STATE OF FLORIDA

AGENCY FOR HEALTH€ARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR FI LED

HEALTH CARE ADMINISTRATI1 'l OCT lO flrl ll 35

ZOil OCT -9

;-/\-.\ 9: 02

vs.

Petitioner,

DlV!SION o;=-

ADMINISTRATlfe\SE NO.: 12-002190MPI

11

,.R' 'f'S C.I. No.: 12-1992-000

KRIS WARD GROUP HOME,

HE

;.,.,

" "' PROVIDER No.: 6776183-96 JUDGE: LINZIE F. BOGAN

RENDITION NO.: AHCA-12- \0\'2_ -S-MDO

Respondent.

                                                                     I

FINAL ORDER

THE PARTIES resolved all disputed issues and executed a settlement agreement, which is attached and incorporated by reference. The parties are directed to comply with the terms of

the attached settlement agreement. Based on the foregoing, this file is hereby CLOSED.

DONE AND ORDERED on this· rza day of           , 2012, m

Tallahassee, Florida.

Agency for Health Care Administration

A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A SECOND COPY ALONG WITH FILING FEE AS PRESCRIBED BYLAW, WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE FLORIDA APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN 30 DAYS OF RENDITION OF THE ORDER TO BE REVIEWED.

Copies furnished to:

Kristina Louise Ward Kris Ward Group Home 338 5th Street

Homeland, FL 33847

Telephone: (863) 534-3601

Facsimile: (863) 534-3601 (SAME)

Email: n2racer@comcast.net

(Via Facsimile and Electronic Mail)

Tracie L. Hardin, Esquire

Agency for Health Care Administration

, 2727 Mahan Drive Building 3, Mail Station 3

Tallahassee, Florida 32308 (Via Electronic Mail)

Agency for Health Care Administration Bureau of Finance and Accounting 2727 Mahan Drive

Building 2, Mail Station 14

Tallahassee, Florida 32308 (Via Interoffice Mail)

Bureau of Health Quality Assurance 2727 Mahan Drive, Mail Stop 9

Tallahassee, Florida 32308 (Via Interoffice Mail)

Mike Blackbum, Bureau Chief Medicaid Program Integrity 2727 Ma..lian Drive

Building 2, Mail Station 6

Tallahassee, Florida 32308 (Via Electronic Mail)

Eric W. Miller, Inspector General Medicaid Program Integrity

2727 Mahan Drive

Building 2, Mail Station 6

Tallahassee, Florida 32308 (Via Electronic Mail)

Division of Administrative Hearings The Desoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060 (Via U.S. Mail)

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addressees by U.S. Mail, or the method designated, on this the ? ay of

'

    ,2012.

Richard Shoop, Esquire Agency Clerk

State of Florida

Agency for Health Care Administration 2727 Mahan Drive, Building #3

Tallahassee, Florida 32308-5403

(850) 412-3630

Docket for Case No: 12-002190MPI

Orders for Case No: 12-002190MPI