives, and Petitioner, Village Women’s Healthcare (hereinafter “Petitioner”), pursuant to Section 120.57(4), Florida Statutes, each individually, a “party,” collectively as “parties,” hereby enter into this Settlement Agreement (“Agreement”) and agree as follows: WHEREAS, the Petitioner is a clinical laboratory licensed pursuant to Chapters 408, Part II, Florida Statutes (2007), and 483, Part I, Florida Statutes (2007), Section 20.42, Florida Statutes (2007), and Chapter 59A-7, Florida Administrative Code; and WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over licensure of Petitioner; and WHEREAS, the Agency served the Petitioner with a Notice of Intent to Impose a Late Fee in the amount of $200.00 in case 2008013586; and WHEREAS, the Agency served the Petitioner with a Notice of Intent to Deny Petitioner’s application for renewal of licensure in case 2008013587; and 1 of 7 WHEREAS, the Petitioner requested administrative hearings by filing election of rights forms or petitions; 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 to be exchanged; 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. 3. Upon full execution of this Agreement, Petitioner agrees to a withdrawal of its requests for administrative proceedings; 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 Orders (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: Page 2 of 7 The Petitioner shall remit to the Agency, within thirty (30) days of the entry of a Final Order adopting this Agreement, administrative fines in the amount of $200.00 on case 2008013586. The Petitioner shall remit to the Agency, within thirty (30) days of the entry of a Final Order adopting this Agreement, an administrative fine in the amount of $200.00 on case 2008013587. The Agency may conduct a licensure survey of the Petitioner facility. Should the Petitioner be cited for the deficient practices as identified in the Notice of Intent to Deny herein and the surveys referenced therein, the Agency shall deny the Petitioner’s application for licensure without further notice. Should the Petitioner’s application for licensure be denied based upon the existence of a deficient practice or practices as identified in paragraph (4)(b) above, Peitioner, on behalf of itself and any related or resulting organizations, affirmatively waives any right to challenge said denial in any forum, judicial or quasi-judicial, including any rights under the Florida Administrative Procedure Act, Chapter 120, Florida Statutes, or pursue any claim, including, but not limited to, a claim for damages, injunctive relief, attorney’s fees, and costs, in any forum, judicial or quasi-judicial. In addition, should the Petitioner or any of its related or resulting organizations challenge the actions of the Agency under this Agreement or seek affirmative relief, monetary or injunctive, Petitioner agrees to indemnify the Agency for any resulting Page 3 of 7 judgment and any attorney’s fees or costs incurred by the Agency in defense of such a claim or action. e. The Notice of Intent to Deny is deemed superseded by the Agreement. ; f. The Petitioner affirmatively waives any right or entitlement to deem licensure as identified by Florida law, including but not limited to, the provisions of Chapters 120, 483, and 408, Florida Statutes. g. Nothing in this Agreement shall prohibit the Agency from denying the Petitioner’s application for licensure based upon any statutory and/or regulatory provisions not identified in the Notices of Intent herein and the surveys referenced therein, 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. 5. Venue for any action brought to interpret, challenge, or enforce the terms of this Agreement or the Final Order entered pursuant hereto shall lie solely in the Circuit Court in Leon County, Florida. 6. By executing this Agreement, the Petitioner admits the facts and legal conclusions raised in the Notice of Intent to Impose Late renewal Fine and Notice of Intent to Deem Application Incomplete and Withdrawing Form Further Review, referenced herein. The Agency agrees that it will not impose any further penalty against the Petitioner as a result of the allegations of its Notices of Intent. However, nothing in this Agreement shall be deemed to preclude the Agency from using this assessment of fines in weighing future administrative actions regarding the Petitioner including, but not limited to, decisions regarding the licensure of Petitioner, including, but not limited to, licensure for limited Page 4 of 7 mental health, limited nursing services, or extended congregate care. The Agency is not precluded from using the subject events for any purpose within the jurisdiction of the Agency. Further, Petitioner acknowledges and agrees that this Agreement shall not preclude or estop any other federal, state or local agency or office from pursuing any cause of action or taking any action, even if based on or arising from, in whole or in part, the facts raised in the Notices of Intent. 7. Upon full execution of this Agreement, the Agency shall enter a Final Order adopting and incorporating the terms of this Agreement and closing the above-styled case(s). 8. Each party shall bear its own costs and attorney’s fees. 9. This Agreement shall become effective on the date upon which it is fully executed by all the parties. 10. The Petitioner, 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 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 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. 11. This Agreement is binding upon all parties herein and those identified in the aforementioned paragraph of this Agreement. 12. The undersigned have read and understand this Agreement and have authority to bind their respective principals to it. Petitioner’s representative has the capacity to execute Page 5 of 7 this Agreement and has done so without the advice of counsel. The Petitioner understands that it has the right to consult with counsel and has knowingly and freely entered into this Agreement without exercising its right to consult with counsel. The Petitioner fully understands that counsel for the Agency represents solely the Agency and Agency counsel has not provided legal advice to or influenced the Petitioner in its decision to enter into this Agreement. 13. In the event that Petitioner was a Medicaid provider at the subject time of the actions alleged in the Notice of Intents referenced herein, this Agreement does not prevent the Agency from seeking Medicaid overpayments related to the subject issues or from imposing any sanctions pursuant to Rule 59G-9,070, Florida Administrative Code. This Agreement does not settle any federal issues pending against Petitioner. This agreement does not prohibit the Agency from taking action regarding Petitioner’s Medicaid provider status, conditions, requirements or contract. 14. Petitioner agrees that if any funds to be paid under this agreement to the Agency are not paid within thirty-one (31) days of entry of the Final Order in this matter, the Agency may deduct the amounts assessed against Petitioner in the Final Order, or any portion thereof, owed by Petitioner to the Agency from any present or future funds owed to Petitioner by the Agency, and that the Agency shall hold a lien against present and future funds owed to Petitioner by the Agency for said amounts until paid. 15. This Agreement contains the entire understandings and agreements of the parties. Page 6 of 7 16. | 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. 17. All parties agree that a facsimile signature suffices for an original signature. 18. The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement. 2727 Mahan Drive, Bldg #1 Tallahassee, Florida 32308 DATED: Fees Tustin Senion a Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 A Katia #”. Larchmont, M.D. Village Women’s Healthcare 2247 Palm Beach Lakes Blvd. Suite #206 West Palm Beach, Florida 33409 DATED: 6 Nelson E. Rodney Assistant General Counsel Agency for Health Care Administration 8350 NW 52™ Terrace, Suite 103 Miami, Florida 33166 DATED: r}/rs]o4 Page 7 of 7

Docket for Case No: 09-000045