Sep 8 2009 12:55 aq/ae/2ae9 12:45 8589218158 PAGE 35/68 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION AHCA No.: 2009004945 Petitioner, Return Receipt Requested: v. 7008 0500 0002 0764 5987 JONI MCCANN d/b/a BIRTHING CENTER OF SOUTH FLORIDA, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (“AHCA”’), by and through the undersigned counsel, and files this administrative complaint against Joni McCann d/b/a Birthing Center of South Florida (hereinafter “Birthing Center of South Florida”), pursuant to Chapter 383, and Section 120.60, Florida Statutes (2008), and alleges: NATURE OF THE ACTION 1. Thig is an action to impose an administrative fine in the amount of $2,000.00 pursuant to Section 383.33, Florida Statutes for the protection of the public health, safety and welfare pursuant to 408, Part II, Florida statutes. SURISDICTION AND VENUE 2. This Court has jurisdiction pursuant to Sections 120.569 and 120,57 Florida Statutes, Chapter 28-106, Florida Administrative Code. Sep 8 2009 12:57 aq/ae/2ae9 12:45 8589218158 PAGE 36/68 3. Venue lies pursuant Rule 28-106.207, Florida Administrative Code, PARTIES 4. AHCA is the regulatory. autherity responsible for licensure and enforcement of all applicable statutes and rules governing birth centers pursuant to Chapter 383, Florida Statutes (2008), and Chapter 59A-11 Florida Administrative Code. 5. Birthing Center of South Florida operates a birth center facility located at 646 West Palm Drive, Florida city, Florida 233034, Birthing Center of South Florida is licensed as a birth center facility license number 315, with an expiration date of July 7, 2009. Birthing Center of South Florida 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 RIRTHING CENTER OF SOUTH FLORIDA FAILED TO MAINTAIN QUALITY OF CARE TO PATIENTS Rule 59A-11,005(3), Florida Administrative Code {REQUIREMENTS FOR LICENSURE) 6. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. Puring a visit conducted on 10/08/08 and based on record review and interview, it was determined that the Sep 8 2009 12:57 o/@e/2689 12:45 8589218158 PAGE 37/68 clinical staff failed to maintain quality of care to patients. 8. Clinical record review conducted on 10/8/08 of 6 sampled patient records revealed that clinical staff failed to complete risk assessments for 5 (#1, #2, #3, #4, and #6 out of 6 sampled records. During an interview conducted on 10/08/08 at 12:50 pm with the Midwife, he/she stated that a risk assessment is not completed at initial sign-up for a patient who doesn't plan to deliver with the birth center. The Midwife stated that if a patient doesn't meet the eriteria as stated in the risk assessment, the risk assessment is not completed. The Midwife was able to verbalize each patients' status at sign-up, but failed to provide documentation to support his/her findings. 9. The oglinical staff failed to conduct clinical record reviews. The Midwife stated he/she has fallen behind in paperwork, and has not conducted clinical record reviews as required. 10. The clinical staff failed to demonstrate reviews of admissions, course of pregnancy and outcome, evaluation of services, condition of mother and newborn on discharge, and transfers. to othér providers. The Midwife was. able to verbalize 2 (#3 and #4) sampled patients that were transferred to other health care providers, but failed ta provide documentation within the 2 (#3 and #4) sampled Sep 8 2009 12:57 o/@e/2689 12:45 8589218158 PAGE 38/68 clinical ‘records. The Midwife confirmed the findings. Correction date: 11-8-2008 il. During the follow-up conducted on 3/26/09 and based on record review and interview, it was determined that the clinical staff still failed to maintain quality of caxe to patients for 3 out of 4 sampled records (#1, #3, and #4). 12. A clinical record review conducted on 3/26/09 at 11:30 am of gampled patient records revealed that clinical staff failed to complete risk assessments for 3 (#1, #3, and #4) out of 4 sampled records. During an interview conducted on 3/26/09 at 12:15 pm with the Midwife, he/she stated a risk assessment is not completed at initial sign-up for a patient who doesn't plan. to deliver with the birth center. The Midwife stated if a patient doesn't meet the criteria as stated in the risk assessment, the risk assessment is not completed. The Midwife was able to verbalize each patients' status at sign-up, but fatled te provide documentation to support ‘his/her findings. 13, The clinical staff failed to conduct clinical record reviews. The Midwife stated ne/she has fallen behind in paperwork, and has not conducted elinical record reviews as required, but she is trying to get better. 14. The clinical staff failed to demonstrate reviews of admissions, course’ of pregnancy and outcome, evaluation of services, condition of mother and newborn on discharge, and Sep 8 2009 12:57 aq/ae/2eed 12:45 8589218158 PAGE 39/68 transfers to other providers. This is an uncorrected deficiency from the 10/08/08 survey. 15. Based on the foregoing, Birthing Center of South Florida violated Rule 59A-11.005(3), Florida Administrative Code, an uncorrected deficiency, which warrants an assessed fine of $200.00. COUNT IT BIRTHING CENTER OF SOUTH FLORIDA FAILED TO ENSURE THAT CLINICAL RECORDS ARE COMPLETED 59A-11.005(4), Florida Administrative Code (REQUIREMENTS FOR LICENSURE) 16. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 17. During the visit conducted on 10/08/08 and based on record review and interview, it was determined that the clinical staff failed to ensure clinical records for 6 sampled patients included at the minimum the following data: (a) Obstetrical risk assessments and preterm labor risk assessments including the dates of the assessments; (b) The dates and topics of the educational sessions attended; (c) Referrals for medical care and transfers to hospitals, including that information germane to the circumstances; (d) Instructions given to the client regarding postpartum care, family planning, care of the newborn; Sep 8 2009 12:57 9/88/2889 12:45 85892148158 PAGE 46/68 arrangements for metabolic testing, immunizations, and follow-up pediatric care. 18. A clinical record review conducted on 10/08/08, revealed 5 (#1, #2, #3, #4, and #6).out of 6 sampled records did not include obstetrical risk assessments and pretexm labor risk assessments. During an interview conducted on 10/08/08 at 12:50 pm with the Midwife, he/she stated @ risk assessment is not completed at initial sign-up for a patient who doesn't plan to deliver with the birth center. The Midwife stated if a patient doesn't meet the criteria as stated in the risk assessment, the risk assessment is not completed. The Midwife was able to verbalize each patients’ status at sign-up, but failed to provide documentation to support his/her findings. The dates and topics of the educational sessions attended was not documented within the clinical record for 5 (#1, #2, #4, #5 and #6) out of 6 patients. The Midwife was able to verbalize @ (#3 and #4 sampled patients that were transferred to other health care providers, but failed to provide documentation within the 2 (#3 and #4) sampled clinical records detailing the circumstances of the transfers. The Midwife was unable Lo provide documentation demonstrating what instructions were given to the client in regards to postpartum care, family planning, care of the newborn, metabolic testing, immunizations, and follow-up pediatric care. The Midwife Sep 8 2009 12:53 o/@e/2689 12:45 8589218158 PAGE 41/68 verbalized there's a pediatrician in the same complex, and all of his/her patients take their babies to him for care. The Midwife atated condoms and other supplies are provided to the mothers as an incentive to conduct follow-up care. The Midwife acknowledged his/her deficient practice and confirmed the findings. Correction date: 11/08/08. 19. During the follow-up conducted on 3/26/09 and based on record review and interview, it was determined that the Clinical still staff failed to ensure clinical records for 6 sampled patients included at the tiinimum the following data: (a) Obstetrical risk assessments and preterm labor risk assessments, including the dales of the assessments; (6) Referrals for medical care and transfers to hospitals ancluding that information germane to the circumstances; (6) Instructions given to the elient regarding postpartum care, family planning, care of the newborn, arrangements for metabolic testing, immunizations, and follow-up pediatric’ care. 20. A clinical record review conducted on 3/26/2009, 11:30 am revealed 3 (#1, #3, and #4) out of 4 sampled records did not include Obstetrical risk assessments and preterm labor risk assessments. 21. During an interview conducted on 3/26/2003 at 12:15 pm with the Midwife, he/she stated a risk assessment is not Sep 8 2009 12:53 aq/ae/2ae9 12:45 8589218158 PAGE 42/68 completed at initial sign-up for a patient who doesn't plan to deliver with the birth center. The Midwife stated if a patient doesn't meet the criteria as stated in the risk assessment, the risk assessment is nat completed. The Midwife was able to verbalize cach patients’ status at sign-up, but failed to provide documentation to support his/her findings. 22. The Midwife was unable to provide documentation demonstrating what instructions were given to the client in regards to postpartum care, family planning, care of the newborn, metabolic testing, immunizations, and follow-up pediatric care. The Midwife verbalized there's a pediatrician in the’ same complex, and all of his/her patients take their babies to him for care. The Midwife stated condoms and other supplies are provided to the mothers as. an incentive to eonduct follow-up care. 23. The Midwife acknowledged his/her deficient practice and confirmed the findings. This is an uncorrected deficiency from the survey of 10/08/08. 24, Based on the foregoing, Birthing Center of South Florida violated Rule 59A-11.005(4), Florida Administrative Code, an uncorrected deficiency, which warrants an assessed fine of $200.00. coUNT Tit BIRTHING CENTER OF SOUTH FLORIDA FAILED TO DETERMINE RISK AT INITIAL SIGN-UP, AND FAILED TO EVALUATE PATIENTS THROUGH PREGNANCY Sep 8 2009 12:53 aq/ae/2ae9 12:45 8589218158 PAGE 43/68 Rule 59A-11.009(1), Florida Administrative Code (RISK STATUS CRITERIA) 25. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 26. During the survey conducted on 10/08/08 and based on record review and interview, it was determined that the clinical staff failed to determine risk at initial sign-up, and failed to evaluate 1 (#1) out of 6 sampled patients throughout pregnancy to assure the patient remained at low risk for a poor pregnancy outcome. 27. A review of patient #i's clinical record conducted on 10/08/08 revealed that the clinical staff failed to complete a risk assessment at initial sign-up to document patient #1's status. On visit 9/23/08, patient #1's blood pressure and heart rate were not recorded. During an interview with the Midwife, he/she advised the intern failed to document the clinical record appropriately. The student was instructed by the Midwife to review his/her records. The student did not have tha information recorded. The Midwife confirmed the findings, and . acknowledged the deficient practice. Correction date: 11-8-2008 28. During the follow=up conducted on 3/26/09 and based on recerd review and interview, it was determined that the clinical still staff failed to determine risk at initial sign-up, and failed to evaluate 2 (#1, and #3) out of 4 Sep 8 2009 12:53 aq/ae/2ae9 12:45 8589218158 PAGE 44/68 sampled patients throughout pregnancy to assure the patient remained at low risk for a poor pregnancy outcome. 29. A review of patient #1's clinical record conducted on 3/26/09 revealed that the clinical staff failed to complete a visk assessment at initial sign-up to document patient #l's status. On visit 3/03/09, patient #1's blood pressure and heart rate were not recorded. 30. A review of patient #3's clinical record conducted on 3/26/09 revealed the clinical staff failed to complete a risk agsessment at initial sign-up to document patient #3's status. On visit 3/12/09, patient #3's blood pressure and heart rate were not recorded. 31. During an interview with the Midwife, he/she advised the intern failed to document Lhe clinical record appropriately. The student was instructed by the Midwife to review his/her records. The student did mot have the information recorded. The Midwife confirmed the findings, and acknowledged the deficient practice. This is an uncorrected deficiency from the 10/08/08 survey. 32, Based on the foregoing, Birthing Center of South Florida violated Rule 59A-11.009(1), Florida Administrative Code, an uncorrected deficiency, which warrants an assessed fine of $200.00. Sep 8 2009 12:59 aq/ae/2ae9 12:45 8589218158 PAGE 45/68 COUNT IV BIRTHING CENTER OF SOUTH FLORIDA FAILED TO INCLUDE A RISK ASSESSMENT ON PATISNT RECORDS Rule 59A-11:009(2), Florida Administrative Code (RISK STATUS CRITERIA) 33. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 34. During a survey conducted on 10/08/08 and based on record review and interview, it was determined that the alinical staff failed to include in 5 out of 6 sampled records, a risk assessment. 35. During facility record review conducted on 10/08/08, the birth center's policy and procedure manual has a written risk assessment system in place, however; the clinical staff failed to implement the. system. 36. A clinical record review conducted on 10/08/08, revealed that 5 (#1, #2, #3, #4, and #6) out of 6 sampled records did not include risk assessments. During an interview conducted on 10/08/08 at 12:50 pm with the Midwife, he/she stated a risk assessment is not completed at initial sign-up for a patient who doesn't plan to deliver with the birth center. The Midwife stated if a patient doesn't meet the criteria as stated in the risk assessment, the risk assessment is not completed. The Midwife was able to verbalize each patients' status at sign-up, but failed to provide documentation to support his/her findings. The i Sep 8 2009 12:59 o/@e/2689 12:45 8589218158 PAGE 46/68 Midwife confirmed the findings, and acknowledged the deficient practice. Correation date: 11-8-2008. 37. During the follow-up conducted on 3/26/09 and based on record review and interview, it was. determined that the clinical staff still failed to include in 3 (#1, #3, and #4) out of 4 sampled records, a risk assessment. 38. During facility record review conducted on 3/26/05, the birth center's policy and procedure manual has a written risk assessment system in place. 39, A clinical record review conducted on 3/26/2009, revealed that 3 (#1, #3, and #4) out of 4 sampled records did not include risk assessments. 40. During an interview conducted on 3/26/2009 at 12:30 pm with the Midwife, he/she stated a risk assessment is not completed at initial sign up for a patient who doesn’t plan to deliver with the birth center. The Midwife stated if a patient doesn't meet the criteria as stated in the risk assessment, the risk assessment is not completed. 41. The Midwife confirmed the findings, and acknowledged the deficient practice, but continues to express how she is trying hard to get. better. This is an uncorrected deficiency from the survey of 10/08/08. 42. Based on the foregoing, Birthing Center of South Florida violated Rule 59A-11,009(2),. Florida Administrative 12 Sep 8 2009 12:59 aq/ae/2ae9 12:45 8589218158 PAGE 47/68 Code, an uncorrected deficiency, which warrants an assessed fine of $200.00. COUNT V BIRTHING CENTER OF SOUTH FLORIDA FAILED TO OBTAIN THE CLIENT’S WRITTEN CONSENT FOR BIRTH CENTER SERVICES Rule 59A-11.010(2), Florida Administrative Code (INFORMED CONSENT) 43. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 44, During the survey conducted. on 10/08/08 and based on record review and interview, it was determined that the clinical staff failed to obtain the client's written consent for birth center services for 6 sampled patients, and failed to document their consent using form "Consent to Deliver in a Birth Center", AHCA Form 3139-3003. 45. A review of 6 sampled patient records conducted on 10/08/08, revealed that the consent forms were not within the patients! record. The Midwife advised that the documentation should be.in the record. The Midwife was unable to provide the written consent for the 6 sampled patients at the time of the survey. The Midwife confirmed the findings, and acknowledged the deficient practice. Correction date: 11/08/08. 46. During the follow-up conducted on 3/26/09 and based on récord review and interview, it was determined that the elinical staff still failed to cbtain the client's written consent for birth center services for 4 out of 4 sampled “13 Sep 8 2009 12:59 aq/ae/2ae9 12:45 8589218158 PAGE 48/68 patients, and failed te document their consent using form "Consent to Deliver in a Birth Center", AHCA Form 3130-3003. 47. A review of 4 sampled patient, records conducted on 3/26/2009, revealed that the consent forms were not within the patients' record. 48. The Midwife advised thé documentation should be in the record. The Midwife was unable to provide the written consent for the 4 sampled patients at the time of the survey. 49. The Midwife confirmed the findings, and acknowledged the deficient practice. This is an uncorrected deficiency from the 10/08/08 survey. 50. Based on the foregoing, Birthing Center of South Florida violated Rule 59A-11.010(2), Florida Administrative Code, an uncorrected deficiency, which warrants an assessed fine of $200.00. COUNT VI BIRTHING CENTER OF SOUTH FLORIDA FAILED TO INCLUDE THE SIGNED CONSENT WITHIN THE CLIENT’S INDIVIDUAL CLINICAL RECORD Rule 59A-11.010(3), Florida Administrative Code. (INFORMED CONSENT) 51. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 52. During the survey conducted on 10/08/08 and based on record review and interview, it was determined that the clinical staff failed to obtain the client’s written consent for birth center services for 6 sampled patients, and to 14 Sep 8 2009 12:59 aq/ae/2ae9 12:45 8589218158 PAGE 49/68 include the signed consent within the client’s “individual clinical record. 53. A review of 6 gampled conducted on 10/08/08 revealed that the consent forms were not within the patients’ records. The Midwife advised the documentation should be in the record. The Midwife was unable to previde the written consent for the 6 sampled patients at the time of the survey. The Midwife confirmed the findings, and acknowledged the deficient practice. Correction date: 11-8-2008 54. During the follow-up conducted on 3/26/03 and based on record review and interview, it was determined that the clinical staff still failed to obtain the client’s written congent for birth center services for 4 out of 4 sampled patients, and to include the signed consent within the client’s individual clinical recerd. 53. A vecord review of 4 sampled patient records conducted on 3/26/2009, revealed that the consent forms were not within the patients' record. 56. The Midwife advised that the documentation should be in the record. The Midwife was unable to provide the written consent for the 4 sampled patients at the time of the survey. 57. The Midwife confirmed the findings, and acknowledged the deficient practice, This is an uncorrected deficiency from the 10/08/08 survey. 15 Sep 8 2009 13:00 aq/ae/2ae9 12:45 8589218158 PAGE 58/68 58. Based on the foregoing, Birthing Center of South Florida violated Rule 59A-11.010(3), Florida Administrative Code, an uncorrected deficiency, which Warrants an assessed fine of $200.00. COUNT VIT BIRTHING CENTER OF SOUTH FLORIDA FAILED TO COMPLETE AT THE TIME OF INITIAL VISIT A COMPREHENSIVE HEALTH HISTORY FOR THE PATIENTS Rule 59A-11.012(1), Florida Administrative Code {PRENATAL CARE) 59.. AKCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 60. During the visit of 10/08/08 and based on record review and interview, it was determined that the clinical staff failed to complete at the time of the initial visit for 5 (#1, #2, #3, #4, and #6) out of 6 patients, a comprehensive health history which includes medical, emotional, dietary, and obstetrical data including a pre-term delivery risk assessment. 61. B clinical record review conducted on 10/08/08, revealed 5 (#1, #2, #3, #4, and #6) out of 6 sampled records did not include obstetrical risk assessments and preterm labor risk assessments. During an interview conducted on 10/08/08 at 12:50 pm with the Midwife, he/she stated a cisk assessment is not completed at initial sign-up for a patient who doesn't plan to deliver with the bixth center. The Midwife stated if a patient doesn't meet the criteria as 16 Sep 8 2009 13:00 o/@e/2689 12:45 8589218158 PAGE 51/68 stated in the risk assessment, the risk assessment is not completed. The Midwife was able to verbalize each patiénts' status at sign-up, but failed to provide decumentation to support his/her findings. Correction date: 11/08/08. 62. During the follow-up conducted on 3/26/09 and based on record review and interview, it was determined that the clinical staff still failed to complete at the time of the initial visit for 3 (#1, #3, and #4) out of 4 sampled patients, a comprehensive health histery which includes medical, emotional, dietary, and obstetrical data ine¢luding a pre-term delivery risk assessment. 63. A clinical record review conducted on 3/26/2009 at 11:30 am, revealed that 1 out of 3 sampled records did not include obstetrical risk assessments and preterm labor risk assessments. 64. During an interview conducted on 3/26/2009 at 12:30 pm with the Midwife, he/she stated a risk assessment is not completed at initial sign-up for a patient who doesn't plan to deliver with the birth center. The Midwife stated that if a patient doesn't meet the criteria as stated in the risk assessment, the risk assessment is not completed. The Midwife was able to verbalize each patients’ status at sign-up, but failed to provide documentation to support his/her findings. This is an uncorrected deficiency from tha 10/08/08 survey. 17 Sep 8 2009 13:00 aq/ae/2ae9 12:45 8589218158 PAGE 52/68 65. Based on the foregoing, Birthing Center of South Florida violated Rule 59A-11.012(1), Florida Administrative Code, an uncorrected deficiency, which warrants an assessed fine of $200.00. coUNT VIII BIRTHING CENTER OF SOUTH FLORIDA FAILED TO SCHEDULE RETURNS PRENATAL VISITS Rule 59A-11.012(3), Florida Administrative Code ‘(PRENATAL CARE) 66. BHCA re-alleges and incorporates panagraphs (1) through (5) as if fully set forth herein. 67. During the visit conducted on 10/08/08 and based on record review and interview, it was determined that the clinical staff failed te schedule return prenatal visits at least every four weeks until the 32nd week, every two weeks until the 36th week, and then every week until delivery. 68. A clinical record review conducted on 10/08/08, revealed the clinical staff failed to document scheduling for return prenatal visits for 5 (#1, #2, #3, #4, and #6) out of 6 sampled records. The Midwife stated it's difficult to get the patients to return for care on a scheduled basis. The Midwife was unable to provide documentation demonstrating attempts made by the clinical staff to schedule prenatal return visits. The Midwife stated he/she sends out certified mail. There were no certified mail réceipts within the Sep 8 2009 13:00 aq/ae/2ae9 12:45 8589218158 PAGE 53/68 clinical records for the 5 sampled records. Correction date: 11/08/08. 69. During the follow-up conducted on 3/26/09 and based ‘om record review and interview, it was determined that the clinical staff still failed to schedule returns prenatal visits at least every four wéeks until the 32nd week, every two weeks until the 36th week, and then every week until delivery 2 out of 4 sample patients (#1 and #3). 70. a Clinical record review conducted on 3/26/2009 at 11:30 am, revealed the clinical staff failed to document scheduling for return prenatal visits for 2 out of 4 sample patients (#1 and #3) records. 71. During an interview conducted on 3/26/2009 at 12:30 pm with the Midwife, he/she stated it's difficult to get the patients to return for care on a scheduled basis. The Midwife was unable to provide documentation demonstrating attempts made by the clinical staff to schedule prenatal return visits, The Midwife stated he/she sends out certified mail. There were no certified mail receipts within the clinical recerds for the 2 sampled records. This is an uncorrected deficiency from the 10/08/08 survey. 72. Based on the foregoing, Birthing Center of South Florida violated Rule 59A-11.012(3), Florida Administrative Code, an uncorrected deficiency, which warrants an assessed fine of $200.00. 19 Sep & 2009 13:01 o/@e/2689 12:45 8589218158 PAGE 54/68 COUNT Ix BIRTHING CENTER OF SOUTH FLORIDA FAILED TO DEMONSTRATE THAT THE HEALTHY START PRENATAL SCREENING INSTRUMENT WAS OFFERED AT THE FIRST PRENATAL CONTACT RULE 59A-11.012(7), Florida Administrative Code (PRENATAL CARE) 73, AHCA re-alleges and incorporates paragraphs (1) through 95) as if fully set forth herein. . 74, During the visit conducted on 10/08/08 and based on record review and interview, it was determined that 9 out of 6 sampled clinical records reviewed, did not demonstrate the Healthy Start Prenatal Screening Instrument was offered at the first prenatal contact. 75. W& clinical record review conducted on 10/08/08, revealed 5S out of 6 clinical records did not contain the Healthy Start Prenatal Screening Instrument, or documentation demonstrating it is offered at the first prenatal contact. The Midwife stated he/she is actively pursuing means to better serve his/her patients, and try to find community resources to help with their care during their pregnancy and after birth. Correction date: 11/08/08. 76. During the follow-up conducted on 3/26/03 and based on record review and interview, revealed that 3 out of 4 (#1, #2, and #3) sampled clinical records reviewed, still did not demonstrate that the Healthy Start Prenatal Screening Instrument was offered at the first prenatal contact. 20 Sep & 2009 13:01 aq/ae/2ae9 12:45 8589218158 PAGE 55/68 77. A clinical record review conducted on, 3/26/2009, yevealed that 3 out of 4 clinical records did not contain the Healthy Start Prenatal Screening Instrument, or documentation demonstrating it is offered at the first prenatal contact. 78. During an interview conducted on 3/26/2009 at 12:40 pm with the Midwife, stated he/she is actively pursuing means to better serve his/her patients, and try to find community resources to help with theiz care during their pregnancy and after birth. This is an uncorrected deficiency from the 10/08/08 survey. 79. Based on the foregoing, Birthing Center of South Florida violated Rule 59A-11.012(7), Florida Administrative Code, an uncorrected deficiency, which warrants an assessed fine of $200.00. COUNT X BIRTHING CENTER OF SOUTH FLORIDA FAILED TO ENSURE THAT FACILITY’ S$ MECHANICAL VENTILATION/COOLING SYSTEM, BATHROOM, AND CARPET OF THE BIRTH ROOM ARE KEP CLEAN Rule 59A-11.023(8), Florida Administrative Code (BUILDING CONSTRUCTION AND FIRE SAFETY) 80. BHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. Bi. During the survey conducted on 10/08/08 and based on observation, it was determined that the clinical staff failed to ensure the facility's mechanical ventilation/ cooling system is kept clean. 21 Sep & 2009 13:01 aq/ae/2ae9 12:45 8589218158 PAGE 56/68 82. During a tour of the birth center's birthing room, the surveyors observed an accumulation of dust on the furnishings of the birth room. The surveyor wiped the shelf to demonstrate the amount of dust observed. The Midwife acknowledged the findings and advised he/she will have someone come into the facility to clean. Correction date: 1108/08 83. During the follow-up conducted on 3/26/09 and based on observation, it was determined that the clinical staff still failed to ensure Lhe facility's mechanical ventilation/cooling system, bathroom, the carpet of the birth room is kept clean. 84. During a tour of the birth center's birthing room on 3/26/2009 at 10:00 am, the surveyors | observed an accumulation of dust on the furnishings, carpet, and the wall of the birth room. The surveyor wiped the shelf and the walls to demonstrate the amount of dust observed. 85. As the tour continues the surveyor entered the bathroom where a foul odor was present as you walked in the bathroom, later it was determined to be dry urine on the floor. The bathroom was found to be very dirty. The Midwife acknowledged the findings and advised he/she will have someone come into the facility to clean. This is an uncerrected deficiency from the survey of 10/08/08. 22 Sep & 2009 13:01 aq/ae/2ae9 12:45 8589218158 PAGE 57/68 86. Based on the foregoing, Birthing Center of South Florida violated Rule 59A-11.023(8), Florida. Administrative Code, an uncorrected deficiency, which warrants an assessed fine of $200.00. 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 Birthing Center of South Florida on Counts IT through XK. 2. Assess an administrative fine of $2,000.00 against Birthing Center of South Florida on Counts I through x for the violations cited above. 3. Grant such other relief as this Court deems is just and proper. Respondent is notified that it has a right to frequest an administrative hearing pursavant to Sections 120.569 and 120.57, Florida Statutes (2008). specific optiens for administrative action are set out in the attached Election of Rights form. All requests for hearing shall be made to the Agency for Health Care Administration, .and delivered to the Agency Clerk, Agancy for Health Care Administration, 2727 Mahan Drive, MS #3, Tallahassee, Florida 32308. Sep & 2009 13:01 aq/ae/2ae9 12:45 8589218158 PAGE 58/68 RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TQ RECEIVE A REQUEST FOR A HEARING WITHIN TWENTY-ONE (21) DAYS OF RECEIPT OF THIS COMPLAINT WLLL 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 Eb REPRESENTED BY AN ATTORNEY IN THE MATTER ee Nélson E. Rodney, Eq. Assistant General Counsel Agency for Health Care Administration Spokane Bldg., Suite 103 6350 N. W. 52°4 Terrace Miami, Florida 33166 Copies furnished to: Field Office Manager Agency for Health Care Administration 8355 NW 53%¢ street, First Floor Miami, Florida 33166 (U.S. Mail) Revenue and Management Unit Finance and Acccunting Agency for Health Care Administration 2727 Mahan Drive, MS #14 Tallahassee, Florida 32308 (Interoffice Mail) Birth Center Unit Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) 24 Sep & 2009 13:02 aq/ae/2ae9 12:45 8589218158 PAGE 59/68 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correet copy of .the foregoing has been furnished by U.S. Certified Mail, Return Receipt Requested to Joni McCann, Administrator, Birthing Center of South Florida, 646 West Palm Drive, Florida City, ye Florida 33034 on this Ilo” day of uke , 2004. Nelson E. be 25 Sep & 2009 13:02 aq/ae/2ae9 12:45 8589218158 PAGE 68/68 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY "Complete items 1, 2, and 3. Also complete itert'4 if Restricted Delivery is desired. @ Print your name and address on the reverse so that we can return the card to you. @ Attach this card to the back of the matipiece, {ar on the front if space permits. D. Is delivery address different from item 1?- [1 Yes (YES, anter delivery address below: —-E] No . een Certified Mail (1 Ey Mall D0 Registered atu Recaipt for Merchandise Ol insured Mat = .0.D. 4, Restricted Dalivery? (Extra Féa} (2 Yes 2., Article Number POOS O500 G00 O7b4 44a? ., Cranster from service isbel} A ET a PS Form 3811, February 2004 Domestic Return Recelpt 102595-02-M-1840 +

Docket for Case No: 09-004862

Orders for Case No: 09-004862