STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION AGENCY FOR HEALTH CARE ADMINISTRATION , Petitioner, AHCA No. 2012003713 Return Receipt Requested: 7009-0080-0000~0586-5686 Vv. NORY’S HOME SERVICES, INC., Respondent. ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (“AHCA”), by and through the undersigned counsel, and files this Administrative Complaint against Nory’s Home Services, Inc. (hereinafter “Nory’s Home Services, Inc.”), pursuant to Chapter 400, Part III, and Section 120.60, Florida Statutes, (2011), and alleges: NATURE OF THE ACTION 1. This is an action to revoke the license and impose a $1,000.00 fine, pursuant to Section 408.815(1)(c), Florida Statutes (2011), and Chapter 59A-8, Florida Administrative Code for the protection of the public health, safety and welfare. JURISDICTION AND VENUE 2. This Court has jurisdiction pursuant to Sections 120.569 and 120.57, Florida Statutes, and 28-106, Florida Administrative Code. Filed October 1, 2012 1:15 PM Division of Administrative Hearings 3. Venue lies pursuant Rule 28-106.207, Florida Administrative Code. PARTIES 4, AHCA is the regulatory authority responsible. for licensure and enforcement of all applicable statutes and rules governing home health agencies, pursuant to Chapter 400, Part III, Florida Statutes (2011), Chapter 408, Florida Statutes (2011) and Chapter 59A-8, Florida Administrative Code. 5. Nory’s Home Services, Inc. opérates a home health agency located at 12966 S.W. 1337¢ Court, Suite A, Miami, Florida 33186. Nory’s Home Services, Inc. is licensed as a home health agency, license number 299992473, with an expiration date of August 8, 2012. Nory’s Home Services, 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. COUNT TI NORY’S HOME SERVICES, INC. FAILED TO PROVIDE AT LEAST ONE SERVICE DIRECTLY TO A PATIENT FOR A PERIOD OF 60 DAYS Section 400.474(1)&(2) (e), Florida Statutes, and/or Rule 59A- 8.008, Florida Administrative Code (DIRECT SERVICES) 6. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. During the State Licensure survey conducted = on 02/27/2012 and based on record review and interview, it was determined that the home health agency failed to provide at least one service directly to a patient for a period of 60 days. 8. The surveyor requested to review payroll documentation for the caregivers providing services. During an interview conducted on 2/27/2012 at approximately 10:20 am with clerical staff responsible for payroll, the surveyor explained that all the home health aides are independent contractors, and are issued 1099s, During an interview with the home health agency's administration conducted on 2/27/2012 at 1:38 pm, clerical staff provided English/Spanish translation for the Administrator/owner. Clerical staff explained that the home health agency previously applied for accreditation with Joint Commission, and was told they had to choose nursing as their direct service. Clerical staff explained that the application dated 5/11/2010, reflects nursing as their direct service, and home health aide as their contracted service. Clerical staff stated that the home health agency is not providing nursing services. Clerical staff stated that the home health agency is only providing non skilled care and services. Clerical staff stated that the director of nursing does not see patients providing skilled care. The home health agency's administration was unable to provide documentation demonstrating that at least one service was being provided directly to a patient for a period of 60 days. 9. Based on the foregoing, Nory’s Home Services, Inc. violated Section 400.474(1)&(2) (e), Florida Statutes, and/or Rule 59A-8.008(4), Florida Administrative Code, which carries, in this case, a revocation of license and a $1,000.00 fine. PRAYER FOR RELIEF WHEREFORE, the Petitioner, State of Florida Agency for Health Care Administration requests the following relief: A. Make factual and legal findings in favor of the Agency on Count I. B. Revoke the Respondent’s license and impose a $1,000.00 fine, pursuant to Sections 408.815(1)(c), and 400.474, Florida Statutes (2011). Cc. 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 pursuant to Sections 120.569 and 120.57, Florida Statutes (2011). Specific options for administrative action are set out in the attached Election of Rights Form. All requests for hearing shall be made to the Agency for Health Care Administration, and delivered to the Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop #3, Tallahassee, Florida 32308, attention Agency Clerk, telephone (850) 922-5873. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO RECEIVE A REQUEST FOR 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. IF YOU WANT TO HIRE AN ATTORNEY, YOU HAVE THE RIGHT TO BE REPRESENTED BY AN ATTORNEY IN THIS MATTE ‘son E. ‘Rodney Assistant General Counsel Agency for Health Care Administration 8333 N.W. 537¢ Street Suite 300 Miami, Florida 33166 Copies furnished to: Field Office Manager Agency for Health Care Administration 8333 N.W. 53%° Street, Suite 300 Miami, Florida 33166 (Inter-office mail) Home Care Unit Agency for Health Care Administration 2727 Mahan Drive, MS #34 Tallahassee, Florida 32308 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail, Return Receipt Requested to Norys Nodarse, Administrator, Nory’s Home Services, Inc. 12966 S.W. 13374 Court, Suite A, Miami, Florida 33186 on Gs. “t , 2012. ehson E. Rodne STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION RE: Nory’s Home Services, Inc. AHCA No. 2012003713 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 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 Chapter120, Florida Statutes (2008) 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 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 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 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 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. 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: 1. 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. 3. A statement of when you received notice of the Agency’s proposed action. 4. 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) I hereby 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 U.S. Postal Service vs CERTIFIED MAIL. RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) For delivery. inform: Postage Cartifled Fea Postmark Hare 9/o 7 [2003- Return Recelpt Fea (Endorsement Required) Restricted Delivery Fea (Endorsement Required) Total Postage & Fees 7009 0080 OOO0 osa4 5h4h 3. Service Type. Certified Mall 1 Reglatered {DA Insured. Malt 4, Restricted Delive i 7009, wed 180 O00 0586 Sbab 008

Docket for Case No: 12-003239

Orders for Case No: 12-003239