STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

FIL.ED

AHCA

AGENCY CLERK

2016 SEP -b A fl: 2

DOAH No. 16-2869

vs.

Petitioner,

AHCA Nos. 2016001704

2016001809

File No. 11968059

License No. 12022

COOLIDGE PALMS ASSISTED LIVING RESORT, INC.,

Respondent.

                                                                              I

Provider Type: Assisted Living Facility

RENDITION NO.: AHCA- \ - Ol, lt5 -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 issued the attached Administrative Complaint and Election of Rights forms to the Respondent. (Ex. 1). The Election of Rights forms advised of the right to an administrative hearing.

   
   

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

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

   
   

4. The Respondent shall pay the Agency $10,000.00. 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

   
   

5. Except for his current providers, Mr. Herskovitz, individually, agrees, that pursuant to § 429.14(3), Fla. Stat., for a period of no less than five years from the date of the Final Order in this case, he will not apply for or hold, directly or indirectly, any type of license issued by the Agency, or exercise

Filed September 13, 2016 4:25 PM Division of Admi1nistrative Hearings

any type of control, directly or indirectly, over any Agency licensee.

ORDERED at Tallahassee, Florida, on this _I!.._ day of ' 2016.

cretary

are Administration

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_E5Wy of this Final Order was served on the below-named persons by the method designated on this _Q_ f .             ,2016.

Richard J. Shoop, Agency erk Agency for Health Care Administration

2727 Mahan Drive, Bldg. #3, Mail Stop #3

Tallahassee, Florida 32308-5403

Telephone: (850) 412-3630

Docket for Case No: 16-002869

Orders for Case No: 16-002869