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AHCA

STATE OF FLORIDA AGENCY CLERK

AGENCY FOR HEALTH CARE ADMINISTRATION

2014 MAR 31 A fl: 23

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

vs.

SENIOR CARE GROUP, INC. d/b/a THE INN AT LAKESHORE VILLAS,

             Respondent.                                                              

/

DOAH No. 14-997

AHCA No. 2013008675

RENDITION NO.: AHCA- I y- - OlbCf -S-OLC

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 has jurisdiction over the above-named Respondent pursuant to Chapter 408, Part II, Florida Statutes, and the applicable authorizing statutes and administrative code provisions.

   
   

2. The Agency issued the attached Administrative Complaint and Election of Rights form to the Respondent. (Ex. 1) The Election of Rights form advised of the right to an administrative hearing.

   
   

3. The parties have since entered into the attached Settlement Agreement. (Ex. 2) Based upon the foregoing, it is ORDERED:

1. The Settlement Agreement is adopted and incorporated by reference into this Final Order. The parties shall comply with the terms of the Settlement Agreement.

   
   

2. The Administrative Complaint is DISMISSED.

tary Administration

ORDERED at Tallahassee, Florida, on this _21_ day of-+-, ---=-/4=-=--> ' 2014.

Filed April 11, 2014 4:10 PM Division of Administr1ative 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 of this Final Order was served on the below-named persons by the method designated on this .3l         of ,,/l/4.cc( , 2014.

, gency Cler

Agency for Health Care Administration 2727 Mahan Drive, Bldg. #3, Mail Stop #3

Tallahassee, Florida 32308-5403

Telephone: (850) 412-3630

2

cc: State Survey Agency State Medicaid Agency

Medicare Administrative Contractors Jackie Glaze, DMCHO, ARA Stephanie M. Davis, LTCCEB Manager

NOTE TO THE MEDICARE ADMINISTRATIVE CONTRACTORS:

This letter replaces the CMS-2007, Provider Tie-In Notice

Docket for Case No: 14-000997

Orders for Case No: 14-000997