STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, v. AHCA No. 2015004343 License No. 1093 MUSCULOSKELTAL AMBULATORY File No. 14960365 SURGERY CENTER, INC. d/b/a Provider Type: Ambulatory Surgical Center THE SURGERY CENTER AT POINTE WEST, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, Agency for Health Care Administration (hereinafter Agency), by and through the undersigned counsel, and files this Administrative Complaint against Respondent, Musculoskeletal Ambulatory Surgery Center, Inc. d/b/a The Surgery Center at Pointe West, (hereinafter Respondent), pursuant to Section 120.569, and 120.57, Florida Statutes, (2014), and alleges: NATURE OF THE ACTION This is an action to revoke the ambulatory surgical center license of Respondent pursuant to Sections 395.003(7), and 408.810(4), Florida Statutes (2014). PARTIES 1. The Agency is the regulatory authority responsible for issuance of ambulatory surgical center licenses and enforcement of all applicable state statutes and rules governing licensure pursuant to Part I, Chapter 395; Part I], Chapter 408, Florida Statutes (2014); and Rule 59A-5, Florida Administrative Code. Page 1 of 7 2. Respondent holds an ambulatory surgical center license (LICENSE#: 1093), located at 6015 Pointe West Boulevard, Bradenton, Florida 34209, and is thereby subject to the jurisdiction of the Agency. 3. Section 395.001, Florida Statutes (2014), provides, in pertinent part: Legislative intent— It is the intent of the Legislature to provide for the protection of public health and safety in the establishment, construction, maintenance, and operation of hospitals, ambulatory surgical centers, and mobile surgical facilities by providing for licensure of same and for the development, establishment, and enforcement of minimum standards with respect thereto. 4. Section 395.003, Florida Statutes (2014), provides, in pertinent part: Licensure; denial, suspension, and revocation.— (1)(a) The requirements of part II of chapter 408 apply to the provision of services that require licensure pursuant to ss. 395.001- 395.1065 and part II of chapter 408 and to entities licensed by or applying for such licensure from the Agency for Health Care Administration pursuant to ss. 395.001-395.1065. A license issued by the agency is required in order to operate a hospital, ambulatory surgical center, or mobile surgical facility in this state. (7) In addition to the requirements of part II of chapter 408, whenever the agency finds that there has been a substantial failure to comply with the requirements established under this part or in tules, the agency is authorized to deny, modify, suspend, and revoke: (a) A license; 5. Section 408.810, Florida Statutes (2014), provides, in pertinent part: Minimum licensure requirements.— In addition to the licensure requirements specified in this part, authorizing statutes, and applicable rules, each applicant and licensee must comply with the requirements of this section in order to obtain and maintain a license. Page 2 of 7 (4) Whenever a licensee discontinues operation of a provider: (a) The licensee must inform the agency not less than 30 days prior to the discontinuance of operation and inform clients of such discontinuance as required by authorizing statutes. Immediately upon discontinuance of operation by a provider, the licensee shall surrender the license to the agency and the license shall be canceled. (b) The licensee shall remain responsible for retaining and appropriately distributing all records within the timeframes prescribed in authorizing statutes and applicable rules. In addition, the licensee or, in the event of death or dissolution of a licensee, the estate or agent of the licensee shall: 1. Make arrangements to forward records for each client to one of the following, based upon the client’s choice: the client or the client’s legal representative, the client’s attending physician, or the health care provider where the client currently receives services; or 2. Cause a notice to be published in the newspaper of greatest general circulation in the county in which the provider was located that advises clients of the discontinuance of the provider operation. The notice must inform clients that they may obtain copies of their records and specify the name, address, and telephone number of the person from whom the copies of records may be obtained. The notice must appear at least once a week for 4 consecutive weeks. 6. Section 408.811, Florida Statutes (2014), provides, in pertinent part: Right of inspection; copies; inspection reports; plan for correction of deficiencies.— (1) An authorized officer or employee of the agency may make or cause to be made any inspection or investigation deemed necessary by the agency to determine the state of compliance with this part, authorizing statutes, and applicable rules. 7. The Agency made attempts to conduct inspection surveys upon Respondent’s facility in February, March and April of 2015, but found the facility to be closed during all attempted visits. Page 3 of 7 8. On March 25, 2015, the Respondent notified the Agency that it had discontinued operation at its licensed address. WHEREFORE, the Agency intends to revoke Respondent's ambulatory surgical center license pursuant to Sections 395.003(7) and 408.810(4)(a), Florida Statutes (2014). CLAIM FOR RELIEF WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, respectfully requests the Court to grant the following relief: A. Enter findings of fact and conclusions of law in favor of the Agency as set forth in the complaint, specifically sustaining the sanctions sought to be imposed hereby. B. Order any other relief deemed appropriate. RESPECTFULLY SUBMITTED this2)'7 tr, of May, 2015. kMt4— Bradford C. Herter Assistant General Counsel Florida Bar No. 69060 Office of the General Counsel Agency for Health Care Administration 2727 Mahan Drive, MS 3 Tallahassee, Florida Telephone: (850) 412-3639 Facsimile: (850) 922-6484 Page 4 of 7 NOTICE The Respondent is notified that it has the right to request an administrative hearing pursuant to Sections 120.569 and 120.57, Florida Statutes. If the Respondent wants to hire an attorney, it/he/she has the right to be represented by an attorney in this matter. Specific options for administrative action are set out in the attached Election of Rights form. The Respondent is further notified if the Election of Rights form is not received by the Agency for Health Care Administration within twenty-one (21) days of the receipt of this Administrative Complaint, a final order will be entered. The Election of Rights form shall be made to the Agency for Health Care Administration and delivered to: Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Mail Stop 3, Tallahassee, FL 32308; Telephone (850) 412-3630. 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 named below by the method designated on this 90” day of May, 2015. Bradford C. Herter, Assistant General Counsel Florida Bar No. 69060 Office of the General Counsel Agency for Health Care Administration 2727 Mahan Drive, MS 3 Tallahassee, Florida 32308 Telephone (850) 412-3639 Facsimile (850) 922-6484 Bradford.Herter@ahca.myflorida.com Copies furnished to: Musculoskeletal Ambulatory Surgery Center, Inc. CFRA, LLC 1917 Worth Court 100 S Ashley Drive, Suite 400 Bradenton, Florida 34211 Tampa, Florida 33602 (U.S. Certified Mail 91 7199 9991 7033 7530 5854) | (U.S. Certified Mail 91 7199 9991 7033 7530 5847) Page 5 of 7 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION RE: MUSCULOSKELTAL AMBULATORY SURGERY CENTER, INC. d/b/a THE SURGERY CENTER AT POINTE WEST AHCA NO. 2015004343 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 you receive the attached Notice of Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine or Administrative Complaint. If your Election of Rights with your selected option is not received by AHCA within 21 days of the day you received this proposed agency action by AHCA, you will have given up your right to contest the 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 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 to the allegations of facts and law contained in the Notice of Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine, or 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 to the allegations of facts contained in the Notice of Intent to Impose a Late Fee, 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. Page 6 of 7 OPTION THREE (3) I dispute the allegations of fact contained in the Notice of Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine, or 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 reccived 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. 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: Number and Street City Zip Code Telephone No. Fax No. E-Mail 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. 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Docket for Case No: 15-006571