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STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

l STATE OF FLORIDA,

! AGENCY FOR HEALTH CARE

ADMINISTRATION,

., vs.

Petitioner,

Case No.2011002107

l NEW HORIZON EAST, INC.,

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d/b/a NEW HORIZON NORTH;

Respondent.

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ADMINISTRATIVE COMPLAINT

COMES NOW the Petitioner, State of Florida, Agency for Health Care Administration (hereinafter "the Agency"), by and through its undersigned counsel, and files this Administrative Complaint against the Respondent, NEW HORJZON EAST, INC. d/b/a NEW HORIZON NORTH (hereinaft r "the Respondent"), purs ant to Sections 120.569 and 120.57, Florida Statutes (2010), and states:

NATURE OF THE ACTION

This is an action to impose an administrative fine against an assisted living facility in the sum of FIVE HUNDRED DOLLARS ($500.00) based upon one (1) uncon-ected Class III deficiency pursuant to Section 429.19(2)(c), Florida Statutes (20I0).

JURISDICTION AND VENUE

1. The Court has jurisdiction over the matter pursuant to Sections 120.569 and

   
   

   120.57, Florida Statutes (2010).

   
   

2. 'Ibe Agency has jurisdiction ovel' the Respondent pursuant to Sections 20.42 and 120.60, and Chapters 408, Part II, and 429, Paq I, Florida Statutes (2010).

3. Venue lies pursuant to Rule 28-106.207, Florida Administrative Code.

   
   

   PARTIES

   
   

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4. The Agency is the licensing and regulatory authority that oversees assisted living . facilities in Florida and enforces the applicable federal and state regulations, statutes and nlles governing such facilities. Chapters 408, Part II, and 429, Part I, Florida Statutes (201O); Chapter 58A-5, Florida Admin,istrativc Code. The Agency may deny, revoke, or suspend any_ license

   ; issued to an assisted living facility, or impose an administrative fine in the manner provided in

   
   

   · Chapter 120, Florida Statutes (2010). Sections 408.813, 408.815 and 429.14, Florida Statutes

   (2010).

   
   

5. The Respondent was issued a license by the Agency (License Number 10263) to operate a 6-bed assisted living facility located at 8112 Northwest 74th Terrace, Tamarac, Florida 33321, and was at all times material required to comply with the applicable federal and state

   regulations, statutes and rules governing assisted living facilities.

   
   

   COUNT I _

   The Respondent Failed To Ensure That Prescriptions For Residents Who Receive Assistance With Self-Administration Of Medications Or Medication Administration Were

   Filled Or Refilled In A Timely Manner In Violation Of Rule 58A-5.0185(7)(i), Florida

   Administrative Code

   
   

6. The Agency re-alleges and incorporates by reference paragraphs one (1) through five (5).

7. Pursuant to Florida law, Sections 429.255 and 429.256, Florida Statutes (2010), and Rule 58A-5.0l 85 Florida Administrative Code, licensed facilities may assist with the self­ administration or administration of medications to residents in a facility. A resident may not be compelled to take medications butmay be counseled in accordance wi1h Rule S8A-5.0l 85, Florida Administrative Code. The facility shall make every reasonable effort to ensure that

. prescriptions for residents who receive assistance with self-administration of medication or medication administration are filled or refilled in a timely manner. Rule 58A-S.0185(7)(f), Florida Administrative Code.

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8.. On or about December 27, 2010 the Agency conducted a Relicensure Survey of

the Respondent's facility.

1. Based on observations, interviews and record reviews, it was detennined the facility failed to make every reasonable effort to ensure prescriptions for residents are refilled in a timely manner for one (1) of three (3) sampled residents, specifically Resident number one (1).

2. During a medication review of Resident number one's (1) medications and related records conducted on December 27, 2010 at approximately 12:00 p.m. the following was noted.

3. Resident number one's (0 December 2010 medication observation.record

   documented a physician's order for Duoneb 2.5.Q.5 mg/3 ml use one (1) vial via jet nebulizer four (4) times a day. A.review of the medication observation record and the medications revealed the medication was not available on the day of the survey, and has not been available since· Resident number one's (1) admission to the facility on December 10, 2010. Resident number one

   (1) was admitted with the diagnosis of acute and chronic respiratory failure.

   
   

4. The administrator stated on December 27, 2010 that the physician1s order had not been filled. The facility had no documentation of any persistent efforts made to obtain a medication supply. The facility did not notify Resident number one's (1) physician of this · omission in medication assistance.

5. During an interview on December 27, 2010 at approximately2:30 p.m., the administrator acknowledged the findings.

6. The Respondent's deficient practice was related to the operation and maintenance of a provider or to the care of clients which the Agency determined indirectly or potentially threatened the physical or emotional health, safety, or security of clients, other than Class I or Class II violations, and constituted a Class III deficiency as provided for in Section 429.l 9(2)(c), Florida Statutes (2010).

7. The Agency cited the Respondent for a Class III violation in accordance with

   
   

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   Section 429.19(2)(c), Florida Statutes (2010).

   
   

   1. On or about February 111 2011, the Agency conducted a Follow-Up Survey to the Relicensure Survey of December 27, 2010 of the Respondent's facility.

   2. Based on observations, interviews, and record reviews, it" was determined the

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      facility failed to make every reasonable effort to ensure prescriptions for residents are refilled in

      1 a timely manner for one (1) of five (5) sampled residents, specifically Resident number five (5).

   3. During a medication review of Resident number five's (5) medications and related records conducted on February 11, 2011 at approximately 11:00 a.m. the following was noted.

   4. Resident number five's (5) February 2011 medication observation record documented facility staff assisting Resident number five (5) with Aricept ten (10) mg one (1) tab at bedtime. A review of the medication observation record and the medications revealed the medication was not avai1able on February 11, 2011 and has not been available since the

      · beginning of the month when the medication was returned to the pharmacy to repackage.

      
      

   5. During an interview on February 11, 2011 at approximately 12:30 p.m., the administrator acknowledged the findings.

   6. This remains an uncorrected deficiency.

      
      

   7. The Respondent's deficient practice was related to the operation and maintenance of a _provider or to the care of clients which the Agency determined indirectly or potentially threatened the physical o emotional health, safety, or security of clients, other than Class I or Class II violations, and constituted a Class III deficiency as provided for in Section 429.19(2)(c), Florida Statutes (2010).

   8. The Agency cited the Respondent for a Class III violation in accordance with Section 429.19 (2)(c), Florida Statutes (2010).

   9. The Respondent's deficient practice constituted an uncorrected Class III violation

      
      

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      in accordance with Section 429.19(2)(c), Florida Statutes (2010).

      
      

   10. The Agency shall impose an administrative fine for a cited Class III violation in an amount not less than five hundred dollars ($500.00) and not exceeding one thousand dollars

.($1,000.00) for each violation. Section 429,19(2)(c), Florida Statutes (2010).

WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration,

1 . intends to impose an administrative fine against the Respondent in the amount of FJVE HUNDRED DOLLARS ($500.00) pursuant to s·ection 429.19(2)(c), Florida Statutes (20I0).

CLAIM FOR RELIEF

WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Admini'stratiori,

respectfully requests the Court to grant the following relief:

1. Enter findings of fact and conclusions oflaw in favor of the Agency.

   
   

2. Impose an administrative fine against the Respondent in the amount of FIVE HUNDRED DOLLARS ($500.00).

3. Order any other relief that the Court deems just and appropriate.

Respectfully submitted on this - q·-t1t"\day of \'y\ O-··"  ".  \··, , 2011.

Andrea M. Lang, Assistant General Counsel Florida Bar No. 0364568

Agency for Health Care Administration

Office of the General Counsel

2295 Victoria Avenue, Room 346C Fort Myers, Florida 33901 Telephone: (239) 335-1253

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NOTICE

RESPONDENT IS NOTIFIED THAT IT/HE/SHE HAS A RIGHT TO REQUEST A.N

. ADMINISTRATIVE HEARING PURSUANT TO SECfiONS 120.569 AND 120.57, FLORIDA STATUTES. THE RESPONDENT IS FURTHER NOTIFIED THAT IT/HE/SHE HAS THE RIGHT TO RETAIN AND·BE REPRESENTED BY AN ATTORNEY IN THIS MATTER. SPECIFIC OPTIONS FOR ADMINISTRATIVE ACTION ARE SET OUT IN THE ATTACHED ELECTION OF RIGHTS.

ALL REQUESTS FOR HEARING SHALL BE MADE AND DELIVERED TO THE ATTENTION OF: THE AGENCY CLERK, AGENCY FOR HEALTH CARE ADMINISTRATION, 2727 MAHAN DRIVE, BLDG #3, MS #3, TALLAHASSEE, FLORIDA 32308; TELEPHONE (850) 412-3630.

THE RESPONDENT IS FURTHER NOTIFIED THAT IF A REQUEST FOR HEARING IS NOT RECEIVED BY THE AGENCY FOR HEALTH CARE ADMINISTRATION WITHIN TWENTY-ONE (21) DAYS OF THE RECEIPT OF THIS ADMINISTRATIVE COMPLAINT, A FINAL ORDER WILL BE ENTERED BY THE AGENCY.

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the Administrative Complaint and Ele.ction of Rights fonn were served to: Joan Bennett-Riley, Administrator and Registered Agent for New Horizon East, Inc. d/b/a New Horizon North, 8112 Northwest 74 th Terrace, Tamarac, Florida 33021, by United States Certified Mail, Return Receipt No. 7009 1680 0001 5449 4578

on this Gl,C\•t·'Y'\ day of      

(Y\.:...,,    ....,6--:=...,...,<"-= ;..!-h.---"' ' 2011.

Q  ,_s.._, ,.",._; ii-,. ':i.Qr-·f ..

Andrea M. La g, Assistant General Counf I

Florida Bar No. 0364568

Agency for Health Care Administration

Office of the General Counsel 2295 Victoria Avenue, Room 346C Fort Myers, Florida 33901

(239) 335-1253

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Copies :furnished to:

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STATE OF FLORIDA

I AGENCY FOR HEALTH CARE ADMINISTRATION

i

i STATE OF FLORJDA,

AGENCY FOR HEALTH CARE

I ADMINISTRATtON,

Petitioner,

vs. Case No. 2011002107

NEW HORIZON EAST, INC., d/b/a NEW HORIZON NORTH,

Respondent.

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 an Administrative Complaint, Notice of Intent to Impose a Late Fee, or Noti oflntent _to Impose a Late Fine.

Your Election of llights must be returned by mail or by fax within twentx oile (21) days of the date you receive the attached Administrative Complaint, Notice oflntent to Impose a Late Fee. or Notice of Intent to Impose a Late Fine. · ·

If your Election of Rights with your elected 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 in accordance with Chapter 120, Florida Statutes (2010) and Rule 28, Florida Administrative Code.

PLEASE RETURN YOUR ELECTION OF RIGHTS T. O THIS ADDRE. SS:

Agency for Health Care Administration Attention: Agency Clerk

2727 Mahan Drive, Mail Stop #3

Tallahassee, Florida 32308

Phone: 850-412-3630 Fax: 8S0-921-0158

PLEASE SELECT ONLY 1 OF THESE 3 OPTIONS

OPTION ONE (1) - I admit the allegations of fact 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 adtnit the allegations of fact and law contained in the Notice of · Intent to Impose a Late Fine or Fee, or Administrative Complaint, but I wish to be heard at

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an. informal proceeding (pursuant to Section 120,57(2)1 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 and law contained in the Notice of

Intent to Impose a Late Feet. the Notice of Intent to Impose a Late Fint:t 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.

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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 fonnal hearing before

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, the Division of Administrative Hearings under Section 120.57(1), Florida Statutes. It must be I received by the Agency Clerk at the address above within 21 days of your receipt of this proposed I administrative action. The request for fonnal hearing must confonn to the requirements of Rule 28

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106.2015, Florida Administrative Code, which reguires that it contain:

l. Your name, address, telephone number, and the name, address, and telephone number of

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1 your representative or lawyer, if any.

1. The file number of the pr!)posed action.

2. A statement of when you received notice of the Agency's proposed action.

3. 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.

·ucense Type: _c                                                              (Assisted Living Facility, Nursing Home, Medical Equipment, Other)

Licensee Name:                                        License Number:          _

Contact Person:

Name Title

Address:-

Street and Number City State Zip Code

Telephone Nq. ---- _.Fax No.                         E-Mail (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 above licensee.

Signature:                                                    

Print Name:                                                     

Date:--------

Title:                                        

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PS Form 8811, F'ebn.ta.tY 04 Domclsllo Retu.m ReOelpt 102696-02-t,,-1640

Docket for Case No: 11-001754

Orders for Case No: 11-001754