STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

BHI, LLC d/b/a BLOUNTSTOWN HEALTH AND REHABILITATION CENTER,

Petitioner,

vs.

AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

/

Case No. 15-0190

RECOMMENDED ORDER OF DISMISSAL

Pursuant to notice, this case was heard on March 9, 2015, in Tallahassee, Florida, before E. Gary Early, a designated Administrative Law Judge of the Division of Administrative

Hearings.

APPEARANCES

For Petitioner: No appearance

For Respondent: Steven L. Perry, Esquire

Office of the Attorney General The Capitol, Plaza Level 01 Tallahassee, Florida 32399-1050

STATEMENT OF THE ISSUE

Whether Petitioner utilized the correct Medicaid per diem rates at its facility for the 18-month audit period identified in the November 7, 2011, Medicaid Examination Report.

PRELIMINARY STATEMENT

On May 8, 2012, the Agency for Health Care Administration (Respondent) issued a Medicaid Examination Report to BHI, LLC d/b/a Blountstown Health and Rehabilitation Center (Petitioner) for the 18-month audit period ending on October 31, 2004.

Petitioner was informed of its right to contest the results of the audit, and a timely Petition for Formal Administrative Hearing was filed by Petitioner. The Petition was transmitted to Division of Administrative Hearings and was assigned to the undersigned.

The Initial Order was entered on January 13, 2015. On January 20, 2015, a “Response to Initial Order” was filed by the registered agent for Petitioner, in which the registered agent acknowledged receipt of the pleadings in this case and, since Petitioner had been administratively dissolved, indicated that he had transmitted them to a manager of Petitioner’s corporate parent.

On January 26, 2015, the undersigned entered an Order to Show Cause why the case should not be dismissed based on the administrative dissolution of the corporate facility-owning entities. The response filed by Respondent provided satisfactory grounds for the case to proceed, and the case was set for hearing to commence on March 9, 2015.

On February 18, 2015, the registered agent filed a Notice of Non-Representation and Request for Clarification. On February 19, 2015, an Order on Request for Clarification was entered. The substance of the Order may be determined by reference to the docket in this case.

Petitioner did not file or exchange a witness list, exhibit list, or proposed exhibits, pursuant to the Order of Pre-Hearing Instructions. Respondent timely filed and served its exhibit list, along with an affidavit of a person familiar with the records at issue.

The final hearing was convened at 9:00 a.m. on March 9, 2015, as noticed. No one appeared on behalf of Petitioner. Counsel for Respondent appeared. A court reporter was in attendance, having been retained by Respondent. After preliminary matters were disposed of, a 15-minute recess was granted to allow for an appearance by Petitioner. The final hearing was reconvened at 9:20 a.m., without an appearance by Petitioner. Respondent’s Exhibits 1 and 2, consisting of the Medicaid Audit Report and a recent review thereof, were received in evidence. The final hearing was thereafter adjourned.

Given the burden of proof as discussed herein, post-hearing submittals were determined to be unnecessary.

References to statutes are to Florida Statutes (2014) unless otherwise noted.

FINDINGS OF FACT

1. By letter dated May 8, 2012, which included the Medicaid Audit Report that is the subject of this proceeding, Respondent gave Petitioner notice of its Medicaid reimbursement rate errors, subject to Petitioner’s right to contest the determinations of error and to demonstrate that its rates were correct in an administrative hearing.

2. A timely Petition for Formal Administrative Hearing involving disputed issues of material fact was filed on behalf of Petitioner.

3. After filing the hearing request, Petitioner took no further action to contest Respondent’s audit results. Despite having knowledge of these proceedings through its registered agent, Petitioner failed to comply with the Initial Order or the Order of Pre-Hearing Instructions, and failed to appear at the final hearing.

4. Based on Petitioner’s failure to appear and offer evidence, there is no evidentiary basis on which findings can be made regarding the Medicaid Audit Report, other than it was provided to Petitioner with a notice of rights.

   CONCLUSIONS OF LAW

   
   

5. The Division of Administrative Hearings has jurisdiction over the parties to and the subject matter of this proceeding. §§ 120.569 and 120.57, Fla. Stat. (2014).

   
   

6. As the party challenging the audited Medicaid rates, Petitioner has the burden of proving that its rates were correct. Sunrise Community, Inc. v. Ag. for Health Care Admin.,

   Case Nos. 10-4204, et al., (Fla. DOAH Apr. 25, 2011; AHCA Aug. 25, 2011).

7. Petitioner failed to meet its burden of proof.

RECOMMENDATION

Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Agency for Health Care Administration enter a final order dismissing the Petition for Formal Administrative Hearing and adopting the Medicaid Audit Report as final agency action in this proceeding.

DONE AND ENTERED this 11th day of March, 2015, in Tallahassee, Leon County, Florida.

S

E. GARY EARLY Administrative Law Judge

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060

(850) 488-9675

Fax Filing (850) 921-6847 www.doah.state.fl.us

Filed with the Clerk of the Division of Administrative Hearings this 11th day of March, 2015.

COPIES FURNISHED:

John F. Gilroy, III, Esquire John F. Gilroy III, P.A.

1695 Metropolitan Circle, Suite 2

Tallahassee, Florida 32308 (eServed)

Steven Lee Perry, Esquire Office of Attorney General The Capitol, Plaza Level 01 Tallahassee, Florida 32399 (eServed)

Richard J. Shoop, Agency Clerk

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

Tallahassee, Florida 32308 (eServed)

Stuart Williams, General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308 (eServed)

Elizabeth Dudek, Secretary

Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 1

Tallahassee, Florida 32308 (eServed)

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written exceptions within

15 days from the date of this Recommended Order. Any exceptions to this Recommended Order should be filed with the agency that will issue the Final Order in this case.

Docket for Case No: 15-000190

Orders for Case No: 15-000190