STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

FILED

AHCA

AGHJCY CLERK

2813 MAR -Li A q: 01

vs.

Petitioner,

OLD DOAH CASE NO. 12-2298MPI C.I. No. 12-1831-000

Provider No. 9504451 00

CS CARE, INC., d/b/a COMPLETE SERVICE CARE OF FLORIDA, INC.,

Respondent.

NPI Number 1316058951

AHCA HME License No. 892 DBPR License No. 32851

RENDITION NO.: AHCA-(..J - i:::, M 6 - S- MDO

                                                                          I

FINAL ORDER

THE PARTIES resolved all disputed issues and executed a Stipulation and Agreement. The parties are directed to comply with the terms of the attached Stipulation and Agreement. Based on the foregoing, this file is CLOSED.

DONE AND ORDERED this ay of            

dministration

2o_Jj_, in Tallahassee, Leon County, Florida. 1

Page 1 of 3

Filed March 5, 2013 10:22 AM Division of Administrative Hearings

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 BY LAW, 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:

CS Care, Inc.

d/b/a Complete Service Care of Florida, Inc. ATTN: Carmen Sigas, President

7360 W. 20th AV, STE 139

Hialeah, Florida 33016-1847

June C. McKinney Administrative Law Judge

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060

Agency for Health Care Administration

Debora E. Fridie, Assistant General Counsel, MS #3

Agency for Health Care Administration Division of Health Quality Assurance

Agency for Health Care Administration Home Care Unit, MS #34

Agency for Health Care Administration Bureau of Finance and Accounting, MS #14

Agency for Health Care Administration Bureau of Medicaid Program Integrity, MS#6 ATTN: Mike Blackburn, Bureau Chief

Florida Department of Health

CERTIFICATE OF SERVICE

e

I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order was furnished by United States Mail, interoffice mail, or email transmission to the above-referenced addressees this       day of /1--/a,rc:..Ct_ , 20Q_.

R Cle Agency for Health Care Administration

2727 Mahan Drive, MS #3

Tallahassee, Florida 32308

Telephone No. (850)-412-3630

Fax No. (850)-921-0158

Docket for Case No: 12-002298MPI

Orders for Case No: 12-002298MPI