. STATE OF FLORIDA ; AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, . Petitioner, vs. , , AHCA No. 2014001789 License No. 299992616 QUALITY HEALTH CARE File No. 19965358 PROVIDERS, INC., License Type: Home Health Agency. Respondent. / ADMINISTRATIVE COMPLAINT COMES. NOW the Petitioner, State of Florida, Agency for Health Care Administration (“the Agency”), by. and through its undersigned counsel, and files this Administrative Complaint against the Respondent, Quality Health Care Providers, Inc. (“the Respondent”), pursuant to Sections 120.569 and 120.57, Florida Statutes (2013), and alleges as follows: NATURE OF THE ACTION This is an action to revoke the Respondent’s, home. health agency license and to impose an administrative fine of $6,000.00. against the Respondent. PARTIES 1. The Agency is the licensing and regulatory authority that oversees home health agencies in Florida and enforces the applicable federal regulations and state statutes and rules governing home health agencies. Ch. 408, Part II, Ch. 400, Part Ill, Fla. Stat. (2011), Ch. S9A-8, Fla. Admin. Code. . The Agency is authorized to deny, revoke, or suspend a license, and impose an administrative fine, for violations as. provided in Sections 400.474 and 400.484, Florida Statutes, and Rules 59A-8.003 and 59A-8.0086, Florida Administrative Code. G 2. The Respondent was issued a license by the Agency to operate a home health agency located at 110 West 29% Street, Suite C, Hialeah, Florida 33012, and was required to comply with the statutes and rules governing home health agencies. COUNT I Director of Nursing 3. Under Florida law, a home health agency. that provides skilled nursing care may not operate for more than 30. calendar days without a director of nursing. A home health agency. that provides skilled nursing care and the director of nursing of a home health agency must notify the Agency within 10 business days after termination of the services of the director of nursing for the home health agency. A home health agency. that provides skilled nursing care must notify the Agency of the identity and qualifications of the new director of nursing within 10 days after the new director is hired. If a home health agency that provides skilled nursing care operates for more than 30 calendar days without a director of nursing, the home health agency commits a class II deficiency. . In addition to the fine for a class II deficiency, the Agency may issue a moratorium in accordance with section 408.814 or revoke the license. The Agency shall fine a home health agency that fails to notify the agency as required in this paragraph $1,000 for the first violation and $2,000. for a repeat violation. § 400.476(2)(b), Fla. Stat. (2013). 4. Under Florida law, “director of nursing” means a registered nurse who is a direct employee, as defined in subsection 400.462(9), Florida Statutes, of the home health agency. and who is a graduate of an approved school of nursing and is licensed in this state; who has at least one year of supervisory experience as a registered nurse; and who is responsible for overseeing the professional nursing and home health aide delivery of services of the home health agency. § 400.462(10), Fla. Stat. (2013). 5. Under Florida law, “direct employee” means an employee for whom one of the following entities pays withholding taxes: a home health agency; a management company that has a contract to manage the home health agency on a day-to-day basis; or an employee leasing company that has a contract with the home health agency to handle the payroll and payroll taxes for the home health agency. § 400.462(10), Fla. Stat. (2013). 6. Under Florida law, the director of nursing of the home health agency shall: 1. Meet the criteria.as defined in Section 400.462(10), Florida Statutes, 2. Supervise or manage, directly. or through qualified subordinates, all personnel who. provide direct patient care; 3. Ensure that the professional standards of community. nursing practice are maintained by all " nurses providing care; and 4. Maintain and adhere to. agency procedure and patient care policy manuals. Fla. Admin. Code R. 59A-8.0095(2)(a). 7. The Respondent, at all times material, provided skilled nursing care. 8. On January 2, 2014, the Agency received notice from the Respondent’s former Director of Nursing that he or she had resigned from this position effective December 31, 2013. Ex. A. The Agency did not receive any such notice directly from the Respondent. 9. On February 6, 2014, the Agency sent correspondence to. the Respondent asking ‘for information regarding the name, resume and professional. license of the Respondent’s new Director of Nursing. | Ex. B. 10. To date, the Respondent has not provided the Agency the requested information. 11. The Respondent failed to notify the Agency within 10 business days after termination of the services of the Director of Nursing for the home health agency and/or failed to notify the Agency of the identity and qualifications of the new Director of Nursing within 10 days after the new Director or Nursing is hired. 12. The Respondent operated a home health agency for more than thirty (30) calendar days without a Director of Nursing. Sanction 13. Under Florida law, if a home health agency that provides skilled nursing care operates for more than 30 calendar days without a director of nursing, the home health agency commits a class II deficiency. In addition to the fine for a class II deficiency, the Agency may issue a moratorium in accordance with section 408.814 or revoke the license. The Agency shall fine a home health agency that fails to notify the agency as required in this paragraph $1,000 for the first violation and $2,000 for a repeat violation. § 400.476(2)(b), Fla. Stat. (2013). 14, Under Florida law, upon finding a class II deficiency, the agency shall impose an administrative fine in the amount of $5,000 for each occurrence and each day that a deficiency exists. § 400.484(2)(b) , Fla. Stat. (2013).. Under Florida law, each day of violation constitutes a separate violation and is subject to a separate fine. For fines imposed by final order of the Agency and not subject to further appeal, the violator shall pay the fine plus interest at the rate specified in section 55.03 for each day beyond the date set by the Agency for payment of the fine. § 408.813(1), Fla. Stat. (2013). 15. Under Florida law, the Agency may deny, revoke, and suspend a license and impose an administrative fine in the manner provided in Chapter 120. § 400.474(1), Fla. Stat. (2013). Any of the following actions by a home health agency or its employee is grounds for disciplinary action by the Agency: . (a) Violation of this part, part II of chapter 408, or of applicable rules... § 400.474(2)(a), Fla. Stat. (2013). 16. Under Florida law, in addition to the grounds provided in authorizing statutes, grounds that may be used by the Agency for denying and revoking a license or change of ownership application include any of the following actions by a controlling interest: ... (c) A violation of this part, authorizing statutes, or applicable rules. (d) A demonstrated pattern of deficient performance. § 408.815(1)(c)-(d), Fla. Stat. (2013). WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, seeks to revoke the Respondent’s home health agency license and to impose an administrative fine against the Respondent of $6,000.00. . CLAIM FOR RELIEF WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, respectfully seeks an order that: 1. Makes findings of fact and conclusions of law in favor of the Agency. 2. Imposes sanctions against the Respondent as set forth above. Respectfully. submitted on this (D? aay of March, 2014. Florida Bar No.. 064854 Agency. for Health Care Administration _ 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308. Telephone: (850) 412-3644 Facsimile: (850) 922-6484 Email: Michael. Hardy@ahca.myflorida.com NOTICE Pursuant to Section 120.569, F.S., any party has the right to request an administrative hearing by filing a request with the Agency Clerk. In order to obtain a formal hearing before the Division of Administrative Hearings under Section 120.57(1), F.S., however, a party must file a request for an administrative hearing that complies with the requirements of Rule 28-106.2015, Florida Administrative Code. Specific options for administrative action are set out in the attached Election of Rights form. The Election of Rights form or request for hearing must be filed with the Agency Clerk for the Agency for Health Care Administration within 21 days of the day the Administrative Complaint was received. If the Election of Rights form or request for hearing is not timely received by. the Agency Clerk by 5:00 p.m. Eastern Time on the 21st day, the right to a hearing will be waived. A copy. of the Election of Rights form or request for hearing must also be sent to the attorney. who issued the Administrative Complaint at his or her address. The Election of Rights form shall be addressed to: Agency Clerk, Agency for Health Care . Administration, 2727 Mahan Drive, Mail Stop 3, Tallahassee, FL 32308; Telephone (850) 412-3630, Facsimile (850) 921-0158. Any party who appears in any agency proceeding has the right, at his or her own expense, to be accompanied, represented, and advised by counsel or other qualified representative. Mediation under Section 120.573, F.S., is available if the Agency. agrees, and if available, the pursuit of mediation will not adversely affect the right to administrative proceedings in the event mediation does not result in a settlement... CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy. of the Administrative Complaint and Election of Rights Form were served to the individuals named below by the method designated on this 2? day of March, 2014. : 4 hd (ZL Michael J. Hardy, Assistant Gener unsel Florida Bar No. 064854 Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 Telephone: (850) 412-3644 Facsimile: (850) 922-6484 Email: Michael. Hardy@ahca.myflorida.com Eliseo D. Espaillat, Administrator Quality Health Care Providers, Inc. . 1100 West 29" Street, Suite C Hialeah, FL. 33012 Certified Mail — 7012 1010 0003 2438 1340) Eliseo D. Espaillat, Registered Agent Quality Health Care Providers, Inc. 9898 NW 133" Street Hialeah, FL 33018 Certified Mail - 7012 1010 0003 2438 1357) STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION Re: Quality Health Care Providers, Inc. AHCA No. 2014001789 ELECTION OF RIGHTS This Election of Rights form is attached to a proposed agency 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 may. be returned by mail or by facsimile transmission, but must be filed within 21 days of the day that you receive the attached proposed agency action. If your Election of Rights with your selected _ option is not received by AHCA within 21 days of the day that you received this proposed agency. action, you will have waived your right to contest the proposed agency 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, and Chapter 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. Telephone: 850-412-3630 Facsimile: 850-921-0158 PLEASE SELECT. ONLY 1 OF THESE 3 OPTIONS OPTION ONE (1). I admit. the allegations of facts and conclusions of law contained in the 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 the allegations of facts contained in the 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) I dispute the allegations of fact contained in the Administrative Complaint and I request a formal hearing (pursuant to Section 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 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 agency 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. The name, address, telephone number, and facsimile number (if any) of the Respondent. 2. The name, address, telephone number and facsimile number of the attorney or qualified representative of the Respondent (if any) upon whom service of pleadings and other papers shall be made. 3. A statement requesting an administrative hearing identifying those material facts that are in dispute. If there are none, the petition must so indicate. . 4. A statement of when the respondent received notice of the administrative complaint. 5. A statement including the file number to the administrative complaint. Mediation under Section 120.573, Florida Statutes, may be available in this matter if the Agency. agrees. Licensee Name: Contact Person: . Title: Address: Number and Street City Zip Code Telephone No. Fax No. E-Mail (optional) I hereby. certify that I am duly authorized to submit this Election of Rights to the Agency for Health Care Administration on behalf of the licensee referred to above. Signed: Date: Print Name: . Title: _ © FIM S30 LETTER OF RESIGNATION NM TO: Jocelyn Perez, Administrator Quality Health Care Providers, Inc. 1100 west, 29 st, suite Hialeah, Florida, 33012 FROM: Celia Salas, RN, D.O.N To whom it may concer: Please receive this letter of resignation as Director of Nurse because I will start working in | hospital a full time shift. My resignation will be effective 12/31/2013. Sincerely, ; | Celia Salas, RN, D.O.N RECEIVED JAN 02 2014 Central Systems. Mafiagement Unit EX A . : ‘Us. postace welt a. wales nH gin Hee, FL BRIO wat, way papT 19! A neg a3 Hielect, Gerdeng , Fl, Bolg. Hi li a 65 HcA H ‘ Cave Onis . HSdb S44 | . s2% Makau Deive | i ll le he asee , FL, Arno Y Blas HLH ttfdis gif 7020 2760 pog3.482% 3563 RECEIVED JAN 02 2014 ntral Systems Management Unit Ce; FLORA AGENCY FOR HEATH CARE ADMINISTOION RICK SCOTT -_ ELIZABETH DUDEK GOVERNOR Better Health Care for all Floridians ~ SECRETARY February 6, 2014 Administrator HHA # 299992616 Quality Health Care Providers 1100 West 29 Street Suite C Hialeah, FL 33012 Fax: 305-885-7759 RE: Resignation of Director of Nursing (DON) Dear Administrator AHCA has received information that your DON, Celia Ivon Salas, has resigned effective 12/3 1/2013. This office must be notified of the name of the DON you employ to replace the DON that resigned. Please select anew DON complete and send Personnel Change Information Needed Worksheet found at the website http://ahca,myflorida.com/MICHQ/Health Facility Regulation/Home Care/HHA/index.shtmifapplication Click on Frequently Asked Questions, and then go to Section 16 Making Personnel Changes. Effective July 1, 2008-a home health agency that provides skilled nursing may not operate more than 30 calendar _ days without a DON, If the home health agency operates moré than 30 calendar days without this required position the agency commits a class If deficiency. : The DON may also serve multiple agencies in accordance with 400.476 (2) (a) I. and 2. FS.: Up to two licensed home health agencies that. have identical controlting interests that are located within the same geographic service area or in an immediately contiguous county; ¢ Up to five home health agencies if all of the agencies have identical controlling interests; (same legal entity, owner, officers and board-members) located within the same geographic service area or in an immediately contiguous. county and each of the home health agencies has a registered nurse that has the same qualifications as the DON and has a written delegation to serve as the DON in the absence of the named DON. If the DON you select is going to serve three or more hortie health agencies, please include the name of the Registered Nurse Delegate. Please provide this information within 10 days of receipt of this letter. Include a copy of this letter with your response, If you. have any questions, please-call this office.at (850) 412-4398 or fax (850) 922-5374. (Please use only one method when sending in your responses; mail, fax, or email.) Sincerely, Charkene Carley Char Corley, Regulatory Specialist 1 Home Care Unit Mail Stop 34 a Visit ANCA online at hito:/ahca.myflorida.com 2727 Mahan Drive, MS#34 Tallahassee, Florida 32308 TX Result Report 02/06/2014 Poi 19: 24 Serial Ne. A1UNG?i1oO0609 TG: Addressee 613058857759 THR:Timer TX, POL:Polling, Original Size Setting, FME: Frame Erase Tx, Note BBG IBAgET sebarnetan ree atx Tene GF 28in ai" Fx® GREP Panta L TR. CSACICSAC, | EUS Rorward, PCIPC-FAR. BNDiboOUble-Sided Binding Direction, SbiSpeciai Seiginar. FCODE iF code, RIkthe-Tx. RLY iRelay. MBX:Confidential, BUL Bulletin, SIpisiP Fax, EPADA IP Address Fax, I-FAX:Enternet Fax : Resuit OK: Communication OK, S-OK: Stop Communication, PW-OFF: Power Switch OFF, TEL: RX from TEL, NG: Other Error, Cont: Continue, No Ans: No Answer, Refuse: Receipt Refused, Busy: Busy, M-Full:Memory Full, LOUR: Receiving length Over, POVR:Receiving page Over, FIL: File Error, DC: Decode Error, MDN:MDN Response Error, DSN: DSN Response Error. RICK SCOTT ~ ELIZABETH DUDE? BOURRNOR Better tHoalth Gare forall Floridians Storer February 6, 2014 Administrator MLA. 4 299992616 Quality tlealth Care Providers £100. West 29 Street Suite C Hiateah, FL 33012 Fax: 305-885~7759 RE: Resignation of Director of Nursing GOON) Deer Administrator AHCA has received information that your DON, Celia Ivon Salus, has res(gned effective 12/3 1/2013. This office must be notified of the name of the DON you employ to replace the DOW that resigned. Please select a now DON complete and. send Personnel Change Information Needed Worksheet found at the website he isa, es u vi = annlication Click om Frequently Asked Questions, and then go.to.Section 16 Making Personnet Changes. Effective July 1, 2008-2 home health agency that provides skilled nursing may mot operate more than 30 calendar . gays without a DON. if the homo health agency operates more than 30 calendar days without this required posiion the agency cornmits « Class Lt deficiency. ‘The DON may also serve multiple agencies in dccordsnce with 400.476. (2) (a> 1. ana 2. - Up to two licensed home health agencies that have identical controlling interests that are locased within the same geographic service trea or in an immediately. contigueus county: * ° + © Up to five home health agencies if all ofthe agencies have identical controlling interests; (same legal entity, owner, officers and board members) located within the same geographic service urea or in an immediaccly contiguous county and each of the home health agencies has a registered nurse that bus the same qualifications as the DON and has a written delegation to serve as the DON in the absence of the named DON: [f the DOM you select is going to serve three or more home health agencies, please inchuic the name of the Registered Nurse Detegnte. Please provide this information within 10 days of receipt of this letter, Inchide'a copy of this fetter with your response. If you have any questions, please call this office at (850) 412-4398 or fax (850) 922-5374. (Please use only one method when sending In your responses; mati, fax, or eniait.) Sincerely, Char Corley, Regulatory Specialist 1 Home Care Unit Mail Stop 34 2727 Manan Grive, MS#34 Visit AHGA Sniine at Tallahassee, Florida 32308 Rittpr//mhoa.myferida com 74073 | peansty o peyed —] *90} JO} JeseUjsod ynsuoD . ASayeq peyouisey. oO 3S sequinu epme oun ‘MOjeq soeidiyeus el) Uo ,persenbey "ieoon UNO, UN Sseuppy Ss, eessaippy Di bP 2. you s80p eaeds yr 5oeq ean Uo 10 ‘eoerdjeus UL JO UO 9p OF LUO} SIU WORRY a (eax enxe “NOA 03 pula Oy BX Sup tur uo Ga yu 08 tls Jo esta 4 un Seppe pu UE OK ide Ue.J0}) seores GUIMOO} 6U) eAjeNeI OF YS OS|E | ‘e01Aleg idjesey uunjey Buisn 40) noA yURUL Certified Fea Retum Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) 7012 1010 O6003 2438 1357 ee OL See Reverse forinstructions |

Docket for Case No: 14-002605