v.
ADMINISTRATIVE COMPLAINT
NATURE OF THE ACTION
This is an action to revoke the assisted living facility license of funwil Assisted Living [License No,: 9975] pursuant to section 408.815(1)(c)&(d), and Section 429.14(1)(e), Florida Statutes, and to impose an administrative. fine of
$35,500.00 pursuant to Sections 429.14 and 429.19, Florida Statutes (2011), for the protection of public health, safety and
welfare and to impose a survey fee in the amount of $500. 00 pursuant to Section 429.19(2) (c) and 429.19(7), Florida Statutes (2011). Section 429.14 (1) (e), Florida Statutes, provides that the Agency may revoke or deny or suspend an assisted living facility's license if the facility is cited with one or more Class I deficiencies. In thi' case, the facility has been cited with three (3) Class I violations. Section 408,815(1) (c)& (d), Florida Statutes, provides that the Agency may revoke a license for a violation of "this part, authorizing statues, or applicable Rules" or "for a demonstrated pattern of deficient practice". The Agency has considered the factors outlined in Section 419.19(3), Florida Statutes, in imposing the penalty and fixing the amount of the fine.
JURISDICTION AND v;ENUE
This Court has jurisdiction pursuant to Sections
120.569 and 120.57, Florida Statutes (2011), and hapter 28-106, Florida Administrative Code (2011).
venue lies pursuant to Rule 28-106. 207, Florida Administrative C.ode (2011).
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 (2011), and Chapter 58A-5 Florida Administrative Code (2011).
Amwil Assisted Living, Inc operates a 75-bed assisted living facility located at 840 s. W. 8 t h Street, Pompano Beach, Florida 33060. Amwil Assisted Living, Inc. is licensed as an assisted. living facility under license number 9975. Amwil . Assisted Living, Inc. 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.
On Marc.h 24, 2012, the Agency entered an Emergency Suspension of License Order and Moratorium on Admissions because the Agency found that the current conditions at the· assisted living facility presented a direct and immediate threat to the heal th, safety or welfare of the residents and warranted the imposition of an · immediate moratorium on admissions and suspension of Respondent's license.
COUNT I
AHCA re-alleges and incorporates paragraphs (1)
through (5) as if fully set forth herein.
Amwil Assisted Living, Inc. was cited with four (4) Class I deficiencies and two (2) Class II deficiencies as t.he result of licensure survey and a complaint investigation survey
.that were conducted·on March 23, 26, and 27 2012. Additionally, on March 24., 2012, as a result of these surveys, an Emergency Suspension of License Order and Moratorium on Admissions was placed on Amwil Assisted Living, Inc. [AHCA No.: 2012003330).
A survey was conducted on March 23, 2012. Based on observation, interview and record review, it was determined that the facility failed to provide appropriate care and services to the residents to ensure the safety of· the residents as evidenced, among other factors, that Resident #1 was left unsupervised while waiting for the paramedics to arrive, that Resident #1 was not listed in the diabetic log, and that Resident #1's blood sugars were not monitored from July 2011 through March 23, 2012, even though the Resident has been
prescribed Metformin 3 x per day since January of 2012. The findings include the following.
10, On 03/23/12 at 9:05 a,m., the survey team was preparing to enter the facility for their biennial survey. While walking up to the facility, an emergency fire vehicle arrived in front of the facility. Upon entrance through the facility gate, a resident was observed to be sitting in the inner courtyard slumped over in a wheelchair. Four other residents were observed to be sitting outside in close proximity to resident #J.. There was no observation of a facility staff member attending to resident #1. The EMS team was observed to approach resident #1 and initiated an assessment at which time a staff member came outside and stated she called 911 for resident #1.
At 9:10 a. m., an interview was conducted· with one of the paramedics who concurred there were no staff members outside with resident #1 when they arrived. Additionally he stated 'they have been to this facility many times and this is par for the course' . He further stated 'there have been times when we have to do a 360 around the facility to find out which resident they have been called to see.' Resident #1 was assessed by EMS and transported to the hospital.
On 03/23/12 at 9:30 a.m., an interview was conducted with the staff member who called 911 and who identified herself as a Certified Nursing Assistant (CNA), medication technician
and additionally stated she was the person in charge while the Administrator was not in the building. She stated she noted the resident to be weak looking and she took his blood sugar with a result of 692 (normal range 70-105) so she called 911.
She further stated she is not supposed to do blood sugars and it is the responsibility of the home health agency to do that. Additionally, she stated resident #1 is a diabetic and they have a list of all the diabetic residents. Review of the diabetic log for insulin dependent and non-insulin dependent residents revealed resident #1 was not on the list. During the interview with the CNA medication technician on 03/23/12 at 9:30
a.m. she shrugged her shoulders and could not explain why resident #1 was not on the list of diabetic residents.
Review of resident #l's Medication Administration Record (MOR) revealed· an entry dated 07/14/11 for Humulin R Insulin with a sliding scale for coverage subcutaneously depending on the result of the blood sugar. Next to this entry it states 'Home Health Nurse'. On 03/23/12 at 9:45 a.m., an interview was conducted with the CNA medication technician who stated the resident had home health services :Ln July 2011 but that was only for a couple of weeks. She further stated that the ALF staff does not monitor resident #1's blood sugars and that the resident does not do his own blood sugar testing.
Review of the medical record for resident #1 revealed a laboratory requisition dated 08/22/11 documenting the fasting blood sugar was 240 (normal range 70-105)', There were no further laboratory results available for review.
On 03/23/12 at 10:10 a.m., an interview was ·conducted with the Administrator who stated they have a list of diabetics and dietary also has the list. An inquiry was made as to why resident #1 was not on that list andthe Administrator responded by saying she was not aware resident #1 was diabetic.
On 03/23/12 at 11:05 a,m., an interview was conducted with the ALF kitchen cook who stated they have a list of all residents who· are diabetic and that is how they know what foods they can and cannot have. An inquiry was made as to why resident #1 was not on that· list andthe cook stated she was not aware resident #1 was diabetic.
Review of the latest 1823 Health Assessment dated 01/19/11 completed by the physician, revealed under "diagnosis" no documentation that the resident was. diabetic. Under Special Diet Instructions this section did not document the resident to be on a diabetic diet. Under current medications there is no evidence of documentation of diabetes medication.
Review of the Progress Notes revealed the last entry dated 12/08/11 documenting the resident was seen by the primary
doctor and the Metformin (diabetes medication) was increased to three times a ·day;
Review of the January, February, and March MOR revealed the resident was receiving Metformin three times daily. Further revi'ew of the clinical record revealed no evidence of documentation resident #l's blood sugars were being monitored.
On 03/23/12 at 12: 10 p.m., the Administrator, a:f;ter having a telephone conversation with the CNA medication technician, confirmed they were not monitoring resident #l's blood sugars since the home health agency monitored resident #1's blood sugars for 2 weeks back in July. Additionally, the Administrator stated the CNA medication technician may not have been supervising the resident after she called 911 because she may have been making copies of the resident's record for the paramedics. The Administrator further stated during the interview on 03/23/12 at 12:10 p.m. "If we didn't know he was a diabetic then I guess we were not checking his blood sugars."
On 03/26/12 at 12: 56 p.m. a telephone interview was conducted with a Case Manager of the hospital resident #1 was transported to on 03/23/12. The Case Manager confirmed resident #1 remained hospitalized with a discharge date still undetermined;
Based on the foregoing facts, Amwil Assisted Living, Inc. violated Rule SSA-5.0182(1), Florida Administrative Code,
herein classified as a Class II violation, which warrants an assessed fine of $3,000.00.
COUNT II
AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein.
A survey was conducted on March 23, 26, and 27 2012. Based on observa·tion, record review and interview, it was determined the facility failed to ensure residents are treated with dignity, respect and live in a safe environment, free from neglect and abuse, Residents are not ·provided with enough food. The _facility has a pest infestation and does not have sufficient washing machines or dryers to handle the capacity of laundry for
50 residents, There is no separation of clean and dirty laundry and there is water damage throughout the facility. The findings include the following.
During an interview on 3/22/12 at 9:30 AM with 2 random residents, it was stated they were buying their own roach
killer because the facility was infested. They also stated they were being bit by something but didn't know what it was. The residents also stated they are not able to do their laundry because the washers and dryers do not work, the food is terrible, and they do not get enough to eat.
Staff members were observed throughout the survey on 03/23/12 between the hours of 9:20 AM and 3 PM, carrying resident's clean and dirty laundry in shopping carts that were also used to carry garbage and other trash items to garbage bins and trash areas.
Observations of the laundry area on 3/23/12 revealed resident's clothing and linen were· thrown throughout on the floors and shelves. A subsequent interview with staff members revealed some of the clothing was clean and some dirty (dirty items not segregated from clean items). It was revealed only two washers work and it takes a long time to do the wash. Clothes and linens were also seen on the clothes line near trash and were still dirty but staff stated these items had already been washed. Piles of dirty resident blankets, sheets, and clothes were in 3 metal shopping carts lined up beside each other. A few feet away were what the staff member identified as a resident's clean laundry, clothes, and sheets. A staff member reported that two of the three washing machines do not work, and that two of the three dryers do not work.
During interview on 3/23/12, 3 of the housekeeping staff stated that they had seen bugs on the sheets a couple of days ago, but the washing machines are broken so they cannot get the laundry done. The machines are not capable of handling the capacity for·the census of 50 residents.
Observations made of the disposal of approximately 15 to 20 mattresses and pillows at 9:30 a .m. on 3/23/12 revealed .. all had numerous· rips, holes, and stains, including black spot stains. An ·interview at 9:30 a.m. on 3/23/12 with Resident Care Aids assisting in the disposal of the mattresses confirmed that these were the current mattresses used by the residents, but were being discarded today since a majority of the residents had moved out.
Random confidential inte.rviews with residents between the hours of 9:30 AM and 2 PM on 03/23/12 revealed the facility wasnot serving adequate meals; many days they ran out of food and the food was unattractive and very often lacked taste. A confidential interview with a staff member at approximately 10:20 AM on 3/23/12, confirmed that many days within the week,
the
'
kitchen runs out of food at meal times. It was also revealed
the person in charge of the food · (Cook #2) does not allocate sufficient amounts of food to be cooked and he is the only person who has a key to the food storage areas (including refrigerated and freezer items).
An attempt to tour the residents' rooms and bath.rooms in building #1 and #3 between the hours of 9:30 AM and 10:05 AM on 03/23/12, revealed numerous insects (roaches and bedbugs) and insect droppings. A telephone referral was made to the Broward County Health Department due to the environmental concerns. All four buildings are infested with bed bugs, roaches, and other pests.
The Department of Health was contacted due to the numerous sanitation, environmental concerns, and non-working appliances, and inspected the facility. During the inspection conducted by the Broad County Health Department (BCHD) on 3/23/12, numerous violations were noted as per their inspection report for water damage throughout the facility, large amounts of live and dead roaches found throughout the facility, no separation of clean and dirty laundry, only one washing machine and one dryer were working, unclean laundry carts, and seven cats outside with no proof of vaccination.
Approximately 10 cats were observed throughout the
. facility's prope_rty. An interview with the Administrator revealed the facility had not vaccinated any of these animals to ensure the safety of the residents at the facility.
During the survey on 3/23/12, confidential interviews with Staff Members between the hours of 9:30 AM and 3 PM, revealed the Owners refused to make numerous repairs and
purchase needed items in the facility including hiring pest control to eliminate the bed bugs and roaches, Staff members confirmed they had also . been bitten numerous times by these pests.
Review of pest control reports for the year of 2011 and 2012 failed to indicate any treatment for· bedbugs, even though the facility said the pest control company treated for bedbugs. It was also documented on the pest control invoices there was extreme moisture throughout the facility. However, the facility failed to make repairs to resolve this matter to prevent building problems associated with this moisture, An interview with Owner #2 at 11: 30 AM on 3/27 /12, confirmed the facility has bedbugs and the current pest control company does not treat bedbugs,
During an interview on 3/22/12 at 10:30 AM with facility cook #1, it was acknowledged the facility sometimes does not have enough food for the residents depending on what she cooks. The cook reported she does not have the ability to cook more food due to Cook #2, who is Owner #2' s brother, has the key to all food storage and does not issue any additional food.·
At 9: 55 AM on 3/23/12, a Resident Aide was observed with clean linen in a supermarket shopping cart pushing the cart around facility from building to building with dirty clothes
placed on bottom. of shopping cart and clean linen on top of cart.
Random confidential interviews with residents during the survey between the hours of 9:30 AM and 3 PM on 03/23/12, revealed the facility has runs out of daily meals very often and that many of the residents don't get enough to eat or no meal. The confidential interviews also revealed a few residents had even gotten sick from the meals. It was also revealed that roaches and bedbugs are in their rooms and some reported they had been bitten.
4 0. Based on the foregoing facts, Amwil Assisted Living, Inc. violated Section 429.28(1), Florida Statutes, Rule 58A-
5. 0182 (6), Florida Administrative Code, herein classified as a Class I violation, which warrants an assessed fine of
$10,000.00.
COUNT III
41. AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully | set forth her.ein. | ||
42. A survey was | conducted on March 23, | 26, | and 27 2012. |
Based on observation, record review and interview, it was determined the facility failed to ensure the administrator and person (s) designated in writing by the administrator shall be responsible for total food services, the day to day supervision of food services staff and performed his/her duties in a safe and sanitary manner. The findings include the following.
During kitchen/food sanitation tour with Cook #1/Food Manager and Cook #2 conducted by surveyors on . 3/23/12 at 10: 00 AM the following was observed:
Both of the interior ·fan vents located in the reach in refrigerator were leaking water onto the food stored on shelving and blackish debris was noted to be accumulating on the bottom of the refrigerator unit. It wasalso observed 8 bags of unknown resident's food was not labeled or dated and mixed with the resident's facility food. A box of tomatoes, a bag of cucumbers, a head of lettuce, and a bag of carrots were wet, slimy and rotting.
At 10:40 AM a sleeve of bologna was observed open, sitting on the counter at room temperature. The bologna was warm and a pot of beans was also sitting on the stove at room temperature. The cook stated she was getting ready for lunch. A pan of fish was thawing out on the counter at room temperature
and the cook stated that was for dinner. The fish was already thawed out.
The exhaust hood located above the stove was heavily soiled.
A chemical test was conducted on the 3-compartment sink and revealed there were insufficient sanitizing chemicals in the solution. An observation of the dish machine revealed. it
was not in working order. Black dirty water was back flowing into the machine contaminating the dishes.
The cabinet under the sink has major water damage and the wood is rotted and crumbling. Rodent droppings were also observed throughout. A pile of unknown insect like substance/particles was also observed i'n left back corner of cabinet (approximately 4 to 5 cm high) . A damp like smell was extremely prevalent in the cabinet.
In a room off of the kitchen, a reach-in freezer did not have a thermometer and observation revealed that foods within the unit were thawed out including: multiple bags of Pancakes, French .toast, bread, bagels, and packages of American cheese and individual packages of cream cheese.
A second reach-in freezer, also located in the room, revealed a temperature reading of 30 degrees F, instead of zero degrees F or lower, arid contained a bag of unidentified fish, Theowner's family member stated it was his fish.
The facility failed to purchase the foods from approved government sources; it was revealed the fish was caught by the facility family member and comingled with resident food. Bacon, wrapped in a clear wrap, was covered in freezer burn; beef ribs in a clear wrap had freezer burn and were open and not dated. A pan of chicken pieces were all freezer burned.
A large pan of thawed chicken was noted to be discolored. An interview with Food Manager #2 and the Cook revealed the length of time in· the refrigerator could not be identified.
The ice machine was extremely dirty inside and outside. The machine was rusting and peeling in numerous locations on outside of the machine.
Toaster had large accumulated amounts of food debris and dirty.
Cabinets throughout kitchen were observed to contain
insect droppings throughout.
;
The walls in the kitchen were observed to have numerous accumulated particles.
There were two vents noted to be extremely dirty.
Numerous boxes of expired food found in pantry were removed by the cook.
Two freezers were observed outside in closets (located in patio area). The exterior door of both freezers was observed
extremely filthy. Thefreezer on left side in storage room was observed with icicles throughout freezer and buildup of ice on the interior. Several shelve areas surrounding freezer were extremely dirty, wet and moldy. Second freezer on right side in storage room was observed extremely filthy inside with large amounts of ice build-up, dirt, wet, and moldy.
The Department Of Health was contacted immediately due to the serious sanitation concerns and non-working appliances. The Broward County Health Department inspected the facility on 3/23/12. The CHD suspended all food service in the kitchen/dining area until re-inspection.
Based on the foregoing facts, Amwil Assisted Living, Inc. violated Rule 58A-5.020(1), Florida Administrative Code, herein classified as a Class I violation, which warrants an assessed fine of $10,000.00.
COUNT IV
AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully set forth herein,
63, A survey was conducted on March 23, 26, and 27 2012. Based. on observations, record review and interview, it was determined the facility failed to ensure that it had adequate financial resources to meet the resident needs and failed to operate . the facility on sound financial basis. The findings include the following.
64, The facility was inspected by the Broward County Health Department (BCHD) on 03/23/12 as a result of the Agency for Health Care Administrator referral to same for kitchen sanitation and environmental concerns. On 3/23/12 the facility's kitchen was shut down and no food operation or preparation was allowed until the BCHD returned and re-inspected the kitchen.
The facility was informed by the BCHD that all refrigerated/freezer food items had to be discarded and could. not be used. The BCHD informed the facility that all food served had to already be prepared and ready to be served. The facility was prohibited from cooking and preparation in the kitchen.
66, During an interview with the Administrator at 11 AM on 3/23/12,, it was revealed the facility's census was 51 residents. Upon questioning of the Administrator regarding availability of financial resources to ensure that the residents would receive adequate food and drinks during the· period of closure of the kitchen, the Administrator calculated the required funds needed
as approximately $2000 to provide meals from Friday lunch (3/23/12) until Monday morning (3/26/12),
The facility's Administrator revealed to the surveyors that she had one blank check endorsed by the Owners and $100
dol.lars in cash. The Administrator revealed she would purchase lunch for the residents and go get cash at the bank. At approximately 1: 30 PM on 3/23/12, the Administrator left the facility to acquire cash to allow the facility to purchase take out food for the residents for the entire weekend (3 meals a day) and other dietary requirements,
The Administrator returned to the facility at 2:30 PM, and informed. the surveyors that she was unable to get cash. The bank would not cash the check and she was not an authorized person on the account. The Administrator informed the surveyors that she did not have any money to feed the residents.
At about 2:45 PM on 03/23/12, the Administrator informed the surveyor team that a Resident Care Aide was going to lend the facility $2000 in cash. The Resident Care Aide's husband arrived at approximately 3: 15 PM with $2000 in cash and handed it to the Administrator. The Administrator gave the Resident Care Aide and her husband an.IOU for $2000 and promised that the money would be paid in full by April 4, 2011 (copy of the IOU/promissory note obtained).
The Administrator ·stated since the Owners were out of the country, they could not be reached, and she was not sure when they would return, she would not be able to return the money until 04/04/12. Further interview with the Administrator at 3: 30 PM on 3/23/12, confirmed. that she did not have any access to any additional cash other than the cash lent by the employee. It was revealed the Owners had not authorized her access to any of the facility's financial resources at the bank. It was revealed the Owners in the past would just give her cash or pay for any items needed by the facility when they came down to visit once a week from Orlando (their hometown).
Upon request of the facility's financial records from
the Administrator, it was revealed that only the Owners had access to the financial records and financial resources; and that she did not have the ability to provide any information regarding the current finances of the facility. The Administrator also informed the surveyor that with the Owners being out of the country and unable to be reached, that she had no access to the facility's financial resources to provide food or to pay for any repairs, unless they would take a check.
According to the Administrator, the only money she had was the
$2000 that was loaned by the Resident Care Aide on that day.
During the survey, numerous confidential interviews with Staff Members between the hours of 9: 30 AM and 3 PM on
03/23/12 revealed· the Owners refused to make numerous repairs andpurchase needed items in the facility.
During an interview with the Administrator at 9:10 AM on 3/26/12, the Administrator stated that she had reached the Owner by phone late Saturday night. The owners revealed they were out of the country. She had not received any additional funds from the Owners to purchase .take-out meals for the residents, to make repairs to the kitchen, or repay the loan to the Resident Care Aide. It was also revealed the Owner did not inform her when they would be back and had not made any preparation to ensure that the Administrator had the financial resources available to ensure the operation of the facility and the safety and well-being of the residents;
7 4. According to the Administrator, the facility only had
$850 dollars in cash at the present time and still hadto buy lunch. Review· of the receipts of food purchased revealed the facility did not ensure adequate substituted meals were provided to rrieet all the dietary needs. It was also noted the facility hadnot purchased any additional beverages for the residents to consume outside of the three main meals.
A confidential interview with an employee at 10: 50 AM on 03/26/12, revealed the facility had not completely followed the BCHD orders not to prepare any food items in the kitchen. It was also revealed the facility had not spoken with its
consultant licensed dietitian to ensure adequate nutritional value was provided with the substituted meals.
Upon arrival of the BCHD and re-inspection of the. kitchen at 9:30 AM on 3/26/12, all the violations had not been corrected. Therefore, the kitchen would remain shut-down and they would not return until all r_ pairs and violations had been corrected. Further interview with the Administrator revealed the funds she had available would not be sufficient to maintain and provide meals to the current residents. And she confirmed that due to the absence of the Owners, it would be impossible to ensure 3 meals a day until the kitchen opened.
At approximately 2:10 PM on 3/26/12, the Administrator informed .the surveyor that she got $2500 from the bank. However, she was not able to prove that the funds came from the bank and that she could provide food for the residents. During the interview with the Administrator at 2:30 PM on 3/26/12, the Resident Care Aide (employee that lent . the money on 3/23/12) returned to the office and requested all her money back. She informed the Administrator that she and her husband needed their money now and could not afford to be without the $2000 she had loaned to the facility. At that time, the Administrator tried to convince the Resident Care Aid that the owners would return her money but the employee again requested that the money be returned. The Administrator at that time asked if she could give
$1000 back but the employee again requested the return of all the money. The Administrator returned the $2000 in cash to the employee and was. now only left with $500 dollars out of the
$2500 she had gotten from the bank on that day. The Administrator confirmed she only had about $700 dollars total in
cash.
78. On 03/30/12 at
9:45 AM,
the Administrator provided
bank .statements from to
09/11
to 2/30/12. Review of the
facility's bank statements revealed many concerns regarding the expenditure of the facility's cash resources. The following concerns were noted:
· The Owners were transferring funds from the facility's business account monthly to the Owners' family trust.
On 2/6/12 the Owner withdrew a check for $50,000 to self. According to Owner #1 . (by phone on 03/30/12 at 9: 40 AM), she was getting the money back that she had loaned the facility. Sherevealed she had no documentation of this loan.
Bank statements for month ending 1/31/12 revealed the facility hada minus $2700 checking balance. Balance sheets for the month of January 2012 revealed a positive balance.
ct. There were numerous other expenses noted on the
bank statements ( 9/11-2/12) that were personal and had nothing to cjo with the well-being of the residents. For example, $457 payment to pediatric office and numerous other expenses. Bank
statements for each month revealed numerous purchases for fast food restaurants, international purchases at stores, personal cable bill for the Owner and various miscellaneous charges.
An interview with the Owners· at 10: 40 AM on 03/27 /12 revealed the facility uses the facility's business account to deposit all of the resident's funds ( including Representative payee funds). Further interview with the Owners revealed the facility had not established a separate account for all funds received on behalf of the residents, and that the facility had not established a separate account for those residents for which the facility was the Representative payee. Moreover, the facility was comingling resident funds with facility funds even though this is prohibited under the law. Rule SBA-5.021(4) (a) 1 Florida Administrative Code, provides that "comingling of resident funds with facility funds is prohibited."
Review of bank statements provided by the Owners on 03/30/12, revealed it was impossible to distinguish or separate the facility's funds from the resident's funds.
Based on the foregoing facts, Amwil Assisted Living, Inc. violated Rule 58A-5. 021 (1) & ( 3) & ( 4) , Florida Administrative Code, herein classified as a Class I violation, which warrants an assessed fine of $10,000.00,
COUNT V
AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein.
A survey was conducted March 23, 26, and 27 2012.
Based on record review and interview, it was determined that the facility failed to ensure 2 out of 6 sampled employee files contained documentation of compliance with the background screening requirements (Employee #1 and #6).The findings include the following.
Rev.iew of Employee #1's personnel record revealed she has been employed with the facility since 05/21/2002 to provide direct personal care services to residents, including assisting with self-administration of medications. Further review of the file revealed documentation of an FDLE and FBI background screening that documented the following: "date arrested/fingerprinted: 10/18/2010; FBI identification record:
1) Arrested or Received 03/11/2000-charge 1-Fraud; 2) Arrested or Received 04/24/2006-charge 1-deportation only".
Upon interview with the Administrator on 03/27/2012 at approximately 11:00 AM, she stated the facility had documentation of compliance with the background screening requirements for Employee #1. However, further investigation revealed the Administrator could not provide documentation of compliance. On 03/27/2012 at approximately 11: 30 AM, the owner of the facility attempted to gain access to the AHCA background screening results database, but was unsuccessful due to a discrepancy with the facility's password.
Review of Employee #6' s personnel record revealed she has been employed with the facility since 09/14/2011 as a cook, During several observations throughout the day on 03/23/2012, 03/26/2012 and 03/27/2012, Employee #6 was observed entering and exiting resident living areas, as well as personally serving food to the residents residing at the facility. Review of Employee #6' s personnel record revealed the file lacked documentation of compliance with the background screening requirements.
Based on the foregoing facts, Amwil Assisted Living, Inc. violated Section 429.174, Florida Statutes, Section
408. 809, Florida Statutes, Section 435. 02 (2), Florida Statutes, Section 435. 06, Florida Statutes, herein classified as a Class II violation, which warrant.s an assessed fine of $2,500.00.
·SURVEY FEE
Pursuant to Section 429.19(7), Florida Statues (2011), AHCA may assess a survey fee in the . amount of $500, 00 to cover the cost of conducting initial complaint investigations. that result in the finding of a violation that was the subject of the complaint or monitoring visits.
CLAIM FOR RELIEF
Enter a judgment in favor of the Agency for Health care Administration against Amwil Assisted Living, Inc. on Counts I through V.
Revoke the assisted living facility license [License No.: 9975] of Amwil Assisted Living, Inc. based on Counts 1 through V cited above.
Assess an administrative fine of $35,500.00 against Amwil Assisted Living, Inc. on Counts I through V for the violations cited above.
Assess a survey fee of $500. 00 against Amwil Assisted Living on Counts I through V 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 pursqant to Sections 120.569 and 120.57, Florida Statutes (2011). Specific options for administrative action are set out in the attached Election of Rights. All requests for hearing shall be made to the Agency for Health Care Administration, and delivered to the Agency Clerk, Agency £or
Health Care Administration, Tallahassee, Florida 32308.
2727 Mahan Drive, MS #3,
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
c:Fl£a. Bar ,No-.: 9974315
:rt
Assistant General Counsel Agency for Health Care Administration
8333 N.W. 53 Street
Suite 300
Miami, Florida 33166
Copies furnished to:
Arlene Mayo-Davis Field Office Manager
Agency for Health Care Administration 5150 Linton Blvd. - Suite 500
Delray Beach, Florida 33484 (U.S. Mail)(Interoffice Mail)
CERTIFICATE OF SERVICE
Receipt Requested to Gail L. Peters, Administrator, Amwil
Assisted Living, Inc., 840 S. w, a t h Street, Pompano Beach, Florida 33060 on this u_Z%-ay of . £1,e.c.;e , 2012.
,ftf..
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
RE: Amwil Assisted Living, Inc. d/b/a Amwil Assisted Living, Inc.
AHCA No.: 2012003838
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 Notice of Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine or 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 Chapter 120, Florida Statutes (2006) 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) I admit to the allegations of facts and law contained in the Notice
of Iiitent 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 admit to the allegations of facts contained in the Notice oflntent
to Impose a Late Fee, the Notice of Intent to Impose a Late Fine, or 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 Notice of Intent
to Impose a Late Fee, the Notice of Intent to Impose a Late Fine, 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.
PLEASE NOTE: Choosing OPTION THREE (3), by itself, is 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:
I. 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.
A statement of when you received notice of the Agency's proposed action.
· 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), _
Ihereby 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
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10259. ·M-1540:
| Issue Date | Document | Summary |
|---|---|---|
| Oct. 08, 2013 | Agency Final Order | |
| Oct. 08, 2013 | Agency Final Order |
