on Ep PH 3: oy STATE OF FLORIDA AGENCY FOR HEALTH CARE nonsrlti AGENCY FOR HEALTH CARE Sin Abba SOR or ADMINISTRATION, He / STRAT) OF TS 7 Caningdlve Petitioner, AHCA No.: 2009002069 Vv. Return Receipt Requested: 7008 0500 0002 0764 9756 MED-START CORPORATION d/b/a 7008 0500 0002 0764 9763 MED-START CORPORATION, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (“AHCA”), by and through the undersigned counsel, and files this administrative complaint against Med-Start Corporation d/b/a Med-Start Corporation (hereinafter “Med-Start Corporation”), pursuant to Chapter 400, Part III, and Section 120.60, Florida Statutes (2008), and herein alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine of $5,000.00 and revocation of license, pursuant to Sections 400.474 (6) (b) (c), Florida Statutes (2008), for the protection of the public health, safety and welfare. JURISDICTION AND VENUE 2. AHCA has jurisdiction pursuant to Chapter. 400, Part III, Florida Statutes (2008). 3. Venue lies in Broward County pursuant to Rule 28- 106.207, Florida Administrative Code. PARTIES 4. AHCA is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing home health agencies, pursuant to Chapter 400, Part III, Florida Statutes, and Chapter 59A-8 Florida Administrative Code. 5. Med-Start Corporation operates a home health agency presently located at 3303 West Commercial Boulevard, Suite #101, Fort Lauderdale, Florida 33309. Med-Start Corporation is licensed as a home health agency under license number 20678096, with an expiration date of October 31, 2009. Med-Start Corporation was at all times material hereto a licensed facility under the licensing authority of AHCA and was required to comply with all applicable rules and statutes. COUNT I MED-START CORPORATION WAS PROVIDING SERVICE TO RESIDENTS OF AN ASSISTED LIVING FACILITY WITHOUT REMUNERATION Section 400.474(6), Florida Statutes (PROVIDING ALF, ADC, AFCH STAFF OR SERVICES) UNCLASSIFIED DEFICIENCY 6. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. During the complaint investigation conducted on 12/09/08 and based on observation and interview, it was determined that the Home Health Agency was found to be providing service to residents of an ALF (Assisted Living Facility) without remuneration. 8. During a visit to Coral Plaza (ALF) on 12/9/08 from 8:30 AM to 10:30 AM. A brief entrance conference was conducted with the ALF Administrator and he was advised of the reason for the visit. The facility's nursing office was briefly toured with the Administrator and it was observed that no staff was present. The Administrator stated that the nursing staff was taking care of an emergency with a patient. A few moments later, an ALF staff member and a Med- Start LPN (licensed practical nurse,) returned to the nursing office. The ALF Administrator asked the Med-Start LPN how the patient was and the LPN gave him a verbal report. 9. An interview was conducted with the ALF Administrator at 8:30 AM and he was asked about his and/or the facility's relationship with Med-Start Corporation. He responded that the Administrator of Med-Start Corporation invites him to her agency's annual Christmas Party and "we have lunch a couple of times a year but we (the facility) don't get paid by any of the Home Health Agencies that come here." He stated that there are no staff in the facility paid by Med-Start, the facility has no contract for staffing with Med-Start and he nor the facility receive any payment from any home health agency for patient referrals. He stated in the facility, Med-Start, ....(Home Health Agency) and he could not remember the name-of the third. (Med-Start sees patients in the facility for 2 other Medicare Certified agencies) He stated that he gave all the insulin dependent patients to Med-Start because he has had too much trouble in the past with other home health staff not signing off the MARS (Medication Administration Record.) When asked about a patient's choice, he responded that if a resident wants a particular home health agency, "I'll call them but, if the resident doesn't care, the case is assigned to one of the agencies already in the facility.” He added, "I'm not going to have a bunch of different home health agencies roaming around my facility trying to solicit patients." A list of residents in the facility that are seen by the Med-Start LPN was requested. Once received, the Administrator was asked which resident the LPN saw due to an emergency this morning; the name given was not listed as one of the LPN's home health patients. When asked why the LPN was seeing a resident that was not her patient, the ALF Administrator responded, "Because we asked her to." 10. During an interview with the LPN at the ALF on 12/9/08 at 8:50 AM, she stated that she has 6 home health patients in the ALF that she administers insulin to and 1 patient who requires wound care. She confirmed that the home health patients, who require insulin injections, do come down to the ALF nursing office and she provides the care there. She stated that the patients line up outside the door of the ALF nursing office and she brings them in, one at a time, to provide the needed care. When asked why she was seeing home health patients in the ALF's nursing office, rather than in their apartments, she responded that the ALF Administrator told her to see the patients in the ALF nursing office. When asked why she was seeing a resident in the facility this morning that was not her patient, she also responded, "Because they asked me to." 11. During an interview with the Med-Start Corporation Administrator on 12/9/08 at 2:40 PM, she stated that the Home Health Agency does not have a contract to provide staffing services to the ALF. She then asked if the LPN could provide services to non-home health patients in the ALF if the agency submitted a bill for the service to the ALF. When advised that the Home Health Agency needs to have a contract in place with the ALF before, rather than after, the service is provided, she responded that she didn't know how she was going to tell the nurses that they could not assist the ALF with a resident in need 12. Based on -the foregoing facts, Med-Start Corporation violated Section 400.474(6) (b) (c), Florida Statutes, herein an unclassified deficiency, which carries in this case an assessed fine of $5,000.00 and the revocation of the license. CLAIM FOR RELIEF WHEREFORE, the Agency requests the Court to order the following relief: 1. Enter a judgment in favor of the Agency for Health Care Administration against Med-Start Corporation on Count qT. 2. Assess against Med-Start Corporation an administrative fine of $5,000.00 and revocation of license on Count I, for the violation cited above. 3. Assess costs related to the investigation and prosecution of this matter, if applicable. 4, Grant such other relief as the court deems is just and proper on Count I. Respondent is notified that it has a right to request an administrative hearing pursuant to Sections 120.569 and 120.57, Florida Statutes. Specific options for administrative action are set out in the attached Election of Rights. All requests for hearing shall be made to the Agency for Health Care Administration and delivered to the Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, MS #3, Tallahassee, Florida 32308. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO RECEIVE A REQUEST FOR A HEARING WITHIN TWENTY-ONE (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. : IF YOU WANT TO HIRE AN ATTORNEY, YOU HAVE THE RIGHT TO BE REPRESENTED BY AN ATTORNEY IN THIS MATTER Nelson E. Rddney, Es Assistant General Co Agency for Health Care Administration 8355 N.W. 52 Terrace - #103 Miami, Florida 33166 sel Copies furnished to: Field Office Manager Agency for Health Care Administration 5151 Linton Boulevard, Suite 500 Delray Beach, Florida 33484 (Interoffice Mail) Revenue and Management Finance and Accounting Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #14 Tallahassee, Florida 32308 (Interoffice Mail) Home Health Agency Unit Program Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail, Return Receipt Requested to Brenda O’Leary, Administrator, Med- Start Corporation, 3303 West Commercial Boulevard, Suite #101, Fort Lauderdale, Florida 3309; and to Brenda O’ Leary, Registered Agent, 1081 WN. Northlake Met, Hollywood, Florida 33019 on this om day of Maebn _ , 2009. Ae E. ate

Docket for Case No: 09-001757