STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO, 2012-17634 FRANCES O’BRADY HOWELL, R.N., RESPONDENT. / ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Nursing against, Respondent Frances O’Brady Howell, R.N., and in support thereof alleges: 1. Petitioner is the state department charged with regulating the practice of nursing pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 464, Florida Statutes. 2. At all times material to this Administrative Complaint, Respondent was a registered nurse (R.N.) within the state of Florida, having been issued license number RN 2622282. 13y 3. Respondent's address of record is 541 Mountain Valley Road, DeFuniak Springs, Florida 32435. 4. At all times material to this Administrative Complaint, Respondent was the owner of Howell House, an assisted living facility. Respondent was also the registered nurse who oversaw the care and treatment of the patients at Howell House. 5. In or about 2004, L.P. was admitted to Howell House. At that time, L.P. was a 63 year old female patient with Parkinson‘s disease and weakness. The initial health assessment for L.P.'s admission to an assisted living facility indicated that L.P. needed assistance with transferring and ambulation and needed total care for bathing and grooming. 6. In or about February of 2011, Howell House updated L.P.’s service plan. L.P. was now 70 years old. Two of the programs listed in that service plan included fall prevention as a goal. The plan indicated that L.P. needed assistance with ambulation and used a walker. 7. On or about June 30, 2011, Respondent documented a skilled nursing note that indicated L.P. had an unsteady gait, needed assistance with ambulation, and used a walker. Department of Health v, Frances O'Brady Howell, R.N, 2 Case No; 2012-17634 8. On or about July 20, 2011, Respondent directed employee T.M. to make a video recording of L.P. Respondent informed T.M. that she wanted to show that L.P. needed to be placed in a nursing home. T.M. recorded L.P. who was sitting in a chair with her walker in front of her. Respondent directed L.P. to stand. L.P. attempted to stand several times, but only lifted herself a few inches and then sat back down in the chair. Respondent walked behind L.P. and pulled L.P. to a standing position by pulling up on the back of L.P.’s pants. Respondent then moved the chair away from L.P. and walked away. L.P. stood for a few seconds and then fell backwards onto the floor. Respondent then directed T.M. to send L.P. to the emergency room. 9. On or about July 20, 2011, L.P. was sent to Healthmark Regional Medical Center (HRMC). L.P. complained of moderate back pain and was diagnosed with a lumbar strain, but no fractures. After being evaluated and treated, the emergency department physician ordered that L.P. be discharged. Staff at HRMC contacted Howell House to give a report on L.P.'s condition and return L.P. to Howell House. According to L.P.’s medical record, the emergency department nurse documented, “As we Department of Health v, Frances O’Brady Howell, R.N. 3 Case No; 2012-17634 attempted to call report to Howell House, they state [L.P.] no longer meets criteria to be there and they cannot accept her back.” 10. On or about July 20, 2011, L.P. was admitted to HRMC, stayed in the hospital for two days and then was transferred to a nursing home on or about July 22, 2011. ii. T.M. reported the incident to the Medicaid Fraud Control Unit (MFCU). T.M. provided the MFCU detective with a copy of the video. 12. On or about November 8, 2012, Respondent was arrested for abuse of an elderly person or disabled adult without causing great bodily harm in Walton County. The criminal case is ongoing. 13. According to the probable cause affidavit, the MFCU investigator interviewed Respondent who denied that she removed a chair from behind L.P. Respondent stated that L.P. was a fall risk and that it would be “cruel and mean to try and get rid of someone.” Respondent stated there would be no reason to ever remove a chair from behind L.P. since she is a fall risk and unsteady on her feet. Respondent stated that in her professional opinion, a chair shouldn’t be removed from behind L.P. because if L.P.'s going to fall, something needs to be there to support her. Department of Health v. Frances O’Brady Howell, R.N. 4 Case No,: 2012-17634 14. On or about December 3, 2012, a Department investigator interviewed L.P. who remembered the incident. L.P. stated that someone pulled her up by the back of her pants to stand her up and she fost her balance and fell back and hit the floor. L.P. stated she was not sure who | stood her up, but she knew that Respondent was in the room. L.P. also stated she knew a video was made and thought she heard Respondent say something about getting a judge to put LP. in a nursing home. L.P. stated that a couple minutes before the fall, she heard Respondent instruct people not to help L.P. pull up her pants while L.P. was in the bathroom. L.P. came out of the bathroom with her pants down and then someone did help her pull her pants up, but she could not remember who. L.P. stated that she did not break any bones, but did get bruised up really bad from the fall. 15. On or about December 6, 2012, a Department investigator interviewed T.M., a former employee of Howell House. T.M. stated that on the day in question, L.P. was in the bathroom and needed help pulling her pants up. Respondent directed T.M. and another employee not to help L.P., stating L.P. could do it herself. T.M. stated that L.P. came out of the bathroom with her pants down and then the other employee assisted L.P. Department of Health v. Frances O’Brady Howell, R.N. Case No.: 2012-17634 wl with her pants. T.M. stated this happened on more than one occasion. T.M. stated that Respondent then directed T.M. to videotape L.P. attempting to stand up so that Respondent could show that L.P. needled to be placed in a nursing home. T.M. stated he made a video recording of L.P. using his cell phone. L.P. tried to stand up three times, but she would barely get out of the chair before falling back into her seat. T.M. stated that Respondent then pulled L.P. up by the back of her pants and stood L.P. up. Respondent then removed the chair and walked away. Seconds later, L.P. fell to the floor and Respondent stated to send L.P. to the emergency room. T.M. stated that he did not think Respondent should be caring for elderly patients because she treated a lot of patients “that way, but not to that extent.” COUNT ONE 16. Petitioner realleges and incorporates paragraphs one (1) through fifteen (15) as if fully set forth herein. 17. Section 464.018(1)(h), Florida Statutes (2010-2011), provides that unprofessional conduct as defined by board rule constitutes grounds for disciplinary action. Department of Health v. Frances O’Brady Howell, R.N. 6 Case No.: 2012-17634 18. Rule 64B9-8.005(14), Florida Administrative Code, provides that unprofessional conduct includes using force against a patient, striking a patient, or throwing objects at a patient. 19. As set forth above, Respondent used force against L.P., by forcing L.P. into a standing position by lifting her by the back of her pants and removing the chair from behind her, causing her to fail. 20. Based on the foregoing, Respondent violated Section 464.018(1)(h), Florida Statutes (2010-2011), by engaging in unprofessional conduct as defined by Rule 64B-8,005(14), Florida Administrative Code, to include using force against a patient, striking a patient, or throwing objects at a patient. COUNT TWO 21. Petitioner realleges and incorporates paragraphs one (1) through fifteen (15) as if fully set forth herein. 22, Section 464.018(1)(n) Florida Statutes (2010-2011), subjects a licensee to discipline for failing to meet minima! standards of acceptable and prevailing nursing practice, including engaging in acts for which the licensee is not qualified by training or experience. Department of Health v. Frances O’Brady Howell, R.N. 7 Case No,: 2012-17634 23. As set forth above, Respondent failed to meet. minimal standards of acceptable and prevailing nursing practice by deliberately leaving L.P. without assistance after she pulled L.P. up into a standina position. Respondent failed to meet minimal standards of prevailing nursing practice by removing the chair from behind L.P. so that if L.P. lost her balance or tried to sit down, she would fall. As a result of Respondent's actions, L.P. did fall and sustained injuries. 24. Based on the foregoing, Respondent violated Section 464.018(1)(n) Florida Statutes: (2010-2011), by failing to meet minimal standards of acceptable and prevailing nursing practice, including engaging in acts for which the licensee is not qualified by training or experience. Department of Health v. Frances O’Brady Howell, R.N, 8 Case No.: 2012-17634 WHEREFORE, the Petitioner respectfully requests that the Board of Nursing enter an order impasing one or more of the following penalties: permanent revocation or suspension of Respondent’s license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. . _ SIGNED this_/2” day of _/25E022/ 1. _, 2013, JOHN H. ARMSTRONG, MD, FACS State Surgeon General and Secretary of Health Ltr lél—= Lauren A. Leikam Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 Florida Bar Number 0088700 (850) 414 - 8126 Telephone (850) 414 - 1991 Facsimile /LAL pep: a/ja/)3 | | FILED PCP Members: fr putich ¥ LU CREED DEPARTMENT OF HEALTH CLERK 0 dud. Department of Health v. Frances O’Brady Howell, R.N. 9 mene Case No,: 2012-17634 DA ‘ NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to Section 456.072(4), Florida Statutes, the Board shall assess costs related to the investigation and Prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed. Department of Health v. Frances O'Brady Howell, -R.N. 10 Case No.: 2012-17634

Docket for Case No: 13-001624PL