STATE OF FLORIDA P.

AGENCY FOR HEALTH CARE ADMINISTRATION 2019 JUN2 I A If:

31 1

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

vs.

3825 COUNTRYSIDE BOULEVARD OPERATIONS, LLC d/b/a COUNTRYSIDE REHAB AND HEALTH CENTER,

Case No. 2013004491

RENDITION NO.: AHCA· \ • o5Sl -S-OLC

Respondent.

                                                                              /

FINAL ORDER

Having reviewed the Administrative Complaint, and all other matters of record, the Agency for Health Care Administration finds and concludes as follows:

1. The Agency issued the attached Administrative Complaint and Election of Rights form to the Respondent. (Ex. I). The parties have since entered into the attached Settlement Agreement, which is adopted and incorporated by reference into this Final Order. (Ex. 2)

   
   

2. The Respondent shall pay the Agency $16,000.00. If full payment has been made, the cancelled check acts as receipt of payment and no further payment is required. If full payment has not been made, payment is due within 30 days of the Final Order. Overdue amounts are subject to statutory interest and may be referred to collections. A check made payable to the "Agency for Health Care Administration" and containing the AHCA ten-digit case number should be sent to:

   
   

   Central Intake Unit

   Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 61

   Tallahassee, Florida 32308

   
   

3. Conditional licensure status is imposed on the Respondent beginning March 29, 2013, and ending April 20, 2013.

ORDERED at Tallahassee, Florida, on this day of_Ju_L_ ' 2019.

                        ecrctary

Agency for Health Care Administration

Filed July 22, 2019 10:26 AM Division of Administrative Hearings

NOTICE OF RIGHT TO JUDICIAL REVIEW

A party who is adversely affected by this Final Order is entitled to judicial review, which shall be instituted by filing one copy of a notice of appeal with the Agency Clerk of AHCA, and a second copy, along with filing fee as prescribed by law, with the District Court of Appeal in the appellate district where the Agency maintains its headquarters or where a party resides. Review of proceedings shall be conducted in accordance with the Florida appellate rules. The Notice of Appeal must be filed within 30 days of rendition of the order to be reviewed.

CERTIFICATE OF SERVICE

I CERTIFY that a true and correct f this Final Or er was  served on the below-named persons by the method designated on this2/ day of    ,..,,.,, ,2019.

oop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone: (850) 412-3630

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Docket for Case No: 13-002432

Orders for Case No: 13-002432