02/07/13 14:24:27 Bread and Cassel-> 850922&484 RightFax Page 001
BRoAo AND CAsSEL
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BOCA RATON FT. LAUDERDALE MIAMI ORLANDO TALLAHASSEE TAMPA WEST PALM BEACH
)
) )
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
STATE OF FLORIDA, AGENCY FOR
Petitioner,
vs.
Case Nos.
2012012678
GAINESVILLE REHABILITATION AND NURSING CENTER LLC d/b/a PARK.LANDS REHABILITATION AND NURSING CENTER,
Respondent.
HEALTH CARE ADMINISTRATION,
APMINils l'RA:l1VE COMPLAIN'I
COMES NOW the Agency for Health Care Administration (hereinafter "Agency"), by and through the undersigned counsel, and files this Administrative Complaint against Gainesville Rehabilitation and Nursing Center LLC d/b/a Parklands Rehabilitation and Nursing Center (hereinafter "Respondent"), pursuant to §§120.569 and 120.57 Florida Statutes (2012), and alleges:
NATURE OF THE ACTION
This is an action to change Respondent's licensure status from Standard to Conditional commencing October 18, 2012, and ending November 9, 2012, and impose an administrative fine in the amount of ten thousand dollars ($10,000.00), and to !mpose survey fees of six thousand dollars ($6,000.00) with a two (2) year survey cycle based upon Respondent being cited for two (2) isolated State Class II deficiencies.
JURISDICTION AND VENUE
The Agency has jurisdiction pursuant to §§ 120.60 and 400.062, Florida Statutes (2012).
Venue lies pursuant to Florida Administrative Code R. 28-106.207.
I
PARTIBS
facilities pursuant to the Omnibus Reconciliation Act of 1987, Title IV, Subtitle C (as amended),
Chapters 400, Part II, and 408, Part IT, Florida Statutes, and Chapter 59A-4, Florida Administrative Code.
4.
Respondent operates a one hundred twenty (120) bed nursing home, located at 1000
Southwest 16th Avenue, Gainesville, !lorida_ 3 601, and _is licensed asaskiUed nursing facility 1cense num er 10050951.
5. Respondent was at all times material hereto, a licensed nursing facility under the
licensing authority of the Agency, and was required to comply with all applicable rules, and
The Agency is the regulatory authority responsible for licensure of nursing homes and enforcement of applicable federal regulations, state statutes and rules governing skilled nursing
statutes.
COUNT!
The Agency re-alleges and incorporates paragraphs one(I) through five (5), as if fully set forth herein.
That pursuant to Florida law, all licensees of nursing homes facilities shall adopt and make public a statement of the rights and responsibilities of the residents of such facilities and shall treat such residents in accordance with the provisions of that statement. The statement shall assure each resident the right to receive adequate and appropriate health care and protective and support services, including social services; mental health services, if available; planned recreational activities; and therapeutic and rehabilitative services consistent with the resident care plan, with established and recognized practice standards within the community, and with rules as adopted by the agency. § 400.022(1)(1), Fla. Stat. (2012).
)
That Florida law provides the following: '"Practice of practical nursing' means the performance of selected acts, including the administration of treatments and medications, in the care of the ill, injured, or infirm and the promotion of wellness, maintenance of health, and prevention of illness of others under the direction of a registered nurse, a licensed physician, a licensed osteopathic physician, a licensed podiatric physician, or a licensed dentist. A practical nurse is responsible and accountable for making decisions that are based upon the individual's educational preparation and experience in nursing." § 464.003(19), Fla. Stat. (2012).
That on ()_ctoberlS,_2012, the Agency completed a licensure_survey of Respondent's ac11it .
That based upon the review of records, observation, and interview, Respondent failed to ensure the provision of adequate and appropriate health care and protective and support services, including social services; mental health services, if available; planned recreational activities; and therapeutic and rehabilitative services consistent with the resident care plan, with established and recogniz.ed practice standards within the community, said failures materially affecting the health and safety of one (1) of thirty-two (32) sampled residents including but not limited to the failure to obtain necessary care and services to address expressed and known pain and its cause, said failures being contrary to the mandates of law.
That Petitioner's representative interviewed resident number ninety-two (92) on October 15, 2012, and the resident indicated as follows:
Both feet were swollen and the right foot hurt.
The resident fell at home, in August 2012, and the feet have been bothering the resident ever since.
The fingernail on the left index finger was split and the nail would catch on the
i
resident's clothing and it would bring tears to the eyes.
The resident has been asking to see a doctor for some time, but the doctor has not visited yet.
That Petitioner's representative observed the fingernail of resident number ninety-two
(92) during the interview and noted that it was split across the entire length of the nail and part of the nail was jagged.
That Petitioner's representative interviewed on October 16, 2012 the certified nursing
. assislallt_a igned_the car1iof r1isid. 11t 11ulll1>erninety•Jvvc,(92), _and the assistl!nt indicated as follows:
She told the nursing staff about the resident's complaint of right leg pain about
· three (3) weeks ago.
She asked resident ninety-two (92) every day if the doctor had seen the resident and the resident would respond "no."
That Petitioner's representative interviewed on October 16, 2012 Respondent's nursing supervisor regarding resident number ninety-two (92), who indicated as follows:
She had not been informed by the nursing staff of the resident's complaint of pain.
She entered the resident's room at this time and asked to assess the feet and when she touched the resident's right foot the resident hollered out in pain stating that it "hurts."
That on October 16, 2012, Respondent's assistant director of nursing received an order from the physician for resident number ninety-two (92) for an x-ray of the resident's left and right feet.
That Petitioner's representative reviewed Respondent's records related to resident
I )
number ninety-two (92) during the survey and noted as follows:
An x-ray was conducted on October 16, 2012, at 6:11 pm, with findings for the left foot of a small fragment of metallic needle near the base of the proximal phalanx of the third digit that measured 8mm in length.
The findings for the right foot documented an age indeterminate fracture of distal diaphysis of fifth metatarsal bone with mild displacement and angulation.
That Petitioner's representative interviewed on October 16, 2012 Respondent's unit 111an_aj rregarding_l"esident number ninety-two (92), who indicated that the resident did not have
That Petitioner's representative interviewed on October 17, 2012 Respondent's licensed practical nurse for the east wing regarding resident number ninety-two (92), who indicated as follows:
The resident complained to her last week about pain in the feet and she wrote a communication sheet for the doctor and put it in his communication book.
She then walked over to the communication book, reviewed it, and stated that she did not see the communication documentation.
She did not know that she was supposed to call the doctor for concerns about the resident because she is a new nurse.
That Petitioner's representative interviewed on October 17, 2012 Respondent's assistant director of nursing regarding resident number ninety-two (92), who indicated that staff is to call the resident's physician or his on-call staff if the resident is,experiencing any problems.
That Petitioner's representative reviewed the October 18, 2012 physician's follow up notes related to resident number ninety-two (92) and noted that the resident had a contusion of
)
the right medial malleolus, and Onchomycosis, a deep bruise to the right ankle.
That Petitioner's representative reviewed Respondent's policy entitled "Pain-Clinical Protocol," revised October 2010 and approved by the QA colll111ittee on 2/24/11, and noted as follows:
Pageone:
"Assessment and Recognition: 2. The nursing staff will assess each individual for pain upon admission to the facility, at the quarterly review, whenever there is a significant change in condition, and when there is
onsetofnew
"Cause Identification: 3. The physician will perform or order appropriate tests as needed to help clarify sources of pain. For example, an x-ray may help to identify the cause of joint pain. "
Page two - "Treatment and Management: 3. The staff will evaluate and report how much and how often the individual asks for PRN pain medication."
That the above reflects Respondent's failure to ensure the provision of adequate and appropriate health care and protective and support services, including social services; mental health services, if available; planned recreational activities; and therapeutic and rehabilitative services consistent with the resident care plan, and with established and recognized practice standards within the community, including, but not limited to, Respondent's failure to ensure that care for expressed pain and or its underlying cause was obtained, these failures including the failure of nursing staff to respond to expressed indications of resident·pain, the failure of nursing staff to contact physicians upon resident expressions of pain, and the failure of Respondent's
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}
staff to implement its policy and procedure, said failures materially affecting the health and safety of a resident.
That the Agency determined that these failures compromised the resident's ability to maintain or reach his or her highest practicable physical, mental, and psychosocial well-being, as defined by an accurate and comprehensive resident assessment, plan of care, and provision of services and cited this deficient practice as an Isolated State Class II deficiency.
That Respondent was cited with a Class II deficient practice on September 7; 2012.
... WHEREFORE, the.Af!«l!l!lY seeks to im!)9.£!tl\ll administrative fine i11th1t8.IIIQ1l!l.1of.five
pursuant to§§ 400.23(8)(b) and 400.102, Florida Statutes (2012).
COUNT II
The Agency re-alleges and incorporates paragraphs one (1) through five (5), as if fully set forth herein.
That pursuant to Florida law
) Each resident admitted to the nursing home facility shall have a plan of care. The plan of care shall consist of:
Physician's orders, diagnosis, medical history, physical exam and rehabilitative or restorative potential.
A preliminary nursing evaluation with physician's orders for immediate care, completed on admission.
A complete, comprehensive, accurate and reproducible assessment of each resident's functional capacity which is standardized in the facility, and is completed within 14 days of the resident's admission to the facility and every twelve months, thereafter. The assessment shall be:
I. Reviewed no less than once every 3 months,
Reviewed promptly after a significant change in the resident's physical or mental condition,
Revised as appropriate to assure the continued accuracy of the assessment. Rule 59A-4.109(1), Florida Administrative Code.
That on October 18, 2012, the Agency completed a licensure survey of Respondent's facility.
That based upon the review of records, observation, and interview, Respondent failed to ensure a plan of care which contained a complete, comprehensive, accurate and reproducible assessment of each resident's functional capacity for two (2) of thirty-two (32) sampled residents including but not limited to the failure to identify pain and incontinence and to implement interventions therefore, said failures being contrary to the mandates of law.
. 29.· ·.. That Petitioner's..reJ>resentative int rvl wed r«i.side11t number ninety-two(92) on October 15 201
Both feet were swollen and the right foot hurt.
The resident fell ai home, in August 2012, and the feet have been bothering the resident ever since.
The fingernail on the left index finger was split and the nail would catch on the resident's clothing and it would bring tears to the eyes.
The resident has been asking to see a doctor for some time, but the doctor has not visited yet.
That Petitioner's representative interviewed on October 16, 2012 the certified nursing assistant assigned the care of resident number ninety-two (92), and the assistant indicated as follows:
She told the nursing staff about the resident's complaint of right leg pain about three (3) weeks ago.
She asked resident ninety-two (92) every day if the doctor had seen the resident and the resident would respond "no."
j
That Petitioner's representative interviewed on October 16, 2012 Respondent's nursing supervisor regarding resident number ninety-two (92), who indicated as follows:
She had not been informed by the nursing staff of the resident's complaint of pain.
She entered the resident's room at this time and asked to assess the feet and when she touched the resident's right foot the resident hollered out in pain stating that it "hurts."
That Petitioner's representative reviewed Respondent's records related to resident number ninety-two (92) during the survey and noted as follows: ...............··· ·
An x-ra was conducted on
left foot of a small fragment of metallic needle near the base of the proximal phalanx of the third digit that measured 8mm in length.
The findings for the right foot documented an age indeterminate fracture of distal diaphysis of fifth metatarsal bone with mild displacement and angulation.
The resident's minimum data set dated August 29, 2012, does not reflect that pain was assessed for the resident after the resident's readmission to the facility on August 24, 2012.
That on October 18, 2012, resident number ninety-two (92) was seen by an orthopedic physician and the second diagnosis revealed a deep bruise to the right ankle.
That Petitioner's representative reviewed Respondent's policy entitled "Pain-Clinical Protoco " revised October 201O and approved by the QA committee on 2/24/11, and noted as follows:
Pageone:
"Assessment and Recognition: 2. The nursing staff will assess each
)
individual for pain upon admission to the facility, at the quarterly review, whenever there is a significant change in condition, and when there is onset of new pain or worsening pain."
"Cause Identification: 3. The physician will perform or order appropriate tests as needed to help clarify sources of pain. For example, an x-ray may help to identify the cause of joint pain. "
Page two - "Treatment and Management: 3. The staff will evaluate and report how much and how often the individual asks for PRN pain m it:a!i91t"
Th
resident number one hundred sixty-six (166), dated June 28, 2012, during the survey and noted it
. documented the resident as being continent of bladder, however the quarterly minimum data set dated September 12, 2012 documented the resident as incontinent of the bladder.
That Petitioner's representative interviewed on October 18, 2012 Respondent's minimum data set coordinator regarding resident number one hundred sixty-six (166), who indicated as follows:
She used the documentation from the certified nursing assistant (C.N.A.) activities of daily living (ADL) log that documented the resident as continent of bladder on a daily basis for the initial minimum data set.
It was not until after she interviewed the resident and spouse during the quarterly review of September 12, 2012, that she was informed that the resident has been incontinent for several years.
That Petitioner's representative reviewed Respondent's nursing noted related to resident number one hundred sixty-six (166) during the sul'Vey and noted they routinely indicated the
I'
)
resident was incontinent of bladder.
That the above reflects Respondent's failure to ensure a plan of care including a complete, comprehensive, accurate and reproducible assessment of each resident's functional capacity with interventions to address reswident needs, said failures materially affecting the health and safety of residents.
That the Agency determined that these failures compromised the resident's ability to maintain or reach his or her highest practicable physical, mental, and psychosocial well-being, as
. . ... de_ffae.d_by_an_accurate and comprehensiv-e resident assessment, plan o.f_c_are,_ and pm'llision of
That Respondent was cited with a Class II deficient practice on September 7, 2012.
WHEREFORE, the Agency seeks to impose an administrative fine in the amount of five thousand dollars ($5,000.00) against Respondent, a skilled nursing facility in the State of Florida, pursuant to§§ 400.23(8)(b) and 400.102, Florida Statutes (2012).
COUNT III
The Agency re-alleges and incorporates paragraphs one (I) through five (5), as if fully set forth herein.
The Agency re-alleges and incorporates Counts I and II of this Complaint as if fully recited herein.
That Respondent has been cited with two (2 State Class II deficiencies and therefore is subject to a six (6) month survey cycle for a period of two years and a survey fee of six thousand dollars ($6,000) pursuant to Section 400.19(3), Florida Statutes (2012).
WHEREFORE, the Agency intends to impose a six (6) month survey cycle for a period of two years and impose a survey fee in the amount of six thousand dollars ($6,000.00) against
)
Respondent, a skilled nursing facility in the State of Florida, pursuant to Section 400.19(3), Florida Statutes (2012).
COUNTIV
The Agency re-alleges and incorporates paragraphs one (1) through five (5) and Count I of this Complaint as if fully set forth herein.
Based upon Respondent's two (2) State Class Il deficiencies, it was not in substantial compliance at the time of the survey with criteria established under Part Il of Florida Statute 400, or tlte rules adopted by theAgency, a violationsubjecting it to.assignment _of a conditional
WHEREFORE, the Agency intends to assign a conditional licensure status to Respondent, a skilled nursing facility in the State of Florida, pursuant to § 400.23(7), Florida Statutes (2012) commencing October 18, 2012 and ending November 9, 2012.
/,,.·
Respectfully submitted this?day of January, 2013.
// _,/,
.<l:I/,··
.
/'.,,• ,/
;Jfta.
Tji9niiis'J. Walsh II, Esquire
Bar. No. 566365
· Agency for Health Care Admin. 525 Mirror Lake Drive, 330G St. Petersburg, FL 33701 727.552.1947 (office)
DISPLAY OF LICENSE
Pursuant to§ 400,23(7)(e), Fla. Stat. (2010), Respondent shall post the most current license in a prominent place that is in clear and unobstructed public view, at or near, the place where residents are being admitted to the facility.
Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes. Respondent has the right to retain, and be represented by an attorney
I
in this matter. Specific options for administrative action are set out in the attached Election of
Rights.
All requests for hearing shall be made to the attention of: The Agency Clerk, Agency.for Health Care Administration, 1727 Mahan Drive, Bldg #3, MS #3, Tallahassee, Florida, 31308, (850)
412-3630.
RESPONDENT IS FURTHER NOTIFIED THAT A REQUEST FOR HEARING MUST BE RECEIVED WITHIN 21 DAYS OF RECEIPT OF THIS COMPLAINT OR WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY.
CERTIFICATE OFSERVICE
rn ece1p
Margaret Kaplan, Administrator, Gainesville Rehabilitation and Nursing Center LLC d/b/a Parklands Rehabilitation and Nursing Center, 1000 Southwest 16111 Avenue, Gainesville, Florida 32601, and by U.S. Mail to Corporation Service Company, Registered Agent for Gainesville Rehabilitation and Nursing Center LLC, 1201 Hays Street, TaJJah see, Florida 32301.
Copy furnished to:
Kriste Mennella, FOM
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
RE: Gainesville Rehabilitation and Nursing Center LLC d/b/a Parklands Rehabilitation and Nursing Center
CASE NO. 20121)12678
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 receb:e 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-you.r-selec.ted-o.ptlonis--not receiv.ed-by AHCA-within.-twenty-
(Please use this form unless you, your attorney or your representative prefer to reply according to Chapter120, 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 (l) I admit to the allegations of facts and law contained lo the Notice
of Intent 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 of Intent
to Impose a Late Fee, the Notice of Intent to Impose a Late Fine, or Administrative Complaint, but I willh 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: Chooslllf! OPTION THREE (3), by itself, is filt[ 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.
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.
-bicensetype:-- -- -(Al,F'l-nursing home?medical-equipment?Other-type?)--- Licensee Name: 'Licensenumber: _
Contact person: ------,--c-------------= ---------
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
RICK SCOTT GOVERNOR
January 2, 2013
PARKLAND$ REHABILITATION AND NURSING CENTER
!O00SW 16TH AVE
GAINESVILLE, FL 32601
ELIZABETH DUDEK
SECRETARY
Dear Administrator:
· ····
The attached license with Ce1tificate #17927 is being issued for the operation of your f 'Jity.
--Please review it thorou hi to ensure t · · our
records. If errors or omissions are noted
Agency for Health Care Administration · Long Term Care Section, Mail Stop #33 2727 Mahan Drive, Building 3
Tallahassee, Florida 32308
o
Issued for a Status Change to Standard Sincerely,
Agency for Health Care Administration Division of Health Quality Assurance
Enclosure
cc: · Medicaid Contract Management
2727 Mahan Drive, MS#33 Tallahassee, Florida 32308
Visit AHCA Online at
ahoa.myflorlda. com
CERTIFICAIB#: 17927
LlCENSE #: SNF10050951
AGENCY FOR HEALTH CARE AD . . STRATION ·.
DMSIONOF HEALTH QUALITYAS..,,u,,-=.i.,CE
NURslN·G·.Ho·
STANDARD
I
This is.toconfumthat•GAINESVILLE REHABILITATION AND NURSING ,-,,:m,YM::R. LLC Ii.is complied with the rules. and ·
·. regulations adopted by the State of Florida, Agency For Health Care Administrati n, authorized in Chi!pter400, Part II;Florida Statutes, and as the licensee is·authorized to ope th following: ·
PARKLANDS REHABJLITATION. NURSINGc;ENTER lOOOSW16tHAVE
GAINESVILLE; FL 32601
TOTAL: 120BEDS
STATUS CHANGE·. EFFECTIVEDATE: 11/09/2012.
EXPIRATION DATE: 09/30/2013
)
/ 'I
RICK SCOTT GOVERNOR
January 2, 2013
FLORIDA A(',ENCY FOR HFAI.TH GA.Re..ADMINISTP.ATl0N
ELIZABETH DUDEK SECRETARY
PARKLANDS REHABILITATION AND NURSING CENTER 1000 SW 16TH AVE
GAINESVILLE, FL 32601
Dear Administrator;
The attached license with Certificate #17926 is being issued for the operation of your facility. Please review it thorou bl to ensure that all information is correct a · ith our
Agency for Health Care Administration Long Term Care Section, Mail Stop #33 2727 Mahan Drive, Building 3 Tallahassee, Florida 32308·
o
Issued for a Status Change to Conditional Sincerely,
Agency for Health Care Administration Division of Health Quality Assurance
Enclosure
cc: Medicaid Contract Management
2727 Mahan Drive, MS#33 Tallahassee, Florida 32308
Visit AHCA onllne at
ahca. myflorida. com
CERTIFICATE#: 17926.
AGENCY FOR HEALTH CARE AD.·
DIVISION OF HEALTH QUALITY AS,>-11u uu,CE
NURSING HO
CONDITIONAL
IJCENSE #: SNF10050951
This is to con:finn thatGAINESVIILE REHABILITATION AND NURSING. ' LLC has complied with the rules an.d regulations adopted ):,JtheState ofF!orida, Agency ForHealth CareAdministrati n, thorized iilChapter 40Q;Part II, F!Qrida· Statutes, and as the licensee is authorized to operat th following: .
PARKLANDS REHABILITATION NURSING CENTER 1000 SW 16THAVE
GAINESVILLE, FL 32601 TOTAL: 120BEDS
STATUS CHANGE ·
EFFECTNE DATE: 10/18/2012
EXPIRATION DATE: 09/30/2013
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| Issue Date | Document | Summary |
|---|---|---|
| Aug. 12, 2013 | Agency Final Order | |
| Aug. 12, 2013 | Agency Final Order |
