v.
/
ADMINISTRATIVE COMPLAINT
NATURE OF THE ACTION
This is an action to revoke the assisted living facility license [License No.: 11559], pursuant to Section 429.14(1)(e)&(f), Florida Statutes, and Section 408.815
(1) (c)&(d), Florida Statutes, and to impose an administrative fine of $7,500.00 pursuant to Sections 429.14 and 429.19,
Filed September 22, 2011 2:47 PM Division of Administrative Hearings
Florida Statutes (2010), for the protection of public health, safety and welfare. Section 429.19(1)(e), Florida Statutes, provides that the Agency can revoke or deny a license if five or more uncorrected Class III deficiencies have been cited on·. a single survey. Section 419.14(1)(f), Florida Statutes, provides that the Agency can revoke or deny a license if the facility failed to comply with the background screening standards. The Agency has considered the factors outlined in Section 429.19(3), Florida Statutes, in imposing the penalty and in fixing the amount of the fine.
JURISDICTION AND VENUE
This Court has jurisdiction pursuant to Sections
120.569 and 120.57, Florida Statutes (2010), and Chapter 28-106, Florida Administrative Code (2010).
Venue lies pursuant to Rule 28-106.207, Florida Administrative Code (2010).
PARTIES
AHCA is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing assisted living facilities pursuant to Chapter 429, Part I, Florida Statutes (2010), and Chapter 58A-5 Florida Administrative Code (2010).
Ana Home Care operates a 6-bed assisted living facility located at 20555 S. W. 187 Avenue, Miami, Florida 33187. Ana Home Care is licensed as an assisted living facility under license number 11559. Ana Home Care 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
AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully set forth herein.
Ana Home Care was cited with five (5) Class III deficiencies and one (1) Class II deficiency as a result of complaint investigation surveys that were conducted on February 4, 2011 and March 22, 2011;
A complaint investigation survey was conducted on February 4,. 2011. Based on observation, record review, and interview, it was determined that the facility failed to ensure the number of residents at the facility does not exceed their
licensed capacity of 6 and their ability to provide an appropriate housing and care. The facility's current census was
The findings include the following.
On 02/05/2011 at 8:45 AM, 11 individuals were observed at the facility. Residents #1, #2, #3, #4, #5, #6, #7, #8, #9, #10 & #11. Residents #1 - #4 were observed in the day room. Residents #5 - #11 were observed in various bedrooms. A garage like shed was observed in the backyard. Inside the shed there was a kitchen area and a living room. There was a room partitioned off with a mattress and a wheel chair in it. There was a bathroom and another room with a bed.
On 02/05/2011 at 10:30 AM staff stated that resident #12 left the facility on 02/04/2011.
Record review of the facility license found the
licensed | capacity | was 6. | Record review documents that resident |
#12 was | admitted | to the | facility 11/25/2010 with a discharge |
date of 02/04/2011. Residents #5, #6, and #10 are listed on the admission discharge log. Residents #7, #8, #9 and #11 are not listed on the admission discharge log.
On 02/05/2011 at 10:30 AM, resident #9 stated she lives at the facility and there are over 10 residents currently at the facility. Resident #1 stated he has been at the facility for over 2 weeks. Resident #l's family was contacted by phone at
12:25 PM. The family member stated that the resident has been living at the facility for over 2 months.
On 02/05/2011 at 1:40 PM, resident #12 and family members were interviewed at the rehabilitation facility where the resident is currently located. The resident's brother stated that resident #12 had to stay in the shed behind the house because there was no room for him in the house.
The brother stated that resident #12 is confined to a wheel chair. The brother stated that the facility would leave resident #12 in his wheelchair all night to sleep. The brother stated that on 01/11/2011 resident #12 was in the shed and tried to reach for his urinal and fell out of the wheelchair on to the concrete floor. Resident #12 stated he hit his head when he fell and was unable to get off the cold floor all night as no staff was available in the shed to assist residents. The brother stated that the following morning a 2nd resident called him and told him resident #12 was on the floor.
The mandated date of correction was designated as March 5, 2011.
A follow-up survey was conducted on March 22, 2011.
Based on observations, record review, and interview, it was determined that facility still failed to ensure the number of residents at the facility does not exceed their licensed
capacity of 6. The facility's census was 7. The findings include the following.
Facility tour at 9:30 AM on 3/21/2011 found that resident #1 was observed in the space that was designated to be an office based on the facility's floor plan. Resident #2 was observed in room #1 watching television. Residents #4, #5, #9, and #13 were observed outside the facility in the covered patio area. Resident #3 was in the bathroom in resident room #4.
The owner (staff #2) stated at 9:40 AM on 3/21/2011 that she wanted to expand her bed count, but she would have to meet with the people in city hall so that they could approve her request for more beds.
Record review on 3/21/2011 found that the facility was zoned by the local county to have a maximum of 6 residents.
Observations at 7:00 AM on 3/22/2011 found that there were 7 residents at the facility. Resident #1 was in the space that was designated for the office sleeping. Resident #2 was in room #1. Resident #3 was in his bed in room #3. Residents #4 and #13 were in room #4. Resident #9 was at the facility in his wheelchair sitting outside of the facility in the patio alone. This deficiency remains uncorrected from the survey of February 4, 2011.
Based on the foregoing facts, Ana Home Care violated Section 408.806(1)(d)&(4), Florida Statutes, and Rule 58A-
5.0131(7), Florida Administrative Code, herein classified as a Class II violation, which warrants an assessed fine of
$5,000.00, and gives rise to the revocation of the assisted living facility license.
COUNT II
AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully set forth herein.
A complaint investigation survey was conducted on February 4, 2011. Based on record review and interview, it was determined that the facility failed to ensure 1 of 3 (#1) staff was in compliance with the level II background screening. The findings include the following.
Staff #1 record review found no documentation of compliance with the level II background screening.
On 02-05-11 at 10:50 AM, the administrator's daughter stated that staff #1 was a part time staff member. The administrator's daughter stated that no level II background screen had been completed for staff #1.
The mandated date of correction was designated as March 5, 2011.
A follow-up survey was conducted on March 22, 2011.
Based on record review and interview, it was determined that the facility still failed to ensure that 2 of 6 (#4 and #6) sampled staff have a completed level 2 background screening. The findings include the following.
Employee record review at 10: 00 AM on 3/21/2011 found that staff #4 (caretaker) hired on 09/03/2010 had no documentation of a completed Level II background screening.
Record review for staff #6 documents he was hired on 01/15/2011.
(maintenance worker)
At 5:25 PM on 3/21/2011 staff #6 was observed in
resident room #3 replacing an electrical socket cover. Staff #6's record had no documentation of having a completed Level II background screening.
The owner stated at 5:25 PM on 3/21/2011 that no documentation of a Level II background screening was available for staff #4 or staff #6. This is an uncorrected deficiency from the survey of February 4, 2011.
Section 429.14(l)(f), Florida Statutes, provides that the Agency can revoke or deny a license if the facility failed to comply with the background screening standards of Chapter 429, Section 408.809(1), or Chapter 435.
Based on the foregoing facts, Ana Home Care violated Section 408.809(1), Florida Statutes, and Rule 58A-5.019(3), Florida Administrative Code, herein classified as an uncorrected Class III violation, which warrants an assessed fine of $500.00, and gives rise to the revocation of the assisted living facility license.
COUNT III
AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully set forth herein.
A complaint investigation survey was conducted on February 4, 2011. Based on record review and interview with administrator/daughter on 02-05-11 @ 10:53 am, it was revealed that staff member #1 did not have training in the areas elopement. The findings include the following.
During staff record review on 02-05-11 @ 10:53 am, revealed that the staff member was described to be only a helper who only worked at the facility part of the time, but there were
no documents to show she ever had training in the areas for elopement.
Interviewed administrator/daughter stated that the facility failed to have this employee trained in these areas which are needed because they did know it was needed since she was only temporary.
The mandated date of correction was designated as March 5, 2011.
A follow-up survey was conducted on March 22, 2011.
Based on record review and interview, it was determined that the facility failed to ensure that 1 of 6 (6) staff received elopement training. The findings include the following.
Employee record review at 10 AM on 3/21/2011 found that staff #6 (maintenance worker) was hired on 1/15/2011. At 5:25 PM on 3/21/2011, staff #6 was observed in resident room #3 replacing an electrical socket cover. Staff #6's record had no
documentation training.
of having completed the required elopement
· The owner stated at 5:25 PM on 3/21/2011 that staff #6
had not completed the required training in elopement procedures. This is an uncorrected deficiency from the survey of February 4, 2011.
Based on the foregoing facts, Ana Home Care violated Rule 58A-5.0191(2) (f), Florida Administrative Code, and Rule
58A-5.019(2) (c), Florida Administrative Code, herein classified as an uncorrected Class III violation, which warrants an assessed fine of $500.00, and gives rise to the revocation of the assisted living facility license.
COUNT IV
AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein.
A complaint investigation survey was conducted on February 4, 2011. Based on review and interview, it was determine that the facility failed to maintain accurate Medication Observation Records for 11 (#1, #2, #3, #4, #5, #6, #7, #8, #9, #10 & #11) of 11 current residents. The findings include the following.
Review of the Medication Observation Record (MOR) for resident #1, #2, #3, #4, #5, #6, #7, 38, #9, 310, and #11, were all predated through 02/07/2011.
On 02/05/2011 at 10:00 the administrator's daughter stated that the MOR should not have been pre-dated and changes will be made.
The mandated date of correction was designated as March 5, 2011.
A follow-up survey was conducted on March 22, 2011.
Based on record review and interview, it was determined that the facility still failed to maintain a daily medication observation record (MOR) for 1 out of 7 (#3) sampled residents. The findings include the following.
Medication review completed at 2:45 PM on 3/21/2011 found that resident #3's MOR did not have the bed time dose for Seroquel, 50 milligrams (mg) indicated as given on 03/21/2011. The Seroquel, 50 mg bingo card was missing the dosage for 03/21/2011.
Resident #3's Alendronate, 70 mg ordered weekly was initialed by the facility's staff daily from March 1, 2011 to March 21, 2011. This is an uncorrected deficiency from the survey of February 4, 2011.
Based on the foregoing facts, Ana Home Care ·violated Rule 58A-5.0185(5)(b), Florida Administrative Code, herein classified as an uncorrected Class III violation, which warrants an assessed fine of $500.00, and gives rise to the revocation of the assisted living facility license.
COUNT V
AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully set forth herein.
A complaint investigation survey was conducted on February 4, 2011. Based on record review and interview with administrator/daughter on 02-05-11 @ 10:50 am, it was revealed that staff member #1 did not have any personnel records to verify she has been examined for a communicable disease including TB. The findings include the following.
During staff record review on 02-05-11 at 10:50 am, revealed that the staff member was described to be only a helper who only worked at the facility part of the time, but there were no documents to show she ever had any records to verify she has been examined for a communicable disease including TB.
Interviewed administrator/daughter revealed that the facility failed to have any personnel records for staff member #1 to verify she has been examined for a communicable disease
including TB which are needed to work in this type of environment.
The mandated date of correction was designated as March 5, 2011.
A follow-up survey was conducted on March 22, 2011.
Based on record review, observation, and interview, it was determined that the facility still failed to ensure that 1 out of 6 (#6) staff members have a freedom from communicable disease including tuberculosis statement. The findings include the following.
Personnel record review for staff #6 (maintenance worker) hired 1/15/2011 found no documentation of a freedom from tuberculosis statement.
On 03/21/2011 at 5:25 PM staff #6 was observed in resident room #3 repairing an electrical outlet. On 3/21/2011 at 5:25 PM the owner stated that the maintenance man lives on the property. The owner stated that the facility had no documentation of a freedom from tuberculosis statement for staff #6. This is an uncorrected deficiency from the survey of February 4, 2011.
Based on the foregoing facts, Ana Home Care violated Rule 58A-5.024(2) (a), Florida Administrative Code, and Rule 58A- 5.019(2)(a), Florida Administrative Code, herein classified as an uncorrected Class III violation, which warrants an assessed
fine of $500. 00, and gives rise to the revocation of the assisted living facility license.
COUNT VI
AHCA re-alleges and incorporates paragraphs
through (5) as if fully set forth herein.
( 1)
A complaint investigation survey was conducted on February 4, 2011. Based on record review and interview with administrator/daughter on 02-05-11 at 10: 53 am, it was revealed that staff member #1 did not have training in the areas on HIV and AIDS. The findings include the following.
During staff record review on 02-05-11 at 10:53 am, it was revealed that the staff member was described to be only a helper who only worked at the facility part of the time, but there were no documents to show she ever had training in the areas for HIV and AIDS.
Interviewed administrator/daughter stated that the facility failed to have this employee trained in these areas
which are needed because they did know it was needed since she wasonly temporary.
The mandated date of correction was designated as March 5, 2011.
A follow-up survey was conducted on March 22, 2011.
Based on record review, observation, and interview, it was determined that the facility still failed to ensure that 1 out of 6 (#6) staff members completed an education course on HIV and AIDS. The findings include the following.
Personnel record review for staff #6 (maintenance worker) hired 1/15/2011 found no documentation of completion of an education course on HIV and AIDS.
On 03/21/2011 at 5: 25 PM, staff #6 was observed in resident room #3 repairing an electrical outlet.
On 3/21/2011 at 5:25 PM, the owner stated that the maintenance man lives on the property. The owner stated that the facility had no documentation of completion of an education course on HIV and AIDS. This is an uncorrected deficiency from the survey of February 4, 2011.
7 0. Based on the foregoing facts, Ana Home Care violated Section 429.275(2), Florida Statutes, Rule 58A-5.024 (2) (a) 1,
Florida Administrative Administrative Code,
Code, Rule 58A-5.0191(3), Rule 58A-5. 019(2) (c),
Florida Florida
Administrative Code, herein classified as an uncorrected Class
III violation, | which warrants an assessed fine | of $500.00, and |
gives rise to | the revocation of the assisted | living facility |
license. |
CLAIM FOR RELIEF
Enter a judgment in favor of the Agency for Health
Care Administration against Ana Home Care on Counts I through
VI.
Assess an administrative fine of $7,500.00 against Ana Home Caie on Counts I through VI for the violations cited above.
Revoke the assisted living facility license [License No.: 11559] of Ana Home Care based on Counts I and VI for the violations cited above.
Assess costs related to the investigation and prosecution of this matter, if the Court finds costs applicable.
Grant such other relief as this Court deems is just and proper.
Respondent is notified that it has a right to request an administrative hearing pursuant to Sections 120.569 and 120.57, Florida Statutes (2010). Specific options for administrative action are set out in the attached Election of Rights. All
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
Copies furnished to:
"&_q -JU
A.Naranjo, Esq.
Fla. Bar No.: 997315
Assistant General Counsel Agency for Health Care Administration
8333 N.W. 53 Street
Suite 300
Miami, Florida 33166
305-718-5906
Field Office Manager
Agency for Health Care Administration 8333 N. W. 53 Street - Suite 300
Miami, Florida 33166 (Interoffice Mail)
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 Armando Hidalgo, Administrator, Ana Care, 20555 S.W. 187 Avenue, Miami, Florida 33187 on this day of {:, 2011.
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| Issue Date | Document | Summary |
|---|---|---|
| Jan. 19, 2012 | Agency Final Order |
