STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, AHCA 2010003919 © . Return Receipt Requested Vv. : 7009 0080 0000 0586 2838 7009 0080 0000 0586 2845 COLUMBIA HOSPITAL CORPORATION 7009 0080 0000 0586 2852 OF SOUTH BROWARD d/b/a WESTSIDE REGIONAL MEDICAL CENTER, Respondent. ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (hereinafter “AHCA”’), by and through the undersigned counsel, files this Administrative Complaint against Columbia Hospital Corporation of South Broward d/b/a Westside Regional Medical Center, (hereinafter “Westside Regional Medical Center”) pursuant to Chapter 395, Part I, Florida Statutes (2009), and Chapter 120, Florida Statutes (2009) hereinafter alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine in the amount $1,000.00 pursuant to Section 395.1041(5) (a) Florida Statutes. JURISDICTION AND VENUE 2. This court has jurisdiction pursuant to Section 120.569 and 120.57 Florida Statutes and Chapter 28-106 Florida Administrative Code. 3. Venue lies pursuant to = 28-106.207, Florida Administrative Code. PARTIES 4. AHCA is the enforcing authority with regard to hospital licensure law pursuant to Chapter 395, Part I, Florida Statutes and Rule 59A-3 Florida Administrative Code. 5. Westside Regional Medical Center is a hospital facility located at 8201 West Broward Boulevard, Plantation, Florida 33324 and is licensed under Chapter 395, Part I, Florida Statutes and Chapter 59A-3. Florida Administrative Code, license #4399 with an expiration date of November 4, 2011. COUNT TI WESTSIDE REGIONAL MEDICAL CENTER FAILED TO ENSURE IT MAINTAINED RECORDS OF ALL PATIENTS WHO REQUESTED EMERGENCY CARE AND SERVICES Chapter 395.1041(4) (a)2., Florida Statutes (EMERGENCY CARE) 6. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. During the complaint investigation conducted on March 10, 2010 and based on review of documentation and records, and facility staff interview, it was determined that the facility failed to ensure it maintained records of all patients who requested emergency care and services, or persons on whose behalf emergency care and services are requested for one of twenty records reviewed, Patient #1. 8. A review of the EMS (emergency medical service/ambulance) record dated 1/16/10 for Patient #1 revealed the following documentation: " the patient sustained a four inch laceration to the forearm ....Prior to transport to Hospital B, Westside Hospital was contacted and refused to accept the patient. Westside states per Dr. ----, do not bring this patient because they believe he might need a hand surgeon. Westside was advised that this patient does not meet any trauma or high index criteria". 9. An observation during the initial emergency department (ED) tour on 3/10/2010 at approximately 9:50 AM revealed that the facility had a 2-way radio for communication with EMS (emergency medical services/ambulance.) An interview with the CNO (chief nursing officer) and the VP Compliance Officer at this time revealed the nurses, any ED staff, or physicians may accept or communicate to the EMS staff. They confirmed that logs were maintained of these in-coming calls from EMS. Further interview with them revealed there is no specific policy to designate who can accept these calls, but anyone in the ED who is available can do this. Interview with the Nursing Director of ED during the tour verified there was a log sheet maintained of in-coming calls that includes the date, time, rescue unit # and the patient's chief complaint. Further interview with the ED Nursing Director revealed they log the information. If there is a concern from the physician at this time, that the patient is not appropriate i.e... trauma, and there is continued communication with EMS; EMS may upgrade the patient, but the closest facility accepts the patient. She stated the physician can be at the radio if there is any concern about this; and she is not aware of any patient being refused based on information taken over the radio. 10. An interview with the Medical Director of the ED on 3/10/2010 at approximately 10:20 AM revealed they would accept the call and initial story from EMS, would never refuse a patient, but would recommend, i.e. Trauma, or Obstetrical facility, if that is the concern or issue with the patient, as those services are not offered here. He stated they would recommend, and the decision is at the discretion of the EMS team. He verbalized for Pediatric patients, this occurs possibly once a week or so where they recommend another facility to EMS as they do not offer Pediatrics in the hospital, but again it is at the discretion of the EMS team, and "we would never refuse a patient of any kind". When questioned related to lacerations, he stated we would never refuse a patient with a laceration, but we don't have a hand surgeon on call and would recommend another facility if necessary per the EMS team's discretion to go to the nearest facility with that specialty. The physician and VP Compliance Officer verified the facility was capable of suturing lacerations. 11. Review of the documentation/log provided revealed Patient #1 was not on the ED/EMS log of calls-in from EMS during the month of January 2010. Further review revealed there was incomplete information on these logs, such as no dates, no time, and no rescue unit . Further interview on 3/10/10 at approximately 11:55 AM, with the VP Compliance Officer, CNO and Nursing Director of ED confirmed that all in-coming EMS communication is logged on these ED/EMS log forms. The VP Compliance Officer verbalized they would never refuse a patient and the intention is not to refuse a patient but the potential. and perception by EMS might be they are refusing the patient if the service is not offered at the hospital. 12. An interview with the CEO (Chief Executive Officer) on 3/10/2010 at approximately 3:50 PM revealed she feels that sometimes EMS calls the ED to see what service/s is/are offered and not to transport a patient in to them. She verbalized she is not aware that a patient calling in inquiring about services offered should be logged, such as a patient calling from home, and feels this is what EMS does sometimes, as they would not refuse a patient being transporting in. 13. Further interview on 3/10/2010 at approximately 4:10 PM with an ED physician who was scheduled in the ED on the evening of 1/16/10 revealed he did not recall receiving a call or speaking to EMS via radio in January related to Patient #1, as he doesn't take calls from EMS, and does not tell them not to bring a patient here. He stated he would not refuse a patient, but could advice EMS not to bring a patient here if the patient would be better served at another facility with that specific specialty i.e. laceration if a hand surgeon were required. 14. Based on the foregoing, Westside Regional Medical Center violated Chapter 395, Florida Statutes, and Chapter 59A-3, Florida Administrative Code, an unclassified deficiency, which carries in this case a $1,000.00 fine. CLAIM FOR RELIEF WHEREFORE, AHCA requests the following relief: A. Make factual and legal: findings in favor of the Agency on Count f. B. Assess a fine against the facility in the amount of $1,000.00. Cc. Grant such other relief as the court deems proper. The Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes. Specific options for administrative action are set out in the attached Explanation of Rights (one page) and Election of Rights (one page). All requests for hearing shall be made to the Agency for Health Care Administration, attention Agency Clerk, 2727 Mahan Drive, Mail Stop #3, Tallahassee, Florida 32308, Telephone (850) 922-5873. RESPONDENT IS FURTHER NOTIFIED THAT FAILURE TO RECEIVE A REQUEST FOR A HEARING WITHIN 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. Ir YOU WANT TO HIRE AN ATTORNEY, YOU HAVE THE RIGHT TO BE PRESENTED BY AN ATTORNEY IN THIS MATTER. Respectfully submitted elson E. Rodney, Esquife Assistant General Coundel Spokane Bldg., Suite #103 8350 NW 52°¢ Terrace Miami, Florida 33166 (305) 470-6802 Copies furnished to: Field Office Manager Agency for Health Care Administration $150 Linton Boulevard, Suite 500 Delray Beach, Florida 33484 (Interoffice Mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true copy hereof was sent by U.S. Mail, Return Receipt Requested to Mrs. Mary Lynn Swartz, CEO, Westside Regional Medical Center, 8201 Weston Broward Boulevard, Plantation, Florida 33324; Columbia Hospital Corporation of South Broward, P.O. Box 750, Nashville, TN 37202, and CT Corporation System, 1200 S. Pine Island Road, Plantation, Florida 33324-0000, on Mom [Uf , 2010. STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION RE: Columbia Hospital Corporation of South Broward d/b/a CASE NO: 2010003919 Westside Regional Medical Center 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 attorney or your representative prefer to reply according to Chapter120, Florida Statutes (2008) 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: 850-412-3630 Fax: 850-921-0158. PLEASE SELECT ONLY 1 OF THESE 3 OPTIONS OPTION ONE (1) J 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 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 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 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) [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 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ™ Complete items 1, 2, and 3. Also complete Item 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 mailpiece, or on the front if space permits. 1. Article Addressed to: . delivery address below; MAY 18 2010 = 3. Service Type a [-cértified Mall (C1 Express Mall (i Registered Ed} Return Recelpt for Merchandise C1 Insured Mail ~=01G.0.D. - 4, Restricted Delivery? (Extra Fee) ‘2 Article Number 2009 0080 DO00 0586 2845 (Transfer from service labe_____. PS Form 3811, February 2004 Domestic Return Recelpt SENDER: COMPLETE THIS SECTION im Complete items 1, 2, and 8. Also complete item 4 If Restricted Delivery Is deslred. C Agent @ Print your name and address on the reverse Claddressee, so that we can return the card to you. B. Racelved by (Printed Name) C. very ll Attach this card to the back of the mailpiece, I or on the front if space permits, 1. Article Addressed t feloridadion., Pl 333 b F D. Is delivery addlress different from Item 1? {C1 Yes If YES, enter delivery address below: C1 No i + Service Type Certified Mail (C1) Express Mali 1 Registered 2l-Return Recelpt for Merchandise Ci Insured Mail [1 C.0.0. 4, Restricted Delivery? (Extra Fee) QO Yes 2 Arico Mumbo oj 7004 D080 D000 058b 2838 eturn Receipt 102595-02-M-1540 j PS Form 3811, February 2004 Domestic R COMPLETE THIS SECTION ON DELIVERY SENDER: COMPLETE THIS SECTION ™ Complete items 1, 2, and 3. Also complete AY Sigitaturg semen item 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 mailpiece, _ C'hgent x “RED SOG #4q_ (1 Addressee B. Recalved by (Printed Name) or on the front ifgspace permits. ww a x D. Is delivery addrass ‘al teen Exes 1. Artlele Addressed 1, If YES, enter dellvery address below: cy Sse ip ce sinks atta tanec. kyaaatag /2 ve So ie eal fee , ray ‘ 3, Service Type Vbuitetion i Ctehan [icértified Mall 1 Express Mail 4 C1 Registered GReturn Recelpt for Merchandise 1 tnsured Mall —C} G.0.D. 4, Restricted Delivery? (Extra Fea) D Yes 2. Article Number 7004 0080 o000 058b 2852 (Transfer from. service labe. PS Form 3811, February 2004 Domestic Return Recelpt 19860802 Mtg

Docket for Case No: 10-009033