FiLEO

1\ HCA

STATE OF FLORIDA AGE NCY CLERK

AGENCY FOR HEALTH CARE ADMINISTRATIO't'ooq NO -S A S: \ 1

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

v.

AHCA No.: 2009002316

DOAH No.: 09-3589

GLOBAL NURSING HOME HEALTH INC. d/b/a GLOBAL NURSING HOME HEALTH INC.,

Respondent.

RENDITION NO.: AHCA-09- I 1113 -S-OLC

FINAL ORDER

Having reviewed the administrative complaint dated June 10, 2009, 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 other party to these proceedings, and being otherwise well-advised in the premises, find·s 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.

   
   

   Filed November 9, 2009 11:55 AM Division of Administrative Hearings.

   
   

2. Respondent shall pay an administrative fine in the amount of

   
   

   $5,000.00. The administrative fine is due and payable within thirty (30) days of the date of rendition of this Order.

3. A check should be made payable to the "Agency for Health Care Administration." The check, along with a reference to this case number, 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 amounts pursuant to this Order will be subject to statutory interest and may be collected by all methods legally available.

5. Each party shall bear its own costs and attorney's fees.

   
   

6. The above-styled case is hereby closed.

DONE and ORDERED this d_day of , 2009, in Tallahassee, Leon County, Florida.

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 f=EE 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:

..

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

method designated, on this the S-¾ay of /J6've--6?c:::=: , 2009.

-

Richard J. Shoop Agency Clerk

Agency for Health Care Administration 2727 Mahan Drive, Building #3

Tallahassee, Florida 32308

(850) 922-5873

STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR HEALTH

CARE ADMINISTRATION,

Petitioner,

v.

AHCA No.: 2009002316

Return Receipt Requested: 7008 0500-0002 0764 8438

7008 0500 0002 0764 8445

GLOBAL NURSING HOME HEALTH INC. d/b/a GLOBAL NURSING HOME HEALTH INC.,

Respondent.

/

ADMINISTRATIVE COMPLAINT

COMES NOW the State of Florida, Agency for Health Care Administration ("AHCA"), by and through the undersigned counsel, and files this administrative complaint against Global Nursing Home Health Inc. d/b/a Global Nursing Home health Inc. (hereinafter "Global Nursing Home Health Inc."), 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(2) (e), Florida Statutes (2008), for the protection of public health, safety and welfare.

   EXHIBIT

   
   

   I

   
   

   JURISDICTION AND VENUE

   
   

2. A.HCA has jurisdiction pursuant to Chapter 400, Part III, Florida Statutes (2008).

3. Venue lies in Miami-Dade 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 (2008) I and Chapter 59A-8 Florida Administrative Code.

5. Global Nursing Home Health Inc. operates a home health agency located at 1756 S.W. 8th Street, Suite 205, Miami, Florida 33135-3544. Global Nursing Home Health Inc. is licensed as a home health agency under license number 2999922.92. Global Nursing Home Health Inc. 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.

   
   

   2

   
   

   CO'UNT I

   
   

   GLOBAL NURSING HOME HEALTH INC. FAILED TO PROVIDE AT LEAST 01-tE SERVICE DIRECTLY TO PATIENT FOR A PERIOD OF 60 DAYS.

   
   

   SECTION 400.474(2)(e), FLORIDA STATUTES RULE 59A-8.008(4), FLORIDA ADMINISTRATIVE CODE

   RULE 59A-8.0086(1) (d), FLORIDA ADMINISTRATIVE CODE

   
   

   UNCLASSIFIED VIOLATION

   
   

6. AHCA re-alleges and incorporates paragraphs ( 1)

   
   

   through (5) as if fully set forth herein.

   
   

7. Global Nursing Home Health Inc. was cited with one (1) unclassified violation as a result of licensure survey conducted on November 26, 2008.

8. A licensure survey was conducted on November 26,.2008.

   
   

   Based on record review and interview, it was determined that the facility failed to provide at least one service directly to patient for a period of 60 days required to maintain licensure. The findings include the following.

9. During the entrance conference on 11/24/08, the

   
   

   Administrator/DON (Director of Nursing) stated that the agency

   
   

   does not have any active skilled and non -skilled patients.

   
   

10. Review of the PAC (Professional Advisory Committee) log book revealed the following:

    1. For 2008, 4 meetings were held (2/14; 4/25; 7/14 and 10/20/08).

       
       

       3

       
       

    2. During the Febn:ary meeting, the fallowing were documented "the DON a:1.d his/her associate had c.issolved partnership by selling the agency late November 2007 to an individual who purport to own 100% of the agency. The sale never went through because the said individual only paid portion of the sale and failed to complete the purchase per contract".

    3. During the April meeting, the following were documented "The DON/President expressed concern with the renewal application process of the MEDICARE/MEDICAID license. He/She explained that during the renewal application, the candidate applying as Alternate Administrator falsely documented his/her experience and has caused problems and delays with the issuance of the agency' s license".

    4. During the July meeting, the following were

       
       

       documented "During the course of time that the agency was being sold in November 2007, the agency's license renewal was due in December 2007. Under contract, the individual who wanted to purchase the agency submitted the application of the Alternate Administrator. The proposed Alternate Administrator provided false information in his/her resume which resulted in AHCA (Agency for Health Care Administration) denying the agency's license renewal.

    5. During the October meeting the following were documented "Due to financial reasons, the agency has decided to

       down size t1:e agency from office space. to e::i.ployees. At the en.d of the agency's lease on 10/31/08, only Unit 205 will be used. Units 206 and 207 will no longer be occupied by the agency. Along with employees downsizing, the agency has NOT admitted any new patient. We will take this opportunity of the agency's downsizing · to restructure the cycle of duties, organize everything to be as efficient as possible working in one leased unit versus three to make our daily flow of work easier".

11. Interview with the Administrator/DON was done on 11/26/08. He/She confirmed that the last patient (Sample patient #6) was discharged on 9/26/08. From 9/27/08. to the day of the exit conference 11/26/08, the agency did not provide service directly to patients. The Administrator stated the following "I wanted to sell because I plan to relocate at West Palm Beach. I can get a contract with other agencies such as Infusion but they require a copy of our license and I can't give it since our license had expired (expired date 12/14/07). So I'm waiting for our license to be renewed".

12. Based on the forgoing. facts, Global Nursing Home

Health Inc. violated Section 400.474(2)(e), Florida Statutes, Rule 59A-8.008(4), Florida Administrative Code, Rule 59A- 8.0086(1)(d), Florida Administrative Code, herein classified as an unclassified violation, which warrants 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 Global Nursing Home Health Inc. on Count I.

2. Assess against Global Nursing Home Health Inc. 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 C1erk, Agency £or

Hea1th

Care

Administration, 2727 .Mahan

Drive, MS #3,

Tal1ahassee, Florida 32308.

6

RESPONDENT IS FURTHER NOTIFIED THAT THE FAILJRE TO RECEIVE A

REQUEST FOR A HEARING 1;,JITEIN TWENTY-ONE (21) DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADMISSION OF T:IE 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

rdes A. Naranjo, Es .

Fla. Bar No.: 0880175

Assistant General Counsel Agency for Health Care Admi.nistration

8350 N.W. 52 Terrace - #103

Miami, Florida 33166

Copies furnished to:

R. Steve Emling Field Office Manager

Agency for Health Care Administration

8355 N. W. 53 r d Street Miami, Florida 33166 (Interoffice Mail)

Finance and Accounting

Agency for Health Care Administration

2727 Mahan Drive

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 Antonio Herrera, Administrator, Global

Nursing Home Health Inc., 1756 S.W. 8th Street, Suite 205, Miami,

Florida 33135-3544; Felix R2poso, Registered Agent, 1756 s. w.

/0 day

STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

RE: Global Nursing Home Health Inc. d/b/a AHCA No.: 2009002316 Global Nursing Home Health Inc.

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 Notice oflntent to Impose a Late Fee. Notice oflntent to Impose a Late Fine or 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 attorney or your representative prefer to reply according to Chapter 120, 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: 850-921-0158.

PLEASE SELECT ONLY 1 OF THESE 3 OPTIONS

OPTION ONE (1) I admit to the allegations .of facts and law contained in the Notice

of Intent to Impose a Late Fine or Fee, or 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 Notice of Intent

to Impose a Late Fee, the Notice of Intent to Impose a Late Fine, or Administrative Complaint, but I 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 Notice of Intent

to Impose a Late Fee, the Notice of Intent to Impose a Late Fine, or 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), Floriaa Statutes. It must be received by the Agency Clerk at the address above within 21 days of your receipt of this proposed 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 nan1e, 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, 111.ay 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). _

I hereby certify that I 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

STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

v.

AHCA No.: 2009002316

DOAH No.: 09-3589

GLOBAL NURSING HOME HEALTH INC. d/b/a GLOBAL NURSING HOME HEALTH INC.,

Respondent.

./

SETTLEMENT AGREEMENT

Petitioner, State of Florida, Agency for Health Care Administration (hereinafter the "Agency"), through its undersigned representatives, and Respondent, Global Nursing Home Health Inc. d/b/a Global Nursing Home Health Inc. (hereinafter "Respondent"), 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, Respondent is a home health agency licensed pursuant to Chapters 400, Part III, and 408, Part II, Florida Statutes, Section 20.42, Florida Statutes, and Chapter 59A-8, Florida Administrative Code; and

EXHIBIT

I 9J

WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over Respondent, pursuant to Chapter 400 Part II, Florida Statutes; and

WHEREAS, the Agency served Respondent with an administrative

complaint on or about June 18, 2009, notifying the Respondent of its intent to impose administrative fines in the amount of

$5,000.00; and

WHEREAS, Respondent requested a formal administrative proceeding by selecting Option Three (3) on the Election of Rights form; and

WHEREAS, the parties have negotiated 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 herein 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, Respondent agrees to waive any and all appeals and proceedings to which it may be entitled including, but not limited to, an informal proceeding under Subsection 120.57(2), Florida Statutes, a formal proceeding

   under Subsection 120.57(1); Florida Statutes, appeals under

   
   

   Section 120.68, Florida Statutes; and declaratory and all writs of relief in any court or quasi-court of competent jurisdiction; and 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, Respondent agrees to pay $5,000.00 in administrative fines to the Agency within thirty (30) days of the entry of the Final Order.

5. Venue for any action brought to enforce the terms of this Agreement or the Final Order entered pursuant hereto shall lie in Circuit Court in Leon County, Florida.

6. By executing this Agreement, Respondent neither admits nor denies, and the Agency asserts the validity of the allegations raised in the administrative complaint referenced herein. However, no agreement made herein shall preclude the Agency from imposing a penalty against Respondent for any deficiency/violation of statute or rule identified in a future survey of Respondent.

   
   

7. The Agency is not precluded from using the subject events for any purpose within the jurisdiction of the Agency. Further, Respondent 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 administrative complaint.

8. 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.

9. Each party shall bear its own costs and attorney's fees.

   
   

10. This Agreement shall become effective on the date upon which it is fully executed by all the parties.

11. Respondent for itself and for its related or resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, does hereby discharge the State of Florida, Agency for Health Care Administration, 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

    Respondent or related facilities.

    
    

12. This Agreement is binding upon all parties herein and those identified in paragraph eleven (11) of this Agreement.

13. In the event that Respondent was a Medicaid provider at the subject time of the occurrences alleged in the complaint herein, this settlement 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, Administrative Code.

    Florida

14. Respondent 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 Respondent in the Final Order, or any portion thereof, owed by Respondent to the Agency from any present or future funds owed to Respondent by the Agency, and that the Agency shall hold a lien against present and future funds owed to Respondent by the Agency for said amounts until paid.

15. The undersigned have read and understand this Agreement and have the authority to bind their respective principals to it.

16. This Agreement contains and incorporates the entire understandings and agreements of the parties.

17. This Agreement supersedes any prior oral or written agreements between the parties.

18. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement shall be void.

    
    

19. All parties agree that a facsimile signature suffices for an original signature.

The following representatives hereby acknowledge that they

are duly authorized to enter

DeputY, Secretary

Di ' ion of Health Quality Assurance.

Agency for Health Care Administration

2727 Mahan Drive

Tallahassee, Florida 32308

Dated: '(/

Ju$ukin.M.dnLior: Esq. General Counsel

Agency for Health Care Administration

2727 Mahan Drive

Tallahassee, Florida 32308

into this Agreement.

J/Jt;;; sa,

Esq.

Attorney for Respondent Mesa Garcia-Menocal, PL 730 N. W. 107 Avenue

Suite 115

Miami, Florida 33172

Dated:

ourdes A. Naranjo, Esq. Assistant General Counsel Agency for Health Care Administration

8350 N.W. 52 Terrace - #103

Miami, Florida 33166

Dated: Dated:

Docket for Case No: 09-003589

Orders for Case No: 09-003589