16/13/2889 3:12 3853585113 ANTHONY VITALE PA PAGE , 20s" BSR 57/3 TING sift ~ Eb pes STATE OF FLORIDA AGENCY FOR HEALTE CARE ADMINISTRATION AGENCY FOR HEALTH CARE ADMINISTRATION, Petitionar, : AHCA Ne,: 2009009082 v. : Return Receipt Requested: . » 7008 0500 0002 0764 S663 LOVABLE HOME HEALTH SERVICES 7008 0500 0002 O764 6656 CORP. d/b/a LOVABLE HOME BEALTE SERVICES, CORP., Respondent. . / ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Adrinistration (“AHCA”), by and through the undersigned counsel, and files this administrative complaint against Lovable Home Health Services Corp, d/b/a Lovable Home Health Services, Corp. (hereinafter “Lovable Home Health Services Corp.”), 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 Zine of $3,000.00 pursuant to Section 400.484, Flerida Statutes (2008), for the protection of the public health, safety and welfare. JORISOICTION AND VENUE 2, BHCA has jurisdiction pursuant to Chapter 400, Part III, Florida Statutes (2008). 3... Venue lies pursuant. to Rule 26-106.207, Florida Administrative Coda. id PHORT 1OONE Filed October 20, 2009 11:42 AM Division of Administrative Hearings. 08/22 18/13/2889 83:12 3653565113 ANTHONY VITALE PA PAGE 49/22 3053779347 p.6 PARTIES 4, BHCA is the xegulatery authozity xresponsinle for liceangure end enfercement of all applicable statutes ard rules “goversing home health agencies, pursuant to Chapter 400, Fart TIT, Florida Statutes, and Chanter 59A-8 Plorida Administrative code. , 5. Lovable Home Health Services Corp. operates a home health - agency located at 848 Brickell Avenue, Suite 630, Miami, Florida 33129. Lovable Home Health Services Corp. is licensed as a home health agency under license number 299992202. Lovable Home Health Services Corp. was at all times material hereco a licensed facility under the licensing authority of AHCA and was required to comply with all applicable rules and statutes. COUNT Z , LOVABLE HOME HEALTH SERVICES CORP. FAILED TO PROVIDE AT LHAST ONE SERVICE DIRECTLY THROUGH AGENCY EMPLOYEES Sections 400.474, and 400.462(9}, Florida Statutes, and/or Rules 592-8.008(4), and 598-8,.002(31), Florida Administrative Code (DIRECT SERVICES} ‘ UNCLASSIFIED VIOLATION 6. AHCA re-alleges and incorporates paragraphs (1) through (3) as if fully set forth herein. 7. Durirg the State Licensure Renewal Survey conducted from 6/22/09 through 6/25/09 and based on racord review and interview, it was determined that the facility failed to provide at least one service dizectly throiach agency employees. 10/13/2889 63:12 3053585113 ANTHONY VITALE PA PAGE / 8. Personnel record review conducted from 06/22-24/2009 revealed that 8(2 RN'S, 1 LPN, 1 PTA, 3 HHA'S, 2 OT) sampled employee records showed W-9 form, and a signed independent contract on their files. Reguéest for payroll records revealed that all services pxrovided by the agency are by independent contractars, 3. An intezview with the Administrator/DON on 6/25/09 at 10:45 gonfinmed the abowe findings. The Administrator/DON claimed that he/she is the only nurse that has taxes deducted fron his/her paycheck and the rest of the services are provided by independent ‘contxactors. The Hone Health Agency 2007 licensing application listed nursing as a direct and conizact service, all other services ara contracted. 10. Based on the foregoing facts, Lovable Home Health Services Corp. violated Sections 400.474. and 400.462(9), Florida Statutes, and/or Rules 59A-8.008(4), and 59A-8,.002(31), -Floxida Administrative Code, herein an unclassified deficiency, which carries in this case an assessed fine of $1,000.00. COUNT IZ LOVABLE HOME HEALTH SERVICES CORP, FAILED TO ENSURE THAT ALL . SERVICE EVALUATIONS, INCLUDING THR INITIAL ASSESSMENT WAS - COMPLETED BE A CAREGIVER OTRECTIY EMPLOYED BX THE HOME HEALTH AGENCY my : Section 400.487(5), Florida Statutes, and/or Rule 59A- 8.0086(1) (a), Florida Administrative dode (RESPONSIBILITY OVER CONTRACTORS) UNCLASSIFIED VIOLATION ced TLARD ina 18/22 10/13/2889 63:12 3053585113 ANTHONY VITALE PA PAGE 11/22 ii. AHCA re-alleges and incorporates paregraphs (1) through 19) as if fully set forth herein. . 12. During the Stete Renewal Licensure survey conducted rom 6/22/2009 to 6/25/2009 and based on clinical record review and interview, it was determined that the “acility failed to ensure that all sexvice evaluations, including the initial assessment was completed by a direct employee of the home health agency ir 3 of 12 sampled patients (#4, #5, and #12). 13. A clinical record review conducted on 6/22/2009 through 6/25/2009, revealed that. 3 of 12 sampled patients’ initial comprehensive assesaiments and service evaluations, were completed by independent contractors. 14. An interview with Administrater/BON on 6/25/09 at 11:00 AM confirmed the above findirgs. The Administrator/DON indicated shat he/she was not aware of the requiation, he/she also advised that the agency is training nurses to do the comprehensive assessment and the nurses will be direct employees: The Administrator stated that he/she does most of the comprehensive &asessnments. 15. Based on the foregoing facts, Lovable Home Health Services Corp, violated Sestion 400.487(5), Florida Statutes, and/or Rule 59A-8.0086(1} (c}, Florida Administrative Code, herein an unclassified deficiency, which carries in this case an assessed fine of $1,000.00. need es 18/13/2069 93:12 3053585113 ANTHONY VITALE PA PAGE 12/22 COUNT XIt LOVABLE HOME HEALTH SERVICES CORB, FATLED TO PREVENT FRAUDULENT DOCUNENTATION BY AN EMPLOYER FOR ONE SAMPLED PATTENT Section 400.474(2) (4), Florida Statutes {FRAUDULENT PATIENT RECORDS) UNCLASSIFIED VIOLATION 16. AHCA ve-alleges and incorporates paragvaphs (1) through (5) as if set forth herein. 17. During the State Renewal Licensure survey conducted from 6/22/2609 to 6/25/2009 and based on record review, interview and observation, it was determined that the facility failed to prevent fraudulent documentation by an employee for 1(#3) out of 12 sampled patients, . 18. A clinical recard review of sampled patient #3 mevealed a start of care 01/13/09, diagnosis diabetes. the certification period 5/13/09 to 7/11/09 revealed that the physician ordered to waight patient every visit. ‘The patient weight was recorded at 135 pounds on every visit, from 5/13/09 until 6/21/09, except on the following dates: 5/19/09 @ 7am-145lyg = @ 7:30pm-1351bs 5/26/09 @ Tam-L45lbns - @ 72 30pm=1351bs 6/02/09 @ Tam-145lbs - @ 7:30pm=1351bs 6/09/09 @ 7am-145ibs - @ 7;30pm-1351bs 6/25/09 @ 7am-145ibs = @ 7:30pm-1351lbs 19. Recorded weights reflected a pattern of increase in, weight of 10 lbs in the morning (from 135 lbs) every seven days but on the same the weight gain of 10 lbs is lost in the afternoon, od date roone 16/13/2009 03:12 3953585113 ANTHONY VITALE PA PAGE 13/22 20. There was no evidence that the JON was aware of weight Gair and loss avery seven Gays mor was there any evidence that che DON was informed of any siqnificant change. 21. Observation during the surveyor nome visit revealed the failure of the skilled nurse to follow the physician's order by not weighing patient #3. ) 22. An interview with the Adminis:rator/DON on 6/24/09 at 10:45 AM confizmed the above findings. The Administrator/DON reviewed the record with the surveyor and questioned the authenticity of the recorded weights for sampled patient #3. 23. Based on the foregoing facts, Lovable Home Health Services Corp, violated Section 400,474(2) (d), Florida Statutes, herein an unclassified deliciency, which carries in this case an assessed fine of $1,000.00. CLAIM FOR RELIEF WHEREFORE, the Agency requests the Court ta oxder the following relief: 1. Enter A judgment in favor of the Agency for Health Care Administration against Lovable Home Health Services Corp, on Counts L, II and IITr. 2. Assess against Lovable Home Health Services Corp. an administrative fine of $3,000.00 on Counts I, IT and Tit, for the violation cited above. 3. Assess costs related to the investigation and prosecution of this mattez, if applicable. ed JHORTICONE 16/13/2869 83:12 3853585113 ANTHONY VITALE PA PAGE 14/22 4, Grant such ocher 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 220.869 and 120.57, Plorida Statutea. Specific options for administrative action are set out in the attached Blection of Rights. All requests for hearing shall be made to the Agency for Heaith Care Administration and delivered to the Agency Clerk, Ageney for Health Care Adwinistration, 2727 Mahan Drive, MS #3, Tallahassee, . Florida 32308. RESPONDENT IS FURTHER NOTI®IED THAT THE FAILURE TO RECEIVE A REQUEST FOR A HZARING WITHIN TWENTY-ONE (21) DAYS OF RECKI?T 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. Ir YOU WANT TO HIRE AN ATTORNEY, YOU HAVE THE RIGHT 70 BS REPRESENTED BY AN ATTORNEY IN THIS MATTER Tria Lawton-Russell, Bsq. Assistant General Counsel, Agency fox Health Care Administration : 8355 N.W. 52 Tarxace - #103 Miami, Plorida 33166 Copies furnished to: Field Office Manager Agency for Health Care Administration 8355 NU 5374 Street, First Floor Miami, Florida 33166 (Interoffice Mail} ~ 18/13/2869 83:12 3853585113 ANTHONY VITALE PA PAGE 3053779347 p2 Revenue and Management Unit Finance and Accounting Agency for Health Care Administration 2727 Manan Drive, MS #14 Tallahassae, Florida 32308 (Znteroffice Mail) Home Health Agency Unit Program Agency for Health Care Administration 2727 Mahan Drive, MS #34 Pallahasses, Flerida 32308 (Interoffice Mail} CERTIFICATE OF SERVICE ~ HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mait, Return Receipt Requested to Patricia Gonzalez, Adminiatrator, Lovable Home Home Health Services Corp. 848 Brickell Avenue, Suite 630, Miami, Florida 33129, and