May 14 2009 15:51 MAY-14-2089 17:84 AGENCY HEALTH CARE ADMIN 858 921 9158 P.25735 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION AGENCY FOR HEALTH CARE _ WS &\ ADMINISTRATION, ° Petitioner, AHCA No.: 2009002070 v. Return Receipt Requested: 7008 0500 0002 0764 9701 COMPREHENSIVE WELLNESS SERVICES, 7008 0500 0002 0764 9718 INC. d/b/a COMPREHENSIVE HOME CARE OF BROWARD, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (“AHCA”), by and through the undersigned counsel, and files this administrative complaint against Comprehensive Wellness Services, Inc. d/b/a Comprehensive Home Care of Broward (hereinafter “Comprehensive Home Care of Broward”), 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 pursuant to Section 400.474, 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). May 14 2009 15:52 MAY-14-2089 17:04 AGENCY HEALTH CARE ADMIN 85@ 921 0158 P.26/735 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. Comprehensive Home Care of Broward operates a home health agency presently located at 6450 NW 5° Way, Fort Lauderdale, Florida 33309. Comprehensive Home Care of Broward is licensed as a home health agency under license number 299991208, with an expiration date of February 28, 2010. Comprehensive Home Care of Broward 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 COMPREHENSIVE HOME CARE OF BROWARD FAILED TO ENSURE THAT IT HAD ONLY ONE MEDICAL DIRECTOR CONTRACT IN EFFECT AT ONE TIME Section 400.474(6) (h), Florida Statutes (REMUNERATION TO PHYSICIANS) ) UNCLASSIFIED DEFICIENCY 6. AHCA re-alleges and incorporates paragraphs (1) through (5) as 1f fully set forth herein. May 14 2009 15:52 MAY-14-28@89 17:85 AGENCY HEALTH CARE ADMIN 858 921 @158 =P. 27735 7. During the complaint investigation conducted on 9/11/08 and based on interview and record review, it was determined that the Home Health Agency failed to have only one Medical Director contract in effect at one time. This is evidenced by the lack of documentation to demonstrate the termination of two of three sampled Medical Directors contracts (Medical Director #2 and #3). 8. During an interview with the Director of Patient Services (DPS) conducted on 09/11/08 at 9:20 AM, she stated, “The agency has only one Medical Director on staff. Doctor #1 since July 1, 2008 per the new regulations." Review of three ‘Medical Directors’ contracts provided by the agency revealed Doctor #1 signed a contract effective February 2, 2007, for a four year term. Doctor #2 signed a Medical Director’s contract effective February 14, 2007, for a term of four years and Doctor #3 signed a Medical Director’s contract effective February 2, 2007, for a term of four years. 9. A package of written materials was reviewed which included a letter addressed to “Dear Doctor:” dated July 1, 2008, which per the DPS, during the interview, all physicians were sent this letter with an explanation of the new regulations. This letter documented, in part,"...In accordance with the new law we must notify you in writing that any contracts/agreements that we have with you must be terminated, effective immediately. This letter will serve as that official May 14 2009 15:52 MAY-14-2089 17:85 AGENCY HEALTH CARE ADMIN 858 921 4158 P2835 termination.” Continued review of the letter revealed that the letter did not contain a specific doctor's name. 10. The DPS further stated, during the interview, that Doctor #2 and #3 have received these letters. Continued review of the Medical Director contracts for Doctors #2 and #3 revealed, under item #18, page 6, "Any and ali notices, consents, or any other communication provided for herein shall be in writing and delivered in person or by registered or certified mail, return receipt requested or by confirmed overnight delivery directed to the respective address shown below, unless notice of a change of address has been furnished previously." 11. An interview was conducted with the DPS on 09/11/08 at 11:05 AM requesting documentation to show Doctors #2 and #3 Medical Directors’ contracts were terminated effective July 1, 2008. The DPS stated, during the interview, that she did not know of any written documentation to confirm the contract termination. Additionally, the DPS had a telephone conversation with the agency Administrator and Senior Vice President of Clinical Operations and they stated they have no written documentation of termination of Doctor #2 and #3's Medical Directors’ contracts. A subsequent interview was conducted with the Vice President of Finance, on 09/11/08 at 11:20 AM and he concurred that they have no written documentation and they should have followed the outline of May 14 2009 15:52 MAY-14-2889 17:85 - AGENCY -HEALTH CARE ADMIN 858 921 @158 = P2935 item #18 of the Medical Director contracts as proof of termination of the Medical Directors contracts. 12. At 12:40 PM, on 09/11/08, an interview was held with Dr. #2, via the telephone. He stated that the home health agency advised him of the new regulations by sending him a packet of information in the mail and he spoke to the President of the company. 13. On 09/11/08 at 12:55 PM, a telephone interview was held with Doctor #3. He stated he was handed a protocol regarding the changes in the law, he believes from a representative of the home health agency. He further stated it may have been the owner but he was net sure. 14. On 09/11/08 at 12:45 PM, at the time of the exit conference, the home health agency still was unable to provide written documentation to show the termination of Doctor #2 and #3's Medical Director contracts. 15. On 09/11/08, at 2:30 PM, a call was received by the surveyor from the agency Administrator. She stated she was faxing a copy of the letters sent to Doctor #2 and Doctor #3. On 09/11/08 at 3:20 PM, a fax was received from the DPS. The fax was reviewed and was a copy of the "Dear Doctor" form letter, dated "July 01, 2008" which stated, in part,”...In accordance with the new law we must notify you in writing that any contracts/agreements that we have with you must be terminated, effective immediately. This letter will serve as May 14 2009 15:53 MAY-14-2889 17:85 AGENCY HEALTH CARE ADMIN 858 921 @158 =P. 3835 that official termination." Further review revealed that this letter had the physician's name handwritten after "Dear Doctor" and had hand written sections at the bottom where the name and signature of Doctor #2 were included. According to the time information on the top of the fax, the letter was faxed to the physician's office on 09/11/08 at 2:49 PM signed, faxed to the agency and forwarded to this surveyor on 09/11/08 at 3:20 PM. A second copy of the form letter addressed to Doctor #3, wath the same hand written section after the "Dear Doctor" salutation and hand written sections at the bottom of the doctor's printed name and signature, was forwarded to this surveyor on 09/11/08 at 4:56 PM. The time information on the top of the fax indicated the letter was faxed to the doctor on 09/11/08 at 15:30, signed , faxed back to the agency and forwarded to the surveyor on 09/11/08 at 4:56 PM. 16. Based on the foregoing facts, Comprehensive Home Care of Broward violated Section 400.474(6)(h), Florida Statutes, herein an unclassified deficiency, which carries in this case an assessed fine of $5,000.00. 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 Comprehensive Home Care of Broward on Count I. May 14 2009 15:53 MAY-14-2@89 17:86 AGENCY HEALTH CARE ADMIN 858 921 @158 = P. 31735 2. Assess against Comprehensive Home Care of Broward an administrative fine of $5;000.00 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. : Tria Lawton-Russeli, Esq. Assistant General Counsel Agency for Health Care Administration 8355 N.W. 52 Terrace - #103 Miami, Florida 33166 May 14 2009 15:53 MAY-14-2089 17:06 AGENCY HEALTH CARE ADMIN 85@ 921 9158 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 Charlene Welsh, Administrator, Comprehensive Home Care of Broward, 6450 N.W. gth Way, Fort Lauderdale, Florida 33309; and to Garrett W. Bragg, Registered Agent, 740 S. repre Highw #4014 Pompano Beach, Florida 33062 on this 41 - day of | P.32/735 May 14 2009 15:54 MAY-14-2089 17:26 AGENCY HEALTH CARE ADMIN 850 921 6158 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION RE: Comprehensive Wellness Services, Inc. d/b/a CASE NO: 2009002070 Comprehensive Home Care of Broward ELECTION OF RIGHTS This Election of Rights form is attached to a proposed action by the Agency for Health Care Administration (AHCA). The title may be Notice of Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine or Administrative Complaint. Your Election of Rights must be returned by mail or by fax within 21 days of the day you receive the attached Administrative Complaint. If your Election of Rights with your selected option is not received by AHCA within twenty- one (21) days from the date you received this notice of proposed action by AHCA, you will have given up your right to contest the Agency’s proposed action and a final order will be issued. (Please use this form unless you, your attomey or your representative prefer to reply according to Chapter! 20, Florida Statutes (2006) and Rule 28, Florida Administrative Code.) PLEASE RETURN YOUR ELECTION OF RIGHTS TO THIS ADDRESS: Agency for Health Care Administration Attention: Agency Clerk 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308. Phone: 850-922-5873 Fax: 850-925-0158. PLEASE SELECT ONLY 1 OF THESE 3 OPTIONS OPTION ONE (1) I admit to the allegations of facts and law contained in the Administrative Complaint and I waive my right to object and to have a hearing. I understand that by giving up my right to a hearing, a final order will be issued that adopts the proposed agency action and imposes the penalty, fine or action. OPTION TWO (2) I admit to the allegations of facts contained in the Administrative Complaint, but J wish to be heard at an informal proceeding (pursuant to Section 120.57(2), Florida Statutes) where I may submit testimony and written evidence to the Agency to show that the proposed administrative action is too severe or that the fine should be reduced. OPTION THREE (3) I dispute the allegations of fact contained in the Administrative Complaint, and I request a formal hearing (pursuant to Subsection 120.57(1), Florida Statutes) before an Administrative Law Judge appointed by the Division of Administrative Hearings. PLEASE NOTE: Choosing OPTION THREE (3), by itself, is NOT sufficient to obtain a formal hearing. You also must file a written petition in order to obtain a formal hearing before the Division of Administrative Hearings under Section 120.57(1), Florida Statutes. It must be received by the Agency Clerk at the address above within 21 days of your receipt of this proposed P.33/35 May 14 2009 15:54 MAY-14-2@89 17:87 AGENCY HEALTH CARE ADMIN 858 921 @158 = P. 3435 administrative action. The request for formal hearing must conform to the requirements of Rule 28- 106.2015, Florida Administrative Code, which requires that it contain: 1. Your name, address, and telephone number, and the name, address, and telephone number of your representative or lawyer, if any. 2. The file number of the proposed action. 3. A statement of when you received notice of the Agency’s proposed action. 4. A Statement of all disputed issues of material fact. If there are none, you must state that there are none. Mediation under Section 120.573, Florida Statutes, may be available in this matter if the Agency agrees. License type: (ALF? nursing home? medical equipment? Other type?) Licensee Name: License number: Contact person: Name ; Title Address: Street and number City Zip Code Telephone No. Fax No. Email(optional) Thereby certify that | am duly authorized to submit this Notice of Election of Rights to the Agency for Health Care Administration on behalf of the licensee referred to above. Signed: Date: Print Name: Title: Late fee/fine/AC May 14 2009 15:54 MAY-14-2889 17:07 AGENCY HEALTH CARE ADMIN 858 921 0158 P.35/735 COMPLETE Tet SECTION ON DELIVERY et Cree SENDER: COMPLETE THIS SECTION ™ Complete items 1, 2, and 3, Also complete Item 4 if Restrictad Delivery ls desired. ™ Print your name and address on the reverse C) Registered G2HAtum Receipt for Merchandisa C Insured Matt §=96O1 C.00. 4. Restricted Dellvery? (Extra Fee) Yes CHF ON WF A dhe. FP Kauderdate, Fl II30F 2. Anticie Number Cevserronvence?008 OSOO0 0002 O7b4 9701 PS Form 3811, February 2004 Domestic Retum Recelpt TO2S9B-O244- 1540 ca $0 that We can return the card to you. B. wey The ie) Date of Deliver a ™ Attach this card to the back of the mailpiece, 4, (oO 4y fo or on the front It space permits. 4{o % r 1 i - oD. Le daltvery aeerd Pulte from tem 1? a vo * » Anicle Addressed to: UL IES, onter delivery address below: a ? gl abv S Cheraloae / io f ns Compiohan dre! tome ao Return Recelp! Fee Ca (Endorsement Required) ahe fore park ~ D Reanicied Dafvery Fue $ Say somhaan 1 ‘(Endorsement Requires) Mall ©) Express Mall a in a a a a 6 US. Postal Service -. CERTIFIED MAIL. F seNDER: comecere THIS SECTION LTC Fis SECTION ON DFIIVERY Bie (Domestic Mai! Only; No Insuras a . ™ Complete itams 1, 2, and 3. Also complete ™ Bees: §—— tem 4 If Restricted Delivery Is desired. cr wer fj c Fi ™ Print your name and addrass on the reverse aa ‘ so that we can return the card to you. i ™@ Attach this card to the back of the mailplece, Y or on the front If space permits. a ~— D. Is dallvary address different from item 1? C1 Yes mu It YES, enter delivery address below: ELNo' a oO o a a wn a f- 3. Serylce Type v4 arwefosnd Certified Mal =O Mall a oh oe sen sce nenewamtawanen A? _£ 3 3 A b Zp 1 Registered teyFarum Rocupt for Merchandise a C1 insured Mall = (OC... pro Ba no 710 3 -Fede ‘Ch Sista, Za” 4. Restricted Delivery? (Extra Fea) O ves 2. Article Number (Mrarater from service 7004 O500 0002 0764 49718 i PS Form 3811, February 2004 Domestic Return Receipt 102505-02-M-1660 | TOTAL P.35

Docket for Case No: 09-002581

Orders for Case No: 09-002581