@1/64/2818 4:23 3853779347 LOVABLE HOME HEALTH PAGE 82/89 STATE OF FLORIDA AGENCY FOR HEALTH CARH ADMINISTRATION AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, , AHCA No.: 2009011071 v. Return Receipt Requested: 7008 0500 0002 0764 7356 LOVABLE HOME HEALTH SERVICES 7008 0500 0002.0764 7363. CORP. d/b/a LOVABLE HOME HEALTH SERVICES, CORP., Respondent. / ADMINISTRATIVE COMPLAINT COMES | WoW the Agency for Health Care Administration (“AHCA”), by and through the undersigned counsel, and files this aduinistrative complaint against Lovable Home Health Services Corp. d/b/a Lovable Home Health Services, Corp. (hereinafter “Lovable”), pursuant to Chapter 400, Part ‘II, and Section 120.60, Florida Statutes (2009), and herein alleges: NATURE .OF THE ACTION 1.. This is an action to impose an administrative fine of $5,000.00 pursuant to Section 400.484, Florida Statutes (2009), for the protection of the public health, safety and welfare. " JURISDICTION AND VENUE 2. AHCA has jurisdiction pursuant to Chapter 400, Part Tl, Florida statutes (2009). 3, Venue lies pursnant to Rule — 28-106.207, Florida Administrative Code. Filed January 19, 2010 12:45 PM Division of Administrative Hearings. 61/84/2019 64:23 3053779347 LOVABLE HOME HEALTH PAGE 43/89 PARTIES 4. ANCA is the vegulatory 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. 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 hereto a licensed facility under the licensing authority of AHCA and was required to comply with all applicable rules and statutes. COUNT T : LOVABLE HOME HEALTH SERVICES CORP. FAILED TO PROVIDE AT LEAST ONE ; SERVICE DIRECTLY FOR A PERIOD OF 60 DAYS Sections 400,474(2) (e), and 400.462(9), Florida Statutes, and/or Rules 594-8,008(4), 59A-B.002(30), and 59A-8.002(5), Florida Administrative Code (DIRECT SERVICES) UNCORRECTED ‘UNCLASSIFIED VIOLATION 6. AHCA re~alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. ?. During the follow-up conducted on 8/04/09 and based on record review and interview, it was determined that this home health agency still failed to provide at least one qualifying service directly for a period af 60 days. @1/84/2018 84:23 3053779347 LOVABLE HOME HEALTH PAGE 64/69 8. This Home Health Agency’s application for licensure indicated that nursing services were to be provided directly. A review of the Plan of Correction (POC) submitted by the home health agency (hereinafter “HHA’) to the Agency (AHCA) reiterated that nursing services would ba provided directly. A personnel record review conducted on 8/4/09 revealed that three (3) sampled employees, 3 LPNs, hired after 06/22/05 had W9 forms and signed independent contracts in their files. Lovable still failed to hire any direet nursing staff to provide nuxsing care to its patients. 9. An interview with the Alternate Administrator conducted on 08/04/09 at 11:00 AM confirmed the above findings. He/she stated that tha facility intended for secial work to be the direct service, not nursing services. The Administrator stated that the plan of correction (hereinafter “POC”) was incorrect and it was too late to Ghange it: therefore, Lovable still submitted its POC to avoid penalties for late submission, 10. During an interview with the Dixector of Nursing (hereinafter “DON”) conducted on 08/04/09 at 11:10 AM via telephone she stated that the facility is still in the process of hiring a social worker. This is an unclassified and uncorreated deficienay, 11. Based on the foregoing facts, Lovable Home Health Services Corp. violated Sections 400.474 (2) (e), and 400.462(9), Florida Statutes, and/or Rules S9A-8.008(4), 59A-8.002(9), and B1/G4/2818 84:23 3053779347 LOVABLE HOME HEALTH PAGE 5/69 59A-8.002 (30), Florida Administrative Code, 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 Lovable Home Health Services Carp. on Count I, 2. Assess against Lovable Home Health services Corp. an administrative fine of $5,000.00 on Count 2, 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 1. 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 Rlection of Rights. All) requests for hearing shall be made to the Agency for Health Care Administration and delivered to the Agency Clerk, Ageney for 61/04/2014 04:23 3853779347 LOVABLE HOME HEALTH PAGE 6/29 ‘Health Care Administration, 2727 Mahan Drive, MS #3, Uallahassee, 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 Agency fox Health Care Administration 8355 N.W. 52 Tarrace = #103 Miami, Florida 33166 Copies furnished to: Pield Office Manager Agency for Health Care Administration 8355 NW $3" Street, First Floor Miami, Florida 33166 (Interoffice Mail) Revenue and Management Unit Finance and Accounting Agency for Health Care Administration -2727 Mahan Drive, MS #14 Tallahassee, Florida 32308 (Interoffice Mail) Home Health Aganey Unit Program Agency for Health Care Administration 2727 Mahan Drive, MS #34 Tallahassee, Florida 32308 (Interoffice Mail) 91/04/2818 04:23 3053779347 LOVABLE HOME HEALTH PAGE 67/99 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 Patricia: Gonzalez, Administrator, Lovable Home Home Health Services Corp. 848 Brickell Avenue, Suite 630, Miami, Florida 33129, and to Antonio Perez, Registered Agent, 84 Brick@il Avenue, Suite 630, Miami, Florida 33129 on this day UsPp - Lrack o& Confirm Page lorl Ba esirsivice. Mom | | Track & Gonfirm Track & Confirm Search Results Label/Receipt Number: 7008 0500 0002 0764 7356 Service(s): Certified Mail™ 4 Status: Delivered Enter Label/Receipt Number. Your item was delivered at 12:00 PM on December 28, 2009 in MIAMI, FL . 33131. o> Detailed Results: * Delivered, December 28, 2009, 12:00 pm, MIAMI, FL 33134 * Notice Left, December 24, 2009, 12:23 pm, MIAMI, FL 33131 Track & Confirm by email Get current event information or updates for your item sent to you or others by email. Gor) BUA AS See Inty trae Gone Copyright® 2009 USPS. All Rights Reserved. NoFEAR ActEEO Data FOIA Bees Vers ig| vag dy http://trkenfrm1.smi.usps.com/PTSInternetWeb/InterLabelInquiry.do 1/15/2010 UsFs - Lrack & Contirm Page lorl EISEN. a Track & Confirm FA Track & Confirm Search Results Label/Receipt Number: 7008 0500 0002 0764 7363 Service(s): Certified Mail™ Track & Confirm Status: Delivered Enter Label/Receipt Number. Your item was delivered at 12:00 PM on December 28, 2009 in MIAMI, FL 33131. (G03) Detailed Results: * Delivered, December 28, 2009, 12:00 pm, MIAMI, FL 33131 * Notice Left, December 24, 2009, 12:23 pm, MIAMI, FL 33134 Track & Confirm by email Get current event information or updates for your item sent to you or others by email. (Go>) SiteMap Customer Service == Forms = Gov't Services = Careers = Privacy Policy =» Terms. of Use PRA A stn Ute ed arenas Copyright® 2009 USPS. All Rights Reserved. No FEAR Act EEO Data FOIA @ Srna didos test Inka sup ay http://trkenfrm1.smi.usps.com/PTSInternetWeb/InterLabelInquiry.do 1/15/2010

Docket for Case No: 10-000268