STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

vs. Case Nos. 2011007850

PENSACOLA SNF LLC,

d/b/a SOUTHERN OAKS REHABILITATION AND NURSING CENTER,

Respondent

                                                               I

ADMINISTRATIVE COMPLAINT

COMES NOW the Agency for Health Care Administration (hereinafter "Agency"), by and through the undersigned counsel, and files this Administrative Complaint against Pensacola SNF LLC, d/b/a Southern Oaks Rehabilitation and Nursing Center (hereinafter "Respondent"), pursuant to §§120.569 and 120.57 Florida Statutes (2011), and alleges:

NATURE OF THE ACTION

This is an action to impose an administrative fine in the amount of $5,00.0 based upon Respondent, pursuant to §400:23(8), Florida Statutes (2011). The imposition of this fine is based on one (1) Class II deficiency. The Agency also intends to impose a Conditional rating commencing June 10, 2011 and ending July 26, 2011.

JURISDICTION AND VENUE

1. The Agency has jurisdiction pursuant to§§ 120.60 and 400.062, Florida Statutes (2011).

   
   

2. Venue lies pursuant to Florida Administrative Code R. 28-106.207.

   
   

   1

   
   

   Filed December 7, 2011 2:58 PM Division of Administrative Hearings

   
   

   PARTIES

   
   

3. The Agency is the regulatory authority responsible for licensure of nursing homes and enforcement of applicable federal regulations, state statutes and rules governing skilled nursing facilities pursuant to the Omnibus Reconciliation Act of 1987, Title IV, Subtitle C (as amended), Chapter 400, Part II, Florida Statutes, and Chapter 59A-4, Florida Administrative Code.

4. Respondent operates a 210-bed nursing home, located at 600 West Gregory Street, Pensacola, Florida 32501, and is licensed as a nursing facility license number 1556096.

5. Respondent was at all times material hereto, a licensed nursing facility under the licensing authority of the Agency, and was required to comply with all applicable rules, and statutes.

   COUNT I (Tag N216)

   
   

6. The Agency re-alleges and incorporates paragraphs one (I) through five (5), as if fully set forth herein.

7. That pursuant to §400.102(1), Florida Statutes (2010), Florida law states: In addition to the grounds listed in part II of chapter 408, any of the following conditions shall be grounds for action by the agency against a licensee: (1) An intentional or negligent act materially affecting the health or safety of residents of the facility.

8. That an unannounced licensure survey was conducted between 6/6/11 and 6/9/11 in conjunction with CCR's # 2011004497 and 2011005284.

9. That based on observation, interview with staff and record review the facility failed to prevent the development of a pressure ulcer for 1 (#172) of 4 sampled residents.

10. Based on observation, record review and staff interview it was determined the facility failed to medicate for pain prior to staff intervention for wound assessment/care causing the

    
    

    resident to scream in pain for I (# 212) of2 sampled residents.

    
    

11. A review of the Minimum data set (MDS) dated 5/13/11 indicates a diagnosis peripheral vascular disease (PVD) with Cellulitis to the left foot.

12. The resident was assessed for having pain almost constantly. The resident was ordered Neurontin 300 milligrams three times a day for Depression and Hydrocodone 5/325 milligrams every 4 hours as needed for pain.

13. An observation of wound care on 6/6/11 at 3:34 pm to resident's left foot noted the foot to be swollen and red.

14. An interview with the wound nurse stated we have been treating the area on top of the

    
    

    left foot which is almost healed. He stated the resident has some macerated areas that are new today to the bottom of his left foot.

15. An observation noted several areas that were macerated with thick white wrinkled looking tissue and drainage noted. While the wound nurse was cleaning the area at 3:24 pm on the bottom of the foot the resident screamed in pain.

16. The wound nurse paused and then continued without asking the resident if he needed anything for pain.

17. A review of the 6/6/11 MAR indicated the resident had pain medication that morning at

    
    

    10:20 am. and did not have a dose prior to wound treatment.

    
    

18. An interview with wound care nurse and director of nursing on 6/9/11 in 4:15 pm indicated the wound nurse had not done the wound treatment but was assessing a new area.

19. The wound nurse did not stop treatment or assessment when the resident screamed in pam.

20. The Respondent's actions or inactions constituted an isolated Class II deficiency.

2 I. A class II deficiency is a deficiency that the Agency determines has compromised the resident's ability to maintain or reach his or her highest practicable physical, mental, and psychosocial well-being, as defined by an accurate and comprehensive resident assessment, plan of care, and provision of services. § 400.23(8)(b), Fla. Stat. (2011).

1. A class II deficiency is subject to a civil penalty of $2,500 for an isolated deficiency,

   
   

   $5,000 for a patterned deficiency, and $7,500 for a widespread deficiency. The fine amount shall be doubled for each deficiency if the facility was previously cited for one or more class I or class II deficiencies during the last licensure inspection or any inspection or complaint investigation since the last licensure inspection. A fine shall be levied notwithstanding the correction of the deficiency. § 400.23(8)(b), Fla. Stat. (2011).

2. Respondent was cited for two Class II deficiencies during the September 2010 relicensure survey (tags N203 and N216).

3. The Agency cited Respondent for a patterned Class II deficiency.

   
   

   WHEREFORE, the Agency intends to impose an administrative fine in the amount of

   
   

   $5,000 against Respondent, a skilled nursing facility in the State of Florida, pursuant to

   
   

   §400.23(8)(b), Florida Statutes (2011).

   
   

   COUNT II

   
   

4. The Agency re-alleges and incorporates paragraph one(!) through five (5) and Count I of this Complaint as if fully set forth herein.

5. Based upon Respondent's cited State Class II deficiency, it was not in substantial compliance at the time of the survey with criteria established under .Part II of Florida Statute 400, or the rules adopted by the Agency, a violation subjecting it to assignment of a conditional licensure status under § 400.23(7)(b), Florida Statutes (20I 0).

   
   

   
   

   WHEREFORE, the Agency intends to assign a conditional licensure status to Respondent, a skilled nursing facility in the State of Florida, pursuant to§ 400.23(7), Florida Statutes (2010) commencing June 10, 2011.

   CLAIM FOR RELIEF

   
   

   WHEREFORE, the State of Florida, Agency for Health Care Administration, respectfully requests that this court:

   1. Make factual and legal findings in favor of the Agency on Count I;

      
      

   2. Recommend an administrative fine against Respondent in the amount of $5,000;

      
      

   3. Impose a conditional license commencing June 10, 2011 and ending July 26 2011;

      
      

   4. Assess attorney's fees and costs; and

      
      

   5. Grant all other general and equitable relief allowed by Jaw.

      
      

      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 Election of Rights form. All requests for hearing shall be made to the attention of Richard Shoop, Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, MS #3, Tallahassee, Florida 32308, (850) 922-5873.

      If you want to hire an attorney, you have the right to be represented by an attorney in this

      
      

      matter.

      
      

      RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO REQUEST 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.

      
      

      Respectfully submitted this y of October, 201 1

      
      

      1. a. o. Agency for Healt C 2727 Mahan Dri e

Tallahassee, Florida 32308

(850) 412-3640

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing has been served by

U.S. Certified Mail, Return Receipt No. 7003 1010 0000 9715 1739 to Facility Administrator Andrea L. Pankhurst, Southern Oaks Rehabilitation and Nursing Center, 600 West Gregory Street, Pensacola, Florida 32501 and via email to Jonathan S. Grout, Esq., Goldsmith & Grout, P.A., 2431 Aloma Avenue, Suite 249, Winter Park, Florida 32792 on Octobe Oll.

Copy furnished to:

Donah Heiberg, FOM

Docket for Case No: 11-006207

Orders for Case No: 11-006207