ee STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION _ STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, vs, Case No. 2013002156 MORTON PLANT HOSPITAL ASSOCIATION, INC., d/b/a MORTON PLANT HOSPITAL, Respondent. a | ADMINISTRATIVE COMPLAINT COMES NOW the Agency For Health Care Administration (hereinafter Agency), by and through the undersigned counsel, and files this Administrative Complaint against Morton Plant _ Hospital. Association, Inc., d/b/a Morton Plant Hospital (hereinafter Respondent), pursuant to Section 120,569, and 120,57, Florida Statutes, (2012), and alleges: NATURE OF THE ACTION This is an action to impose administrative fines in the amount of one thousand dollars ($1,000.00) pursuant to Sections 120.569, 120.57, 395.1055 and 395.1065, Fla, Stat, (2012). JURISDICTION AND VENUE 1. The Agency has jurisdiction pursuant to Chapters 395, Part I, and 408, Part II, Fla, Stat. (2012). 2. Venue lies pursuant to Section 120.57 Florida Statutes, and Chapter 28-106.207 Florida Administrative Code. ee! PARTIES 3. The Agency is the regulatory authority with regard to hospital licensing and regulation ' pursuant to Chapters 395, Part I, and 408, Part Il, Florida Statutes, and Chapter 59A-3, Florida Administrative Code, respectively. 4, Respondent is a hospital located at 300 Pinellas Street, Clearwater, Florida 33756, and is licensed under Chapter 395, Part I, Florida Statutes and Chapter 59A-3, Florida Administrative Code, license number 4064. 5, Respondent was at all times material hereto a licensed facility under the licensing authority of the Agency, and was required to comply with all applicable rules, and statutes. COUNT I 6. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. That pursuant to Florida law, the nursing process of assessment, planning, intervention | and evaluation shall be documented for each hospitalized patient from admission through discharge. 1. Each patient’s nursing needs shall be assessed by a registered nurse at the time of admission or within the period established by each facility’s policy. 2. Nursing goals shall be consistent with the therapy prescribed by the responsible medical practitioner. 3. Nursing intervention and patient response, and patient status on discharge from the hospital, must be noted on the medical record. Rule 59A-3.2085(5)(e), Florida Administrative Code. 8. That pursuant to Florida law on hospital records, the form and detail of the clinical records may vary but shall minimally conform to the following standards ... Progress notes shall include regular notations at least weekly by staff members, consultation reports and signed entries by authorized identified staff. Progress notes by the clinical staff shall: 1. Document. a chronological picture of the patient’s clinical course; 2, Document all treatment rendered to the patient; 3. Document the implementation of the treatment plan; 4. Describe each change in each of the patient’s conditions; 5, Describe responses to and outcome of treatment; and 6, Describe the responses of the patient and the family or significant others to significant inter-current events. Rule 59A-3.110(10(c), Florida Administrative Code. 9. That on February 13, 2013, the Petitioner Agency conducted a complaint investigation (CCR 2013001510) of the Respondent facility. 10. That based upon the review of records and interview, Respondent failed to ensure that the nursing staff assessed, planned, and intervened and evaluate nursing care related to personal care needs and implementation of physician orders and or failed to document the same for five (5) of eleven (11) patient records reviewed in contradiction of its policies and the requirements of Florida law. 11. — That Petitioner’s representative reviewed Respondent’s policy and procedure noted as last revised October 2012 entitled "Documentation: Nursing," and noted the policy required that interventions for hygiene will be documented every shift or as indicated by patient condition, 12. That Pétitioner’s representative reviewed Respondent’s records related to patient number three (3) during the survey and noted as follows: a. The patient was admitted to the facility on September 25, 2012, and discharged on February 7, 2013. b. The patient required total assistance with all Activities of Daily Living, c. Documentation of activities of daily living care, including hair care, oral care, peri care and bathing, reflect the following: werd ed i. Hair care: 1, Up to four (4) days would pass with no hair care provided. 2. Documentation from January 18, 2013 through February 7, 2013, reflects that hair care was provided only on January 20, 22, 24, 28, and February 3, 2013. ii, Oral care:. 1. Up to three (3) days would pass with no oral care provided. 2. Documentation from January 18, 2013 through February 7, 2013, reflects that oral care was not provided on January 21, 23, 26, 27, 29, 30, 31, and February 2, 2013. 3, On February 1 and 2, 2013, the documentation indicated the patient was independent in oral care. iii, Incontinence care: 1. Documentation revealed the patient would have bowel movements and urine incontinence multiple times a day. 2. Up to three (3) days would pass with no documentation of bathing provided. 3. Documentation from January 18, 2013 through February 7, 2013, reflects that bathing was not provided on January 25, 26, 28, 29, 31, and February 2, and 7, 2013. Ve iv. Peri care: 1. Up to three (3) days would pass with no documentation that peri care was provided. 2. Documentation from January 18, 2013 through February 7, 2013, | . reflects that peri care was not provided on January 27 and 30, and February 1, 6, and 7, 2013. : 3. On January 26 and February 2, 2013, the documentation reflected the patient was independent in peri care. d, Weight monitoring: i, Physician's admitting orders dated September 25, 2013 at 8:40 p.m. required the patient be weighed on admission and every Sunday, i Wednesday, and Friday in the morning, ii, The patient was weighed on admission and weighed 117 Ibs. (pounds). iii, No documentation reflects that the patient was weighed again or attempted to be weighed until October 31, 2013, approximately thirty (30) days later. iv, On October 31, 2013, nursing documented the patient would not cooperate to be weighed and no weight was recorded. v. On November 11, 2012, the patient was weighed and was 119 Ibs. vi, On November 16, 2012, an attempt to weigh the patient was made and notes reflect the patient would not cooperate. vii. No. other weight was recorded for the patient through discharge on February 7, 2013. a, a. b. 13. That Petitioner’s representative interviewed Respondent's staff who cared for patient number three (3) who indicated as follows: The patient required total assistance and oral care, hair care and bathing were provided on a daily basis, though the record does not reflect this care. . The patient required total care, was demented and non-verbal. Though documentation on several days by patient care technicians reflected the patient was independent with oral care and peri care, staff members on the same unit the patient was admitted indicated the patient required total care, was demented, and was non-verbal, 14. — That Petitioner’s representative reviewed Respondent’s records related to patient number five (5) during the survey and noted as follows: The patient was admitted to the facility on February 6, 2013. The patient was severely cognitively impaired and required maximum assistance with activities of daily living care. The activity of daily living notes dated February 12, 2013 at 8:55 p.m. and signed by mental health technician number one (1) documented the patient refused assistance with feeding and was independent with oral care and personal hygiene. 15. That Petitioner’s representative interviewed Respondent’s registered nurse who cared for patient number five (5) who indicated the patient was not aware of surroundings, was incapable a. of providing own care, and required maximum assistance with all activities of daily living. 16. That Petitioner’s representative reviewed Respondent’s records related to patient number seven (7) during the survey and noted as follows: The patient was admitted to the facility on February 6, 2013. b. Activity of daily living notes dated February 11, 2013 at 10:44 p.m. signed by mental health technician number two (2) indicated the patient required moderate ‘assistance with feeding, maximum assistance witli activities, and maximum assistance with personal hygiene care. c.. Activity of daily living notes dated February 12, 2013 at 5:56 p.m. signed by mental health technician number three (3) indicated the patient was independent in activity, was independent in feeding, and was given hair care by the technician, d. Activity of daily living noted dated February 12, 2013 at 8:45 p.m, signed by niental health technician number one (1) indicated the patient was independent in activities, independent with oral care, and personal hygiene care. 17, That Petitioner’s representative interviewed Respondent’s registered nurse who cared for patient number seven (7) who indicated that the patient required assistance with all activities and ~ -was not capable of providing own care. : 18, That Petitioner’s representative reviewed Respondent’s records related to patient number eight (8) during the survey and noted as follows: a, The patient was admitted to the facility on February 2, 2013. b. Activity of daily living notes dated February 12, 2013 at 5:14 p.m. and signed by . mental health technician number four (4) indicated the patient required maximum assistance with activity, moderate assistance with feeding, and moderate assistance with foot, hair, oral, and personal hygiene care. c, Activity of daily living notes dated February 12, 2012 at 8:42 p.m. signed by mental health technician number one (1) documented the patient required maximum assistance with activity, refused feeding assistance, and was independent in oral and personal hygiene care. 19, That Petitioner’ s representative interviewed Respondent’s registered nurse who cared for patient number eight (8) who indicated the patient required assistance with all activities and was not capable of providing own care without assistance. 20, That Petitioner’s representative reviewed Respondent’s records related to patient number nine (9) during the survey and noted as follows: a, The patient was admitted to the facility on January 29, 2013. b. Activity of daily living notes dated February 12, 2013 at 5:03 p.m, and signed by mental health technician number four (4) indicated the patient required maximum assistance with activity, had refused feeding assistance, and required maximum assistance with foot, hair, oral, and personal hygiene care. ¢. Activities of daily living notes dated February 12, 2013 at 8:37 p.m. and signed ‘by mental health technician number one (1) indicated the patient was independent in oral and personal hygiene care, 21. That Petitioner’s representative interviewed Respondent’s registered nurse who cared for patient number nine (9) who indicated as the patient required assistance with all activities and was not capable of providing own care without assistance, 22. That Respondent’s Director of Patient Services was present at the time of the record reviews and interviews above recited and the director confirmed the findings of the Petitioner’s representative, 23. That the above reflects Respondent’s failure of its nursing personnel to assess, plan, intervene and evaluate nursing care related to personal care needs and implementation of physician orders for patients and or failed to document the same which does not ensure the needs and goals of the patients are met. 24. That the Agency cited the Respondent facility for the above referenced deficiency. 25. That the above cited deficiency subjects the Respondent facility to the imposition of an administrative penalty in a sum not to exceed one thousand dollars ($1,000.00) per violation per day. § 395.1065 (2)(a) Fla. Stat. (2012). WHEREFORE, the Agency intends to impose an administrative fine in the amount of one thousand dollars ($1,000.00) against Respondent, a hospital in the State of Florida, pursuant to § 395,1065 (2)(a) Fla, Stat. (2012). Respectfully submitted thi 5 day of April, 2013. fa. Bar. Mo. 566365 Counselor Petitioner Agency for Health Care Administration 525 Mirror Lake Drive, Suite 330G St. Petersburg, FL 33701 721,552,1525 (office) Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes. Specific options for administrative action are set out in the attached Election of Rights. All requests for hearing shall be made to the Agency for Health Care Administration, and delivered to Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, Bldg #3,MS #3, Tallahassee, FL 32308; Telephone (850) 922-5873. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO REQUEST 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, CERTIFICA' ER) 1 HEREBY CERTIFY that a true and correct copy of the foregoing hasspeen served by U.S. Certified Mail, Return Receipt No. 7012 2210 0002 5727 9245 on April 2013 ee Se to Emil C. Marquardt, Jr., Registered Agent, Macfarlane Ferguson & McMullen, 625 Court Street, 2° Floor, Clearwater, Florida 33756 and by U.S. Mail to Glen D. Waters, CEO, Morton Plant Hospital, 300 Pinellas Street, Clearwater, FL 33756, asf, Walsh II, Esquire Copy furnished to: Pat Caufinan, FOM 10 ) ) ] STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION RE: Morton Plant Hospital Association, Inc. CASE NO, 2013002156 d/b/a Morton Plant Hospital 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. Le 1 ip S sls ‘ Bol DY ims D>) y x AYS e On D ive. th che: ice of Intent to Impose Fee. j Intent to Im: Late Fins i inistrativ in : 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 (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 (1) 1 admit to the allegations of facts and law contained in 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 heaving. 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 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)__—_ 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: 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 format hearing before the Division of Administrative Hearings under Section 120.57(1), Florida Statutes. asi jaca ) oy ‘ ) It must be received by the Agency Clerk at the address above within 2A 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) Lhereby 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. ‘Date: Signed: Title: Print Name: _ Late fee/fine/AC COMPLEIE THIS ZEN OR DELIV Emil C. Marquardt, Jr. Registered Agent 7012 2210 O002 5? th EAR

Docket for Case No: 13-002075

Orders for Case No: 13-002075