Respondent; i) 9 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, va AHCA No. 2012004570 AUTUMN HOME CARE OF _ SOUTH WESTERN FLORIDA, LLC d/b/a AUTUMN HOME CARE, 7 ADMINISTRATIVE COMPLAINT: COMES NOW, the Petitioner, State of Florida, Agency for Health Care Administration (“the Agency”), by and through its undersigned counsel, and files this Administrative Complaint against the Respondent, Autumn Home Care of South Western Florida, LLC d/b/a Autumn Home Care (“the Respondent”), pursuant to Sections 120,569 and 120.57, Florida Statutes, and alleges as follows: NATURE OF THE ACTION ' This is an action against a home health agency to impose administrative fines in the amount six thousand dollars ($6,000.00) based upon one violation. JURISDICTION AND VENUE 1, The Court has jurisdiction over the subject matter pursuant to Sections 120.60 and 120.57, Florida Statutes. Filed August 8, 2012 10:58 AM Division of Administrative Hearings Qo. e) 2, The Agency has jurisdiction over the Respondent pursuant to Sections 20.42 and: 120,60, and Chapters 408, Part II, and 400, Part II, Florida Statutes, | 3, . Venue lies pursuant to Rule 28-106.207, Florida Administrative Code.” PARTIES 4. . The Agency is the licensing and regulatory authority that oversees home health. agencies in Florida and enforces the applicable federal regulations and state statutes and rules governing home health agencies. Ch. 408, Part I, Ch. 400, Part Ill, Fla, Stat., Ch. 59A-8, Fla. Admin, Code. The Agency i is authorized to deny, | revoke, or - suspend a Jicense, and i ‘mposean ve ~—~-administative fine for voltion a provided in Setions 400.474 and 400484; Florida Statue; —— and Rules 39A4-8.003 and 594-8.0086, Florida Administrative Code,--.cc0--ne-e--—wemnemnee ee ccsncssee vneeeees ce es 5. The Respondent was issued a license by the Agency (License No. 299993223) to operate a home health agency located at 876 West Sugarland Highway, Clewiston, Florida 33440, and was at all times material required to comply with the applicable federal regulations and state statutes and rules governing home health agencies. COUNT I The Respondent Failed to Timely Notify the Agency of the Termination of the Services of its Director of Nursing in Violation of F.S. 400.476(2)(b) 6. The Agency re-alleges and incorporates by reference paragraphs | through 5, 7, Under Florida law, ... a home health agency that provides skilled nursing care and the director of nursing of a home health agency must notify the Agency within 10 business days after termination of the services of the director of nursing for the home health agency, A home health agency that provides skilled nursing care must notify the Agency of the identity and qualifications of the new director of nursing within 10 days after the new director is hired... . $400.476(2)(b), Fla. Stat. 9 mG) 8. Under Florida law, “director of nursing” means a registered nurse who is a direct employee, as defined in subsection (9), of the [home health] agency and who is a graduate of an approved school of nursing and is licensed in this state; who has at least one year of supervisory experience as a registered nurse; and who is responsible for overseeing the professional nursing and home health aide delivery of services of the {home health] agency. §400.462(10), Fla. Stat. 9, Under Florida law, “skilled are” 1 means nursing services or therapeutic services required by law to be delivered by a health care professional who is licensed under Part I of _ Chapter. 464; Part I, Part Il, or Part Vv of ‘Chapter 468; or Chapter 486 and who is employed by oo a on -aude: ontiat-with--eensed home health agency or ir-referet-by censet-nmse ves -.§400,462(28), Flea Stitt nn ence rn iso 10, ‘The Respondent, at all times material, provided skilled nursing care. i UL. On or about February 2, 2012, the Agency was notified that the former Director of . Nursing at the Respondent’s home health agency would be on extended medical leave as of February 1, 2012. 12, On or about April 6, 2012, the Agency received information that the former Director of Nursing at the Respondent’s home health agency was terminated as the Respondent’s Director of Nursing (“DON”) as of February 20, 2012. 13, The Respondent failed to inform the Agency that its DON resigned/was terminated within 10 business days of the termination of the services of the DON for the home health agency. Sanctions 14. Under Florida law, the Agency shall fine a home health agency that fails to notify the Agency as required in this paragraph $1,000 for the first violation and $2,000 for a repeat 4) 6 violation. §400.476(2)(b), Fla. Stat. WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, tespectfully seeks an administrative fine against the Respondent in the amount of one thousand dollars ($1,000.00). COUNT I The Respondent Operated For More Than 30 Calendar Days Without a Director of Nursing In Violation of F.S, 400,476(2)(b) 15. The Agency re-alleges and incorporates by reference paragraphs 1 through 5) "16." Under Florida law; a home healthy agency that provides skilled nursing care may _ ~ “ agency “that provides | “skilled nursing care ° operates: for more than 30 calendar days without ¢ a director of nursing, the home health agency commits a class II deficiency. § 400.476(2)(b), Fla, | Stat. | | 17. Under Florida law, “director of nursing” means a registered nurse who is a direct employee, as defined in subsection (9), of the {home health] agency and who is a graduate of an approved school of nursing and is licensed in this state; who has at least one year of supervisory experience as a registered nurse; and who is responsible for overseeing the professional nursing and home health aide delivery of services of the [home health] agency. § 400.462(10), Fla. Stat, 18. Under Florida law, “skilled care” means nutsing services or therapeutic services required by law to be delivered by a health care professional who is licensed under part I of chapter 464; part I, part III, or part V of chapter 468; or chapter 486 and who is employed by or under contract with a licensed home health agency or is referred by a licensed nurse registry. § 400.462(28), Fla. Stat, | \ | | ! i { ! santa director. of ung shall Batblih service policies and proces ircomplience with Chaprex pao eenenen O Q The Role of a Director of Nursing in a Home Health Agency 19, Under Florida law, the director of nursing of the home health agency shall: 1, Meet the criteria as defined in Section 400.462(10), Florida Statutes; 2. Supervise or manage, directly or through qualified subordinates, all personnel who provide direct patient care; . 3. Ensure that the professional standards of community nursing practice are maintained by all nurses providing cate; and, 4. Maintain and adhere to agency procedure and patient care policy manuals, Fla, Admin, Code R. 59A-8.0095(2)(a). 20. Under Florida Jaw, if the administrator i is not a physician or registered nurse, the ... 4B-16, Florida, Administrative Code,.and.state. health statutes-and-administrative-rules-pursuant ---~ - to Section 381,0011(4), Florida Statutes, which generally conform to recommended Centers for Disease Control (CDC) and Occupational Safety and Health Agency (OSHA) guidelines for safety, universal precautions and infection control procedures; 2. Employ and evaluate nursing personnel; 3. Coordinate patient care services; and, 4. Set or adopt policies for, and keep records of criteria for admission to service, case assignments and’ case management, Fla, Admin. Code R 59A-8,0095(2)(b) 21, — Under Florida law, the director of nursing shall establish and conduct an ongoing quality assurance program which assures: 1. Case assignment and management is appropriate, adequate, and consistent with theplan of care, medical regimen and patient needs; 2. Nursing and other services provided to the patient are coordinated, appropriate, adequate, and consistent with plans of care; 3. All services and outcomes are completely and legibly documented, dated and signed in the clinical service record; 4. Confidentiality of patient data is maintained; and 5. Findings of the quality assurance program are used to improve services. Fla. Admin. Code R. O oO 59A-8,0095(2)(0). 22. Under Florida law, in a home health agency with less than a total of 10 full time equivalent employees and contracted personnel, the director of nursing may also be the administrator. Fla. Admin. Code R. 59A-8,0095(2)(d). ) 23. The Respondent, at all times material, provided skilled nursing care. 24, . On or about April 6, 2012, the Agency was notified by the former DON that she : had been terminated by Respondent on February 20, 2012. 25. The Respondent operated for more than thirty (30) calendar days without a _ Annee _—Dirvector-of Nursing: ae 26. “Under Florida law, if a home health agency that provides skilled nursing care operates for more than 30 calendar days without a director of nursing, the home health agency commits a class II deficiency. § 400.476(2)(b) , Fla, Stat. . 27. Under Flotida law, upon finding a class II deficiency, the agency shall impose an administrative fine in the amount of $5,000 for each occurrence and each day that a deficiency exists. § 400.484(2)(b) , Fla. Stat, WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, respectfully seeks an administrative fine against the Respondent in the amount of five thousand | dollars ($5,000.00). CLAIM FOR RELIEF WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, respectfully seeks an order that: 1. Makes findings of fact and conclusions of law in favor of the Agency. CL (1) a ee 2. Imposes sanctions against the Respondent as set forth above. 3. Orders any other relief authorized by Jaw that is just and appropriate. Respectfully submitted on this up day of May, 2012. Bradford C. Herter, Assistant General Counsel Florida Bar No. 69060 Office of the General Counsel Agency for Health Care Administration 2727 Mahan Drive, MS 3 Tallahassee, Florida 32308 ~"Pelephone (850)'412:3630°" —— — . -Paesimile-(850)-924+0158————- neers NOTICE The Respondent has the right to request a hearing to be conducted in accordance with Sections 120.569 and 120.87, Florida Statutes, and to be represented by counsel or other qualified representative. Specitic options for the administrative action are set out within the attached Election of Rights form. The Respondent is further notified if the Election of Rights form is not received by the ’ Agency for Health Care Administration within twenty-one (21) days of the receipt of this’ Administrative Complaint, a final order will be entered, The Election of Rights form shall be made to the Agency for Health Care Administration and delivered to: Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Mail Stop 3, Tallahassee, FL 32308; Telephone (850) 412-3630. peeeeegte eter epee Oo” CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the Administrative Complaint and Election of Rights form were served to: Autumn Home Care, 876 West Sugarland Highway, Clewiston, Florida 33440 by U.S. Certified Mail 7010 1670 0000 1044 3305, and to Anthony M, Cataldo, Registered Agent, 208 Longshore Drive, Jupiter, Florida 33458, by U.S. Certified Mail 7010 1670 0000 1044 3336, on thist{ W day of May, 2012, Copies furnished to: Agency for Health Care Administration _ 2727 Mahan Drive, Mai! Stop #3 Tallahassee, Florida 32308 Telephone (850) 412-3630 Facsimile (850) 921-0158 Anthony M. Cataldo Registered Agent 208 Longshore Drive Jupiter, Florida 33458 (U.S, Certified Mail 7010 1670 0000 1044 3336) Jan Benesh Home Care Unit ; Agency for Health Care Administration (Electronic Mail) Bradford C. Hertex Assistant General Counsel Office of the General Counsel Agency for Health Care Administration (Interoffice) Autumn Home Care 876 West Sugarland Highway Clewiston, Florida 33440 (U.S. Certified Mail 7010 1670 0000 1044 3305) ion @) STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION Re: AHCAy, AUTUMN HOME CARE OF SOUTH WESTERN FLORIDA, LLC d/b/a AUTUMN HOME CARE, AHCA No. 2012004570 ELECTION OF RIGHTS This Election of Rights form is attached to a proposed agency 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 may be teturned by mail or by facsimile transmission, but must be filed within 21 days of the day that you receive the attached proposed agency action. If your Election of Rights with your selected (Please use this form unless you, your attorney or your representative prefer to rep y according to Chapter120, Florida Statutes, and Chapter 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. Telephone: 850-412-3630 Facsimile: 850-921-0158 PLEASE SELECT ONLY 1 OF THESE 3 OPTIONS OPTION ONE (1) J admit to the allegations of facts and law contained in the Notice of Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine, or ’ Administrative Complaint and 1 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 of Intent to Impose a Late Fee, 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, Notice of Intent to Impose a Late Fine, or Administrative oon A statementofwherrthe Ass 1 UUITID th Complaint, and I request a formal hearing (pursuant to Section 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 NOT 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, I must be received by the Agency Clerk at the address above within 21 days of your receipt of this proposéd agency action. The request for formal hearing must conform to the requirements of Rule 28-106,2015, Florida Administrative Code, which requires that it contain: 1, The name, address, telephone number, and facsimile number (if any) of the Respondent, 2. The name, address, telephone number and facsimile number of the attorney or qualified representative of the Respondent (if any) upon whom service of pleadings and other papers shall be made, 3. A statement requesting an. administrative hearing identifying. those material-facts that are in “dispute, If there até none, the petition must so indicate, Licensee Name: Contact Person: _ Title: a Address: Number and Street City Zip Code Telephone No. Fax No, __ a a s E-Mail (optional) I hereby certify that | am duly authorized to submit this Election of Rights to the Agency for Health Care Administration on behalf of the licensee referred to above. Signed: Date: Print Name: Title: COMPLETE THIS SECTION ON DEL IERY { ae AL: RE La No insurance i Print your né errs i dress on the reverse Cea 2 -go.that we oan'returd the card to you, : fy -Récelved by (Printed Name) in REIT © Alot thie dard totho back ofthe maiptecs, || f°) 1 i are) pPelivery o on visit oy , ‘on the front If apace permits. hit. a Lat Lt = | ¢ { A, D, Is delivery address different from iter 1? ELT Yes. m 1, Arlldte Addiessed to: If YES, enter delivery address below: C1No ~ . a umn. ; Autumn Home Care _ ri 9716 West . 876 West Sugarland Highway Sesh Clewiston, sda 33458 Clewiston, Florida 33440 Soni a ster, Flosida ’ , Service Type Fl ca Supt + See eee * WD Cortitted Mall J Express Malt a \ Cl Registered — Return Recolpt for Merchandise aR C1 insured'Mall 06.0.0, ~o ra fa] a a ~ 4, Restrloted Delivery? (Extra Fee) 7010 1b70 O000 LO44 3305 n_Lerremeror remreernre ranean none n PS Form 3811, February 2004 Domestio Roum raveipt : 102595-02.M-1640

Docket for Case No: 12-002625