Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: CRISTAL PALACE RESORT PB, LLC
Judges: LISA SHEARER NELSON
Agency: Agency for Health Care Administration
Locations: Titusville, Florida
Filed: Apr. 10, 2017
Status: Closed
Recommended Order on Friday, June 29, 2018.
Latest Update: Aug. 20, 2018
Summary: The issues to be determined are whether Cristal Palace Resort PB, LLC (Cristal Palace), committed the statutory or rule violations alleged in the Administrative Complaints in Case Nos. 17-2149 and 17-2164, and in the Second Amended Notice of Intent to Deny docketed as Case No. 17-3849; and, if so, what penalty is authorized for the violations proven.The Agency proved a limited number of class III and unclassified violations warranting fines and a survey fee. The Agency did not complete its statu
Summary: The issues to be determined are whether Cristal Palace Resort PB, LLC (Cristal Palace), committed the statutory or rule violations alleged in the Administrative Complaints in Case Nos. 17-2149 and 17-2164, and in the Second Amended Notice of Intent to Deny docketed as Case No. 17-3849; and, if so, what penalty is authorized for the violations proven.The Agency proved a limited number of class III and unclassified violations warranting fines and a survey fee. The Agency did not complete its statutory obligation with respect to the license renewal.
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STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
STATE OF FLORIDA, AGENCY FOR
HEALTH CARE ADMINISTRATION, ;
Case Nos. 2015012605
Petitioner, ; 2016009811
: 2016009813
v. : : 2016009815
. 2016006006
2016008240
2016004117
CRISTAL PALACE RESORT PB LC., 2016003289
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, Cristal Palace Resort PB LC (“Respondent”), pursuant to Sections
120.569 and 120.57, Florida Statutes (2016), and alleges:
NATURE OF THE ACTION
This is an action against an assisted living facility to revoke its licensure to operate an
assisted living facility in the State of Florida and to impose an administrative fine in the amount
of seventeen thousand dollars ($17,000.00) and survey fees of two thousand dollars ($2,000.00),
for a total sum of nineteen thousand dollars ($19,000.00) based upon two (2) Class II
deficiencies, six (6) uncorrected Class III deficiencies, and seven (7) unclassified deficient
practices,
JURISDICTION AND VENUE
1. The Agency has jurisdiction pursuant to §§ 20.42, 120,60, and Chapters 408, Part II, and
429, Part I, Florida Statutes (2016).
2. Venue lies pursuant to Florida Administrative Code R. 28-106.207.
PARTIES
3. The Agency is the regulatory authority responsible for licensure of assisted living ©
facilities and enforcement of all applicable federal regulations, state statutes and rules governing
assisted living facilities pursuant to the Chapters 408, Part II, and 429, Part I, Florida Statutes,
and Chapter 58A-5, Florida Administrative Code, respectively.
4, Respondent operates a two hundred fifty-two (252) bed assisted living facility located at
1881 Palm Bay Road, Palm Bay, Florida 32905, and is licensed as an assisted living facility,
license number 12660, with Extended Congregate Care specialty licensure.
5. . Respondent was at all times material hereto a licensed facility under the licensing
authority of the Agency, and was required to comply with all applicable rules and statutes.
COUNT I
6. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth
herein.
7. That Florida law provides:
An assisted living facility shall provide care and services appropriate to the needs
of residents accepted for admission to the facility.
(1) SUPERVISION. Facilities shall offer personal supervision, as appropriate for
each resident, including the following:
(a) Monitor the quantity and quality of resident diets in accordance with Rule
58A-5.020, F.A.C,
(b) Daily observation by designated staff of the activities of the resident while on
the premises, and awareness of the general health, safety, and physical and
emotional well-being of the individual.
(c) General awareness of the resident’s whereabouts. The resident may travel
independently in the community.
(d) Contacting the resident’s health care provider and other appropriate party such
’ as the resident’s family, guardian, health care surrogate, or case manager if the
resident exhibits a significant change; contacting the resident’s family, guardian,
health care surrogate, or case manager if the resident is discharged or moves out.
(e) A written record, updated as needed, of any significant changes as defined in
subsection S8A-5,0131(33), F.A.C., any illnesses which resulted in medical
attention, major incidents, changes in the method of medication administration, or
other changes which resulted in the provision of additional services.
Rule 58A-5.0182(1), Florida Administrative Code.
8. That on August 26, 2015, the Agency completed a complaint (CCR# 2015004890) survey
of Respondent’s facility.
9. That based upon the review of records, observation, and interview, Respondent failed to
provide care and services, including personal supervision, appropriate to the needs of residents
telating to, inter alia, the provision of medication in accord with physician orders and the
clarification of physician orders, the same being contrary to the requirements of law.
10. That Petitioner’s representative observed resident number five (5) on August 12, 2015, at
12:30 PM, and noted the resident’s blood glucose reading reflected the resident’s blood sugar
level as “Hi,” and the blood sugar level, when retaken was five hundred fifteen (515).
11. That Petitioner’s representative reviewed Respondent’s records related to resident
number five (5) and noted as follows:
a. A physician’s order, dated August 6, 2015, directed medium sliding insulin scale,
check blood sugar before meals and at bedtime.
b. Absent from the records was any sliding scale to be utilizing in calculating the
amount of insulin to be utilized based upon identified blood sugar levels.
c. Absent from the records was any indication that Respondent attempted to clarify the
August 6, 2015, physician's order.
d. The resident's morning blood sugar was one hundred ninety-two (192), but
documentation to indicate if sliding scale insulin was required at that time was not
found in the resident's medical record.
e. The resident’s Assisted Living Facility Health Assessment Form, Form 1823, dated
August 6, 2015, indicated diagnoses of diabetes, retinopathy, neuropathy, chronic
obstructive pulmonary disease and coronary artery bypass surgery.
f. A physician’s order dated August 6, 2015, also directed Humalog Insulin 10 units
with each meal was to be given
g. The resident’s Medication Observation Record (MOR) for August 2015 was reviewed
and documented as follows: |
i. The record did not contain any documentation that sliding scale insulin
was given to the resident.
ii, The back of the record contained documentation dated August 11,
2015, no time documented that Humalog insulin 20 units was given to
the resident by unlicensed staff upon the resident's request.
12. That Respondent called emergency services, 911, on August 12, 2015, at approximately
1:30 PM.
13. That emergency medical technicians (EMT - paramedics) arrived at the facility to provide
emergency care and, when the resident's blood sugar was taken again, it continued to be above
the five hundred (500) ranges, which was a medical emergency and could be caused by not
receiving an adequate amount of insulin.
14. That Petitioner’s representative interviewed Respondent’s marketing director regarding
resident number five (5) on August 12, 2015, at approximately 1:00 PM, who indicated:
a. The resident was recently admitted from a nursing home in another county.
b. The facility did not have a nurse around the clock 24/7 and the resident needed a lot
of care.
c, Was not aware that staffs were not following the physician’s orders related to diabetic
treatment, .
15. That the above reflects the failure of Respondent to provide care and services, including
personal supervision, appropriate to resident needs including but not limited to the failure to
ensure that prescribed medications for treatment of diabetes are provided in accord with
physician orders.
16. | The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of a provider or to the care of clients which directly threatens
the physical or emotional health, safety, or security of the clients, other than class I violations.
17. That the same constitutes a Class II offense as defined in Florida Statute 429.19(2)(b)
(2013). .
WHEREFORE, the Agency intends to impose an administrative fine in the amount of
five thousand dollars ($5,000.00) against Respondent, an assisted living facility in the State of
Florida, pursuant to § 429.19(2)(c), Florida Statutes (2014).
COUNT IL
18. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth
herein.
19. That Florida law provides “(1). ADMINISTRATORS. Every facility must be under the
supervision of an administrator who is responsible for the operation and maintenance of the —
facility including the management of all staff and the provision of appropriate- care to all
residents as required by Chapters 408, Part II, 429, Part I, F.S. and Rule Chapter 59A-35, FAC,
and this rule chapter.” Rule 58A-5.019(1), Florida Administrative Code.
20. That on October 16, 2014, the Agency completed a re-licensure and two (2) complaint
surveys of Respondent’s facility. .
21. That based upon the review of records, observation, and interview, Respondent’s
administrator failed to supervise an administrator the operation and maintenance of the facility
including the management of all staff and the provision of appropriate care to all residents as
required by law.
22. That Count I of this Administrative Complaint is incorporated herein as though fully
recited herein. |
23. That Respondent’s administrator failed to ensure that a licensed nurse was available to
administer medications to a resident as required by law, see, Rule 58A-5.0185(4), Florida
Administrative Code; as evidenced by the following:
a, The medication observation record for resident number five (5) documented on the
reverse that on August 8, 2015, Humalog insulin 20 units was administered to the
resident upon the resident's request by the unlicensed staff.
b. A physician's order dated August 6, 2015, revealed that Humalog Insulin 10 units
were to be given with each meal.
c. The resident’s Assisted Living Facility Health Assessment Form, Form 1823, dated
August 6, 2015, indicated diagnoses of diabetes, retinopathy, neuropathy, chronic
obstructive pulmonary disease and coronary artery bypass surgery.
d, On August 12, 2015, at approximately 12:45 PM, Respondent’s marketing director
said she was not aware the unlicensed staffs were administering insulin.
e. The resident’s August 2015 medication observation record for the resident
documented Humalog insulin 10 units under skin before a meal at 8:00 AM on
August 8, 2015, a Saturday, was signed by unlicensed staff whose initials were in the
box.
f. Respondent’s nutse “C” indicated that he only worked during the week and did not
work on the weekend.
24. That Respondeit’s administrator failed to ensure that it maintained accurate and up-to-.
date medication observation records for residents. as required by law, see, Rule 58A-5.0185(5),
Florida Administrative Code; as evidenced by the following:
a. Petitioner’s representative observed Medication Pass on August 12, 2015, at”
approximately 1:15 PM, and noted Tylenol 325 milligrams 2 tablets every 6 hours as
needed for pain was given by the nurse to resident number five (6).
b. The August 2015 medication observation records for resident number five (5) did not
reflect the administration of the Tylenol as given on August 12, 2015, at
approximately 1:15 PM.
c. On August 12, 2015, at approximately 4:30 PM, Respondent’s marketing director
indicated that she was not aware the medication observation record for resident
number five (5) was not up to date and the medication was not charted.
25. That Respondent’s administrator failed to ensure that medications were maintained in a
locked cabinet, locked cart, or other locked storage receptacle, room, or area at all times as
required by law, see, Rule 58A-5.0185(6), Florida Administrative Code; as evidenced by the
following:
a
On August 12, 2015, at approximately 12:30 PM, Petitioner’s representative observed
Humalog insulin, Lantus insulin in an unlocked refrigerator in the room of resident
number five (5).
Resident number five (5) was sent to the hospital on August 12, 2015, at
approximately 1:30 PM, but the insulin was not secured.
Respondent’s marketing director indicated on August 12, 2015, at approximately
12:45 PM, that she was not aware the insulin was not secured.
26. That Respondent’s administrator failed to ensure that it ensured that staff were not
assigned duties that were not consistent with their training, education, and qualifications as
required by law, see, Rule 58A-5.019(2)(b), Florida Administrative Code; as evidenced by the
following:
a.
The August 2015 medication observation record for resident. number five (5) _
documented by initials that on August 11, 2015, no time noted, Humalog insulin 20
units was given to the resident upon the resident's request.
A physician's order, dated August 6, 2015, prescribed Humalog Insulin 10 units to be
given with each meal.
The resident’s August 2015 medication observation record documented Humalog
insulin 10 units under skin before a meal at 8:00 AM on August 8, 2015, was signed
by unlicensed staff, whose initials were in the box.
Respondent’s nurse “C” indicated that he only worked during the week and did not
work on the weekend.
— .
27.. That Respondent’s administrator failed to ensure that it maintained a written work
schedule reflecting the facility’s twenty-four (24) hour staffing as required by law, see, Rule
58A-5.019(3)(c), Florida Administrative Code; as evidenced by the following:
a. When Respondent’s staffing schedule for August 2015, from the third through
twelfth, was attempted to be reviewed, there was no staffing schedule available for
review. |
b. There was no staff schedule for May 2015 for review.
c. Respondent’s marketing director indicated on August 12, 2015, at approximately
11:00 AM, that she did not have access to the staffing schedules.
28. That Respondent’s administrator failed to ensure that trained dietary staffs were available
to prepare meals and ensure that food service was provided in a safe manner as required by law,
see, Rule 58A-5.020(1), Florida Administrative Code; as evidenced by the following:
a. That Respondent’s marketing director indicated on August 12, 2015, at approximately
11:45 AM, that the cook did not show up to prepare lunch. She said she was not
aware the cook was not going to be available to prepare lunch and dinner that day.
b. Petitioner’s representative observed the following in Respondent’s walk-in freezer on
August 12, 2015, at approximately 11:45 AM:
i. There was food not labeled and/or past it’s identified expiration date.
ii.” The meatloaf was dated August 2, 2015; the sweet potatoes were not
labeled; the rice pilaf was dated July 28, 2015; the rice was labeled
July 31, 2015; the fruit was labeled August 2, 2015; and there were
three (3) containers that were not labeled.
c. Respondent’ marketing director indicated on August 12, 2015, that the facility’s
health department inspection reports were locked in the administrator's desk and she
did not have access to them.
d. A Health Department inspection report dated August 13, 2015, contained the
following:
a. There was a bag of chicken sitting out on the counter to thaw.
b. There were some food containers that were not labeled and/or dated.
c. There were some containers of potentially hazardous foods that were past the
seven (7) day window and some that were past the expiration date on the
packaging.
" d. The walk-in freezer was shut down at the at the time of the inspection and not
able to be opened.
e. The inspection was unsatisfactory.
29. That Respondent’s administrator failed to ensure that it provided a safe living
environment for residents as required by law, see, Rule 58A-5.023(3), Florida Administrative
Code; as evidenced by the following:
a, A Health Department report dated August 3, 2015, documented that there was a
"small amount of what appeared to be mold" behind one of the washing machines,
The area needed to-be thoroughly cleaned and the mold removed.
b. The Health Department inspection report was unsatisfactory.
c. On August 12, 2015, Respondent’s marketing director indicated at approximately
10:30 AM that the mold chad been removed and the Health Department had not
returned for a re-inspection.
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a Petitioner’s representative observed on August 12, 2015, at approximately 1:30 PM,
that there were no lights in the north stairwell, between the first and second floors
near rooms 135 and 235. The residents had access to the stairwell and it was not safe
to use the stairs. Between the fourth and fifth floors, two (2) lights were not working.
e. On August 12, 2015, Respondent’s marketing director indicated at approximately
1:30 PM that she was not aware there were no lights in the stairwell.
30. That Respondent’s administrator failed to ensure that it provided nursing staff for an
extended congregate care resident as required by law, see, Rule 58A-5 .030(4), Florida
Administrative Code; as evidenced by the following: .
a. On August 12, 2015, at approximately 12:00 PM Petitioner’s representative noted.
resident number five (5) had oxygen on per nasal cannula at three (3) liters/minute.
b. On August 12, 2015, at approximately 12:30 PM, resident number five (5) indicated
that the resident was not able to bend over to reach the oxygen concentrator and
“needed help with the oxygen. .
c. The Assisted Living Facility Health Assessment Form, Form 1823, dated August 6,
2015, indicated diagnoses of diabetes, retinopathy, neuropathy, chronic obstructive
pulmonary disease and coronary artery bypass surgery, and further indicated the
resident used a Continuous Positive Airway Pressure (CPAP) machine at night.
d. Respondent’s marketing director indicated on August 12, 2015, at approximately 4:00
PM, that the facility did not have nursing staff twenty-four (24) hours a day to
provide ECC services for oxygen and CPAP machine use.
31. That Respondent’s administrator failed to ensure that extended congregate care services
were authorized by a physician’s order, recorded in progress notes, and completed in accord with
ll
the resident’s service plan as required by law, see, Rule 58A-5.030(8), Florida Administrative
Code; as evidenced by the following:
32,
33.
a.
Petitioner’s representative noted on August 12, 2015, at approximately 12:00 PM that
resident number five (5) had oxygen on per nasal cannula at three (3) liters/minute.
On August 12, 2015, at approximately 12:30 PM, resident number five (5) indicated
the resident was not able to bend over to reach the oxygen concentrator and needed
help with the oxygen: .
The resident’s Assisted Living Facility Health Assessment Form, Form 1823, dated
August 6, 2015, indicated diagnoses of diabetes, retinopathy, neuropathy, chronic
obstructive pulmonary disease and coronary artery bypass surgery. The 1823 also
indicted the resident used a CPAP machine at night.
The resident’s record contained no physician's order for the use of the oxygen, there
were no progress notes, and a service plan had not been developed.
On August 12, 2015, at approximately 4 PM, Respondent’s marketing director stated
she was not aware there was no physician's order for the use of the oxygen, not aware
the resident was not put on ECC services, and not aware the resident did not have a
service plan or progress notes for the use of oxygen.
That Count III is incorporated by reference as if fully recited herein.
That Respondent’s administrator failed to ensure that it posted an activity calendar in a
common area where residents congregate as required by law, see, Rule 58A-5.0182(2)(c),
Florida Administrative Code; as evidenced by the following:
a.
On August 12, 2015, at approximately 10:30 AM, Petitioner’s representative could
not locate an activities calendar in any common area where residents congregate.
b. On August 12, 2105, at approximately 10:30 AM, Respondent's marketing director
Stated the facility did not have an activities calendar.
34. That Respondent’s administrator failed to ensure that the Agency was notified of a
change of use in licensed space.
a. That Petitioner’s representative observed on August 12, 2015, personal belongings of
Respondent’s staff members in resident rooms 101, 103, and 109. _ .
b. Respondent’s marketing director indicated, at approximately 11:30 AM on August
12, 2015, that she stayed at the facility during the week, and the administrator and a
family member stayed in room 109.
c. Respondent’s staff member “C” indicated, at approximately 21:30 PM on August 12,
2015, that he stayed in a room during the week and went home on the weekends. |
. 35. | That Respondent’s administrator failed to ensure that the Facility was accessible to
Agency personnel for inspection as required by law, see, Section 408.811, Florida Statutes
. (2015).
a. Respondent’s representatives attempted to conduct a complaint inspection on August
25, 2015, and from 8:10 PM to 8:25 PM the front doors to the facility were locked.
b. Respondent’s representative attempted phone calls to the facility at the number of
record and the phone number provided to the Agency did not work.
c. On August 26, 2015, at approximately 8:50 PM, in a phone interview with the
marketing director, she stated that the door to the facility was always open until 10:00
PM, and that the facility had communication issues with the phone line and the
number was changed. She was not aware the Agency was unable to contact the
facility.
36. That Respondent’s administrator failed to ensure that it honored resident rights to a safe
and decent living environment, failed to honor resident rights to access to personal funds, and
failed to honor resident rights related to notice of discharge as required by law, see, Section
429.28, Florida | Statutes (2015) and Rule 58A-5.0181, Florida Administrative Code; as
evidenced by the following: |
a. A Health Department inspection report dated August 3, 2015, documented that there
was "a small amount of what appeared to be mold" behind one of the washing
machines.” It noted the area needed to be thoroughly cleaned and the mold removed.
The inspection report was unsatisfactory.
b. Respondent’s marketing director indicated on August 12, 2015, at approximately
10:30 AM, that the mold had been removed and the Health Department had not
returned for a re-inspection. .
c. On August 12, 2015, at approximately 1:30 PM, no lights were in the north stairwell,
between the first and second floors, near rooms 135 and 235. Residents had access to
the stairwell and it was not safe to use the stairs. In between the fourth and fifth
floors, two (2) lights were not working.
d. Respondent’s marketing director indicated on August 12, 2015, at approximately 1:30
- PM indicated that she was not aware the lights in the stairwell were not working.
e. The Agency received information that residents numbered one (1), two (2), and three
(3), were not given a forty-five (45) day notice of their discharge and review of the
admission/discharge log revealed the residents were discharged on May 26, 2015.
14
f. Respondent’s marketing director indicated on August 12, 2015, at approximately 1:00
PM indicated that the residents were immediately discharged when the facility closed
down until July 2015.
g. On August 12, 2017, at approximately 10:30 AM, resident number four (4) stated the
resident wanted to get somie money out of the resident’s personal funds that the
facility was holding for the resident and was unable to do so.
h. Respondent’s marketing director indicated on August 12, 2015, at approximately
11:00 AM indicated that Respondent’s administrator was out of the building at
training, had the key to where the money was held, and she did not have a key.
37. That the above reflects the failure of Respondent’s administrator to meet the management
and care minimum requirements of law.
38. The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of a provider or to the care of clients which directly threatens
the physical or emotional health, safety, or security of the clients, other than class I violations,
39. That the same constitutes a Class II offense as defined in Florida Statute 429.19(2)(b)
(2013).
WHEREFORE, the Agency intends to impose an administrative fine in the amount of
five thousand dollars ($5,000.00) against Respondent, an assisted living facility in the State of
Florida, pursuant to § 429.19(2)(c), Florida Statutes (2014).
COUNT II
40. That on August 26, 2015, the Agency completed a complaint (CCR# 2015004890) survey
of Respondent’s facility.
41. . Under Florida law, the Agency shall require level 2 background screening for personnel as
required in Section 408.809(1)(e) pursuant to Chapter 435 and Section 408.809. § 429.174, Fla.
Stat. (2015).
42. Under Florida law, level 2 background screening pursuant to Chapter 435 must be
conducted through the Agency on each of the following persons, who are considered employees
for the purposes of conducting screening under Chapter 435: (a) The licensee, if an individual.
(b) The administrator or a similarly titled person who is responsible for the day-to-day operation
of the provider. (c) The financial officer or similarly titled individual who is responsible for the
financial operation of the licensee or provider (d) Any person who is a controlling interest if
the Agency has reason to believe that such person has been convicted of any offense prohibited
by Section 435.04. For each controlling interest who has been convicted of any such offense, the
licensee shall submit to the Agency a description and explanation of the conviction at the time of
license application. (e) Any person, as required by authorizing statutes, seeking employment
with a licensee or provider who is expected to, or whose responsibilities may require him or her -
to, provide personal care or services directly to clients or have access to client funds, personal
property, or living areas; and any person, as required by authorizing statutes, contracting with a
licensee or provider whose responsibilities require him or her to provide personal care or
personal services directly to clients. Evidence of contractor screening may be retained by the
contractor’s employer or the licensee. § 408.809(1), Fla. Stat. (2015).
43. Under Florida law, every 5 years following his or her licensure, employment, or entry into
acontract in a capacity that under subsection (1) would require level 2 background screening
under chapter 435, each such person must submit to level 2 background rescreening as a
condition of retaining such license or continuing in such employment or contractual status. For
any such rescreening, the agency shall request the Department of Law Enforcement to forward
the person’s fingerprints to the Federal Bureau of Investigation for a national criminal history
record check unless the person’s fingerprints are enrolled i in the Federal Bureau of
Investigation’s national retained print arrest notification program. If the fingerprints of such a
person are not retained by the Department of Law Enforcement under s. 943.05(2)(g) and (h), the
person must submit fingerprints electronically to the Department of Law Enforcement for state
processing, and the Department of Law Enforcement shall forward the fingerprints to the Federal
Bureau of Investigation for a national criminal history record check. The fingerprints shall be
retained by the Department of Law Enforcement under s.943.05(2)(g) and (h) and enrolled in the
national retained print arrest notification program when the Department of Law Enforcement
begins participation in the program. The cost of the state and national criminal history records
checks required by level 2 screening may be borne by the licensee or the person fingerprinted.
Until a specified agency is fully implemented in the clearinghouse created under s. 435.12, the
agency may accept as satisfying the requirements of this section proof of compliance with level 2
screening standards submitted within the previous 5 years to meet any provider or professional
licensure requirements of the agency, the Department of Health, the Department of Elderly
Affairs, the Agency for Persons with Disabilities, the Department of Children and Families, or
the Department of Financial Services for an applicant for a certificate of authority or provisional
certificate of authority to operate a continuing care retirement community under chapter 651,
provided that: (a) The screening standards and disqualifying offenses for the prior screening
are equivalent to those specified in s. 435.04 and this section; (b) The person subject to
screening has not had a break in service from a position that requires level 2 screening for more
17
than 90 days; and (c) Such proof is accompanied, under penalty of perjury, by an attestation of
compliance with chapter 435 and this section using forms provided by the agency.
§ 408.809(2), Fla. Stat. (2015). |
44, Under Florida law, in addition to the offenses listed in Section 435.04, all persons required
to undergo background screening pursuant to this part or authorizing statutes must not have an
arrest awaiting final disposition for, must not have been found guilty of, regardless of
adjudication, or entered a plea of nolo contendere or guilty to, and must not have been
adjudicated delinquent and the record not have been sealed or expunged for any of the offenses
or any similar offense of another jurisdiction listed in Section 408.809(4). § 408.809(4), Fla.
Stat. (2015). |
45. Under Florida law, if an employer or Agency has reasonable cause to believe that grounds
exist for the denial or termination of employment of any employee as a result of background
screening, it shall notify the employee in writing, stating the specific record that indicates
noncompliance with the standards in this chapter. It is the responsibility of the affected
employee to contest his or her disqualification or to request exemption from disqualification.
The only basis for contesting the disqualification is proof of mistaken identity. § 435.06(1), Fla.
Stat. (2015).
46. Under Florida law, (a) an employer may not hire, select, or otherwise allow an employee
to have contact with any vulnerable person that would place the employee in a role that requires
background screening until the screening process is completed and demonstrates the absence of
any grounds for the denial or termination of employment. If the screening process shows any
grounds for the denial or termination of employment, the employer may not hire, select, or
otherwise allow the employee to have contact with any vulnerable person that would place the
employee in a role that requires background screening unless the employee is granted an
exemption for the disqualification by the Agency as provided under Section 435.07. (b) If an
employer becomes aware that an employee has been arrested for a disqualifying offense, the
employer must remove the employee from contact with any vulnerable person that places the
employee in a role that requires background screening until the arrest is resolved in a way that
the employer determines that the employee is still eligible for employment under this chapter.
(c) The employer must terminate the employment of any of its personnel found to be in
noncompliance with the minimum standards of this chapter or place the employee in a position
for which background screening is not required unless the employee is granted an exemption
from disqualification pursuant to Section 435.07. (d) An employer may hire an employee to a
position that requires background screening before the employee completes the screening
process for training and orientation purposes. However, the employee may not have direct
contact with vulnerable persons until the screening process is completed and the employee
demonstrates that he or she exhibits no behaviors that warrant the denial or termination of -
employment. § 435.06(2)(a)-(d), Fla. Stat. (2015).
47. Under Florida law, any employee who refusés to cooperate in such screening or refuses to
timely submit the information necessary to complete the screening, including fingerprints if
required, must be disqualified for employment in such position or, if employed, must be
dismissed. § 435.06(3), Fla. Stat. (2015).
48. Under Florida law, all staff, who are hired on or after October 1, 1998, to provide personal
services to residents, must be screened in accordance with Section 429.174, F.S. ... Rule 58A-
5.019(3)(a), Florida Administrative Code.
19
49, Under Florida law, “Staff” means any person employed by a facility; or contracting witha
facility to provide direct or indirect services to residents; or employees of firms under contract to
the facility to provide direct or indirect services to residents when present in the facility, The
term includes volunteers performing any service which counts toward meeting any staffing
requirement of this rule chapter. Rule 58A-5.0131(34), Florida Administrative Code.
50. Based upon record review and interview, the Respondents failed to ensure that the Facility
staff had the required background screening or exemption for four (4) of nine (9) sampled staff
members, the same being contrary to law,
51. That Petitioner’s representative telephonically interviewed Respondent’s staff member
“C” on August 12, 2015 at 4:030 PM who indicated that she had been employed at another
assisted living facility six (6) months prior to becoming employed by Respondent.
52. That Petitioner’s representative reviewed Respondent’s personnel records during the
survey and noted the following;
a. Staff member “E:”
i. The staff member was a chef hired on July 28, 2015.
ii. The Agency’s background screening website reflected that a new
screening was required. )
iii, No current background screening was presented.
b. — Staff member “F:”
i, The staff member was a caregiver hired July 28, 2015.
ii. The Agency’s background screening website reflected Agency review was
required.
iii, No current background screening was presented.
20°
c. Staff member “H:”
i, The staff member works in housekeeping with access to residents, their
living areas, and property.
ii. No hire date is reflected
iii. The file lacked any Level 2 criminla background screening.
iv. The Agency’s background screening website reflected the staff memebr
had not undergone criminal background screening.
53. That Petitioner’s representative interviewed Respondent’s administrator on August 12,
2015, who confirmed that the above described staff did not meet the criminal background
screening requirements of law and that Respondent did not have a copy of the latest background
screening for staff member “C.”
54. That Florida law requires that a new Level II criminal histroy background screening be
obtained where there has been a break of employment in a position requiring screening for a
period exceeding ninety (90) days.
55. That providers.are required to obtain and maintain such records as criminal history
background screening for Agency review in personnel records. See, Rule 58A-5.024(2\(a),
Florida Administrative Code.
56. That Respondent allowed individuals, in an employment or volunteer role, access to
residents, their records, and property, without having obtained a criminal history background
check on the individual, the same being contrary to the mandates of law.
57. The Respondent’s actions or inactions constituted a violation of Sections 429.174 and
408.809, Florida Statutes (2015).
21
58. Under Florida law, in addition to the requirements of part II of Chapter 408, the Agency
may deny, revoke, and suspend any license issued under this part and impose an administrative
fine in the manner provided in Chapter 120 against a licensee for a violation of any provision of
Part I or Chapter 429, Part II of Chapter 408, or applicable rules, or for any of the following
actions by a licensee, for the actions of any person subject to level 2 background screening under
Section 408.809, Florida Statutes, or for the actions of any facility employee: ... Failure to
comply with the background screening standards of Chapter 429, Part I, Section 408.809(1), or
Chapter 435, Florida Statutes. § 429.14(1)(f), Fla. Stat. (2015).
59. Under Florida law, the Agency may impose an administrative fine for a violation that is
not designated as a class I, class II, class II, or class TV violation. Unless otherwise specified by
law, the amount of the fine may not exceed $500 for each violation. Unclassified violations
include: Violating any provision of this part, authorizing statutes, or applicable rules. §
408.813(3)(), Fla. Stat. (2015).
WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration,
seeks to impose an administrative fine of one thousand five hundred dollars ($1,500.00) against
the Respondent.
COUNTIV
60. The Agency re-alleges and incorporates paragraphs () through (5) and Counts I through
Ill as if fully set forth herein.
61. That pursuant to Section 429.19(7), Florida Statutes (2015), in addition to any
administrative fines imposed, the Agency may assess a survey fee, equal to the lesser of one half
of a facility’s biennial license and bed fee or $500, to cover the cost of conducting initial
complaint investigations that result in the finding of a violation that was the subject of the
complaint or monitoring visits conducted under Section 429.283)(c), Florida Statues (2015), to
verify the correction of the violations. |
62. That Respondent was subject to the citation of one or more Class II deficient practices or
the citation of a violation that was subject of the complaint which requires the imposition of a
survey pursuant to law. See, Section 429.28(3)(c), Florida Statues (2015).
63. That Respondent is therefore subject to a survey fee of five hundred dollars ($500.00),
pursuant to Section 429.19(7), Florida Statutes (2015). .
WHEREFORE, the Agency intends to impose a survey fee of five hundred dollars
($500.00) against Respondent, an assisted living facility in the State of Florida, pursuant to §
429.19(10), Florida Statutes (2015).
COUNT V
64. The Agency re-alleges and incorporates paragraphs (1) through (5 as if fully set forth
herein.
65. That pursuant to Rule 58A-5.024(3), Florida Administrative Code: RESIDENT
RECORDS. Resident records must be maintained on the premises and include: (c) Any orders
for medications, nursing services, therapeutic diets, do not resuscitate orders, or other services to
be provided, supervised, or implemented by the facility that require a health care provider’s
order.
66. That on October 21, 2015, the Agency completed a complaint (CCR# 2015007966) survey
of Respondent’s facility.
67, That based upon the review of records, observation, and interview, Respondent failed to
obtain or maintain a physician’s order for therapeutic diet that reflects the dietary limitations
prescribed, the same being contrary to the requirements of law.
“23
68. That Petitioner’s representative reviewed Respondent’s records related to resident number
four (4) during the survey and noted as follows:
a. The resident’s Health Assessment Form, Form 1823, dated August 26, 2015,
- indicated the resident suffered from diagnoses including Non-Insulin Dependent
Diabetes Mellitus.
b. An order documented a calorie controlled diet.
c. Absent from the record was a physician’s order, or clarification, which reflected a
clarification as to the calorie limitations sought by the prescribing physician.
69. That Petitioner’s representative interviewed Respondent’s administrator regarding resident
number four (4) on October 21, 2015, who indicated that Respondent had failed to obtain
clarification of the calorie controlled diet prescribed for the resident.
70, The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly or
potentially threaten the physical or emotional health, safety, or security of clients.
71. That the same constitutes a Class III offense as defined in Florida Statute 429.19(2)(c)
(2015), and Respondent was cited with a Class III deficient practice.
72. That Florida law requires that cited deficient practice be corrected within thitty 30) days.
73. That on March 1, 2016, the Agency completed a re-visit to the October 21, 2015,
complaint survey of Respondent’s facility.
74, That based upon the review of records, observation, and interview, Respondent failed to
obtain or maintain a physician’s order for therapeutic diet that reflects the dietary limitations
_ prescribed, the same being contrary to the requirements of law.
24
75. That Petitioner’s representative reviewed Respondent’s records related to resident number
four (4) during the survey and noted as follows:
a. The resident’s Health Assessment Form, Form 1823, dated August 26, 2015,
indicated the resident suffered from diagnoses including Non-Insulin Dependent
Diabetes Mellitus.
b. An order documented a calorie controlled diet.
c. Absent from the record was a physician’s order, or clarification, which reflected a
clarification as to the calorie limitations sought by the prescribing physician.
76. That Petitioner’s representative interviewed Respondent’s manager on March 1, 2016,
regarding resident number four 4) who indicated at 3:00 PM that she needed time to locate the
order and at 4:00 PM that she was awaiting a facsimile transmission.
77. That Petitioner’s representative allowed Respondent to submit an appropriate dietary
order for resident number four (40 by electronic mail, however the electronic mail received by
the Petitioner’s representative at 8:41 PM on March 1, 2016, did not contain an order clarifying
the resident’s caloric needs. |
78. That Respondent had failed to obtain clarification of the calorie controlled diet prescribed
for the resident.
79, The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly or
potentially threaten the physical or emotional health, safety, or security of clients.
80, That the same constitutes a Class III offense as defined in Florida Statute 429.19(2)(c)
(2015), and Respondent was cited with a Class III deficient practice.
81. That the same constitutes an uncorrected Class LIT deficiency as defined by law.
25
WHEREFORE, the Agency intends to impose an administrative fine in the amount of
five hundred dollars ($500.00) against Respondent, an assisted living facility in the State of
Florida, pursuant to § 429.19(2)(c), Florida Statutes (2015). .
| COUNT VI
82. The Agency re-alleges and incorporates paragraphs (1) through (5) and Counts I through
II as if fully set forth herein,
83. That pursuant to Section 429.19(7), Florida Statutes (2015), in addition to any .
administrative fines imposed, the Agency may assess a survey fee, equal to the lesser of one half
of a facility’s biennial license and bed fee or $500, to cover the cost of conducting initial
complaint investigations that result in the finding of a violation that was the subject of the
complaint or monitoring visits conducted under Section 429.28(3)(c), Florida Statues (2015), to
verify the correction of the violations.
84. That Respondent was subject to the citation of one or more Class II deficient practices or
the citation of a violation that was subject of the complaint which requires the imposition of a
survey pursuant to law. See, Section 429.28(3)(c), Florida Statues (2015).
85. That Respondent is therefore subject to a survey fee of five hundred dollars ($500.00),
pursuant to Section 429.19(7), Florida Statutes (2015).
WHEREFORE, the Agency intends to impose a survey fee of five hundred dollars.
($500.00) against Respondent, an assisted living facility in the State of Florida, pursuant to §
429.19(10), Florida Statutes (2015). .
COUNT VII |
86. | The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth .
herein.
26
87. That Florida law provides
Assistance with self-administration of medication includes: ;
(a) Taking the medication, in its previously dispensed, properly labeled container,
from where it is stored, and bringing it to the resident.
(b) In the presence of the resident, reading the label, opening the container, removing
a prescribed amount of medication from the container, and closing the container.
(c) Placing an oral dosage in the resident’s hand or placing the dosage in another
container and helping the resident by lifting the container to his or her mouth.
(d) Applying topical medications. .
(e) Returning the medication container to proper storage. .
(f) Keeping a record of when a resident receives assistance with self-administration
under this section.
§ 429.256(3), Florida Statutes (2014).
88. That Florida law provides:
(3) ASSISTANCE WITH SELF-ADMINISTRATION,
(a) Any unlicensed person providing assistance with self administration of medication
must be 18 years of age or older, trained to assist with self administered medication
pursuant to the training requirements of Rule 58A-5.0191, F.A.C., and must be
available to assist residents with self-administered medications in accordance with
procedures described in Section 429,256, F.S. and this rule.
(b) In addition to the specifications of Section 429.256(3), F.S., assistance with self-
administration of medication includes verbally prompting a resident to take medications
as prescribed.
(c) In order to facilitate assistance with self-administration, trained staff may prepare
and make available such items as water, juice, cups, and spoons. Trained staff may also
return unused doses to the medication container. Medication, which appears 1 to have
been contaminated, must not be returned to the container.
(d) Trained staff must observe the resident take the medication. Any concerns about the
resident’s reaction to the medication or suspected noncompliance must be reported to
the resident’s health care provider and documented in the resident’s record.
Rule 58A-5.0185(a through d), Florida Administrative Code.
89, That on December 17, 2015, the Agency completed a complaint survey of Respondent’s
facility.
27
"90. That based upon observation and interview, Respondent failed to ensure that the
assistance with self-administration of medications met the minimum requirements of law.
91. That Petitioner’s representative observed Respondent’s staff member “A” assisting with
self-administration of medication during the survey at 1:00 PM and noted as follows:
a, The staff member-wore gloves and checked a resident’s medication observation
“record.
b, The staff member retrieved a medication from the cart.
c. A resident stood by the medication cart.
d. The staff member told the resident “This is your Oxybutynin,” and gave the
resident the medication ina cup.
e. The resident ingested the pill.
f, The staff member then retrieved another medication from the cart, poured the pill
ina cup, and told the resident “Here is your morphine sulfate.”
g. The staff member observed the resident take the medication and then the staff
member signed the medication observation record.
92. That Petitioner’s representative interviewed Respondent’s director of nursing regarding
the above practice on December 17, 2017 at 1:30 PM who offered no comments.
93. That the above reflects Respondent’s failure to ensure that assistance with self-
administration of medications was performed within sriinimuma requirements of Jaw including,
but not limited to, retrieving the medication from its container and reading the label in the
presence of the resident.
28°
94, The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly or
potentially threaten the physical or emotional health, safety, or security of clients.
95, That the same constitutes a Class III offense as defined in Florida Statute 429.19(2)(c)
(2013), and Respondent was cited with a Class II deficient practice. :
96. That Florida law requires that cited deficient practice be corrected within thirty (30) days.
97. That on May 24, 2016, the Agency completed a follow-up to the January complaint
survey of Respondent’s facility. . | .
98. That based upon observation and interview, Respondent failed to ensure that the
assistance with self-administration of medications met the minimum requirements of law.
99. That Petitioner’s representative observed Respondent’s staff member “J” assisting with
self-administration of medication during the survey at 1:45 PM and noted as follows.
a. The staff member sanitized her hands.
b. The staff member reviewed the medication observation record. and
retrieved the medications.
c. The staff member placed the medications in a small plastic cup, secured
the medication containers and brought the cup with the medications to
resident number three (3), who was in the resident’s room.
d. The staff member told the resident "This is your Morphine, Baclofen and
Tramadol." |
e. The resident requested Lorazepam.
f. The staff member told her “Okay,” since it was as needed /as requested
medication.
29
oe
Mew
g.- The staff member then proceeded to follow the same procedure. The staff
got the Lorazepam and put it inside a small plastic cup. She secured the
medication and brought the medication cup to the resident.
h. The staff member then signed the medication observation record.
100. That Petitioner’s representative interviewed Respondent’s staff member . on May 25,
2016 at 2:00 PM who indicated that she did not know she was required to read the medication
label in the presence of the resident.
101. That Petitioner’s representative interviewed Respondent’s assistant administrator
regarding the above practice on May 25, 2016 at 3:00 PM who offered no comments.
102. That the above reflects Reéspondent’s failure to ensure that assistance with self-
administration of medications was performed within minimum requirements of law including,
but not limited to, retrieving the medication from its container and reading the label in the
presence of the resident. .
103. The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly or
potentially threaten the physical or emotional health, safety, or security of clients.
104. That the same constitutes a Class III offense as defined in Florida Statute 429.19(2)(c)
(2013), and Respondent was cited with a Class III deficient practice.
105. That the same constitutes an uncorrected Class III deficiency as defined by law.
WHEREFORE, the Agency intends to impose an administrative fine in the
amount of five hundred dollars ($500.00) against Respondent, an assisted living facility in the
State of Florida, pursuant to § 429.19(2)(c), Florida Statutes (2015).
30
COUNT VII
106. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth,
herein,
107. That Florida law provides:
(3) RESIDENT RECORDS. Resident records must be maintained on the premises
and include:
(a) Resident demographic data as follows:
1. Name;
2. Sex;
3, Race;
4. Date of birth;
5. Place of birth, if known;
6. Social security number;
7. Medicaid and/or Medicare number, or name of other health insurance carrier;
8. Name, address, and telephone number of next of kin, legal representative, or
individual designated by the resident for notification in case of an emergency; and -
9. Name, address, and telephone. number of the health care provider and case
manager, if applicable.
(b) A copy of the Resident Health Assessment form, AHCA Form 1823 described
in Rule 58A-5.0181, F.A.C.
(c) Any orders for medications, nursing services, therapeutic diets, do not
resuscitate orders, or other services to be provided, supervised, or implemented by
the facility that require a health care provider’s order.
(d) Documentation of a resident’s refusal of a therapeutic diet pursuant to Rule
58A-5.020, F.A.C., if applicable. ,
(e) The resident care record described in paragraph 58A-5,0182(1)(e), F.A.C.
(f) A weight record that is initiated on admission. Information may be taken from
AHCA Form 1823 or the resident’s health assessment. Residents receiving
assistance with the activities of daily living must have their weight recorded semi-
annually.
(g) For facilities that will have unlicensed staff assisting the resident with the self-
administration of medication, a copy of the written informed consent described in
Rule 58A-5.0181, F.A.C., if such consent is not included in the resident’s
contract. :
(h) For facilities that manage a pill organizer, assist with self-administration of
medications or administer medications for a resident, copies of the required
medication records maintained pursuant to Rule S8A-5.0185, F.A.C.
(i) A copy of the resident’s contract with the facility, including any addendums to
the contract as described in Rule 58A~-5.025, F.A.C.
G) For a facility whose owner, administrator, staff, or representative thereof,
31
108.
facility.
serves as an attorney in fact for a resident, a copy of the monthly written
statement of any transaction made on behalf of the resident as required in Section
429.27, FS.
(k) For any facility that maintains a separate trust fund to receive funds or other
property belonging to or due a resident, a copy of the quarterly written statement
of funds or other property disbursed as required in Section 429.27, F.S.
(1) If the resident is an OSS recipient, a copy of the Department of Children and
Families form Alternate Care Certification for Optional State Supplementation
(OSS), CF-ES 1006, October 2005, which is hereby incorporated by reference and
available for review at: http://www. flrules.org/Gateway/reference.asp?No=Ref-
04004. The absence of this form will not be the basis for administrative action
against a facility if the facility can demonstrate that it has made a good faith effort
to obtain the required documentation from the Department of Children and
Families.
(m) Documentation of the appointment of a health care surrogate, health care
proxy, guardian, or the existence of a power of attomey, where applicable.
(n) For hospice patients, the interdisciplinary care plan and other documentation
that the resident is a hospice patient as required in Rule 58A-5.0181, F.A.C.
(0) The resident’s Do Not Resuscitate Order, DH Form 1896, if applicable.
(p) For independent living residents who receive meals and occupy beds included
within the licensed capacity of an assisted living facility, but who are not
receiving any personal, limited nursing, or extended congregate care services,
record keeping may be limited to the following at the discretion of the facility:
1. A log listing the names of residents participating in this arrangement;
2. The resident demographic data required in this paragraph,
3. The health assessment described in Rule 58A-5.0181, F.A.C.;
4. The resident’s contract described in Rule 58A-5.025, F.A.C.; ‘and
5. A health care provider’s order for a therapeutic diet if such diet is prescribed
and the resident participates in the meal plan offered by the facility.
(q) Except for resident contracts, which must be retained for 5 years, all resident
records must be retained for 2 years following the departure of a resident from the
facility unless it is required by contract to retain the records for a longer period of
time. Upon request, residents must be provided with a copy of their records upon
departure from the facility.
(r) Additional resident records requirements for facilities holding a limited
mental health, extended congregate care, or limited nursing services
license are provided in Rules 58A-5.029, 58A-5.030 and 58A-5.031,
F.A.C., respectively.
Rule 58A~5.024(3)), Florida Administrative Code.
That on December 17, 2015, the Agency completed a complaint survey of Respondent’s
32
109. That based upon the review of records and interview, ‘Respondent failed to resident
records were maintained as required by law for one (1) of eleven (11) sampled residents
including a medication observation record for a resident requiring assistance with self-
administration of medications and or a health care provider’s order discontinuing the need. for
medication assistance, the same being contrary to the requirements of law.
110. That Petitioner’s representative reviewed Respondent’s records related to resident
number four (4) during the sutvey and noted the following:
a. The resident was admitted to the Respondent facility on September 23, 2015,
b, The resident’s health assessment form, Form 1823, dated August 25, 2015, and an
updated health assessment dated December 5, 2015, executed by the resident’s
health care provider, both indicated that the resident required assistance with self-
administration of medications.
Cc, There was no medication observation record maintained for the resident for the
month of October 2015.
d. There was no health care provider’s order indicating that the resident no longer
required assistance with the self-administration of medications.
111. That Petitioner’s representative interviewed Respondent‘s director of nursing on
December 17, 2015 at 1:30 PM regarding the records of resident number four (4) and the director
indicated:
a. She was unable to locate the medication observation record for the resident.
b. The resident self-administered medications.
112. That the above reflects Respondent’s failure to obtain or maintain records related to
resident care and services as required by law,
33
113. The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly ot
potentially threaten the physical or emotional health, safety, or security of clients.
114. That the same constitutes a Class III offense as defined in Florida Statute 429.19(2)(c)
(2015), and Respondent was cited with a Class III deficient practice.
115. That Florida law requires that cited deficient practice be corrected within thirty (30) days.
116. That on May 25, 2016, the Agency completed. a follow-up to the January complaint
survey of Respondent’s facility.
117. That based upon the review of records and interview, Respondent failed to resident
records were maintained as required by law for two (2) of nine (9) sampled residents including a
completed health assessment forms and informed consents, the same being contrary to the
requirements of law. .
118. That Petitioner’s representative reviewed Respondent’s records related to resident
number one (1) during the survey and noted the following:
a. The informed consent form regarding assistance with medications from
unlicensed staff, dated February 18, 2016, did not indicate whether or not the
unlicensed staff who provided the assistance would or would not be supervised by
licensed staff.
_b. The resident’s health assessment, form 1823, dated April 26, 2016, did not
contain the name of the healthcare provider, the provider’s medical license
number or the address of the provider who conducted the examination.
c. The health assessment did not indicate if the resident needed assistance with
medications.
34
119. That Petitioner’s representative reviewed Respondent’s records related to resident
number three (3) during the survey and noted that the resident’s health assessment, form 1823,
dated November 15, 2015, did not indicate whether or not the resident had any allergies with that
portion of the report was blank.
120. That Petitioner’s representative interviewed Respondent's assistant administrator on May
25, 2016, at 3:00 PM, regarding the omitted information in the resident records for residents
numbered one (1) and three (3) and the administrator indicated the information was overlooked.
121. That the above reflects Respondent’s failure to obtain or maintain records related to
resident care and services as required by law.
122. The Agency determined that this deficient practice was a condition or oceurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly or
potentially threaten the physical or emotional health, safety, or security of clients.
123. That the same constitutes a Class III offense as defined in Florida Statute 429.19(2)(c)
(2015), and Respondent was cited with a Class ITI deficient practice. .
124, That the same constitutes an uncorrected Class III deficiency as defined by law.
WHEREFORE, the Agency intends to impose an administrative fine in the amount of
five hundred dollars ($500.00) against Respondent, an assisted living facility in the State of
Florida, pursuant to § 429.19(2)(c), Florida Statutes (2015). .
COUNT IX
125. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth
herein.
126. That Florida law provides:
(2) STAFF IN-SERVICE TRAINING. Facility administrators or managers shall
provide or arrange for the following in-service training to facility staff:
35
(a) Staff who provide direct care to residents, other than’ nurses, certified nursing
assistants, or home health aides trained in accordance with Rule 59A-8.0095,
F.A.C., must receive a minimum of 1 hour in-service training in infection control,
including universal precautions, and facility sanitation procedures before providing
personal care to residents. Documentation of compliance with the staff training
requirements of 29 CFR 1910.1030, relating to blood borne pathogens, may be used
to meet this requirement. _
(b) Staff who provide direct care to residents must receive a minimum of | hour in-
service training within 30 days of employment that covers the following subjects:
1. Reporting major incidents.
2. Reporting adverse incidents,
3. Facility emergency procedures including chain-of-command and staff roles
relating to emergency evacuation.
(c) Staff who provide direct care to residents, who have not taken the core training
program, shall receive a minimum of 1 hour in-service training within 30 days of
employment that covers the following subjects:
1, Resident rights in an assisted living facility.
2. Recognizing and reporting resident abuse, neglect, and exploitation.
(d) Staff who provide direct care to residents, other than nurses, CNAs, or home
health aides trained in accordance with Rule 59A-8.0095, F.A.C., must receive 3
hours of in-service training within 30 days of employment that covers the following
subjects:
1. Resident behavior and needs.
2. Providing assistance with the activities of daily living,
(e) Staff who prepare or serve food, who have not taken the assisted living facility
core training must receive a minimum of 1-hour-in-service training within 30 days
of employment in safe food handling practices.
(f) All facility staff shall receive in-service training regarding the facility’s resident
elopement response policies and procedures within thirty (30) days of employment.
1. All facility staff shall be provided with a copy of the facility’s resident elopement
response policies and procedures.
(a) Except as otherwise noted, certificates, or copies of certificates, of any training
required by this rule must be documented in the facility’s personnel files. The
documentation must include the following:
1. The title of the training program;
2. The subject matter of the training program;
3. The training program agenda;
4. The number of hours of the training program;
5. The trainee’s name, dates of participation, and location of the training program;
36
6. The training provider’s name, dated signature and credentials, and professional
license number, if applicable.
Rule 58A-5.0191(2 and 12), Florida Administrative Code.
127. That on October 21, 2015, the Agency completed a complaint survey of Respondent’s
facility.
128. That based upon the review of records and interview, Respondent failed to ensure that its
staff obtained required training and or failed to obtain or maintain required documentation
thereof for five (5) of eight (8) staff members, the same being contrary to the requirements of
law.
129. That Petitioner’s representative reviewed Respondent’s personnel records during the
survey, and interviewed some staff, and noted as follows:
a. Staff member A:
i. The staff member was hired on September 1, 2015.
ii. The staff member’s personnel file reflected no documentation that
the staff member had timely completed required training in reporting
major and adverse incidents, emergency procedures including chain-of-
command and staff roles related to emergency evacuation, the facility’s
elopement response policies and procedures, and safe food handling
practices. )
b. Staff member B:
i, The staff member was hired on September 19, 2015, and was a direct
care giver.
- 37
ii.
The staff member’s personnel file reflected no documentation that the staff
member had timely completed required training in reporting major and adverse incidents,
the facility’s elopement response policies and procedures, the facility’s emergency
procedures including chain-of-command and staff roles related to emergency evacuation,
recognizing and reporting resident abuse, neglect, and exploitation, resident rights in an
assisted living facility, and safe food handling practices.
C. Staff member C: ~
i.
ii.
The staff member was hired on September 8, 2015.
The staff member’s personnel file reflected no documentation that the
staff member had timely completed required training on recognizing and
reporting resident abuse, neglect, and exploitation, resident rights in an
assisted living facility, the facility’s elopement response policies and
procedures, reporting major and adverse incidents, the facility’s
emergency procedures including chain-of-command and staff roles related
to emergency evacuation, and safe food handling practices.
d. Staff member D:
i.
ii.
The staff member was hired July 1, 2015, and was a direct care giver.
The staff member’s personnel file reflected no documentation the staff
member had received required training in elopement policies and
procedures, emergency preparedness and evacuation, reporting adverse
and major incidents, resident rights, and recognizing and reporting abuse,
neglect, and exploitation.
38
e, Staff member F:
i. The staff member was hired in September 22, 2015.
ii. The staff member’s reported that she was a house keeper and did not assist
with medications, however she further reported that she helped three (3Z0
residents: one with compression hose; another with positioning on the
wheel chair and toileting; and provided hydration to a hospice resident.
iii, The staff ‘member’s personnel file reflected no documentation the staff
member had received required training in infection control practices prior
to providing direct care to residents,
130. That Petitioner’s representative interviewed Respondent‘s administrator on October 21,
2015, at 4:00 PM, regarding the training issues above addressed and the administrator indicated
that he did not have any documéntation that the identified staff members had received training in
the identified areas.
131. That the above reflects Respondent’s failure to ensure its staff completed training as
required by law or to obtain or maintain documentation thereof.
132. The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly or
potentially threaten the physical or emotional health, safety, or security of clients.
133, That the same constitutes a Class III offense as defined in Florida Statute 429.19(2)(c)
(2015), and Respondent was cited with a Class III deficient practice.
134. That Florida law requires that cited deficient practice be corrected within thirty (30) days.
135. That on March 1, 2016, the Agency completed a complaint survey of Respondent’s
facility.
39
136. That based upon the review of records and interview, Respondent failed to ensure that its
staff obtained required training and or failed to obtain or maintain required documentation
thereof for four (4) of four (4) staff members, the same being contrary to the requirements of |
law.
137. That Petitioner's representative reviewed Respondent’s personnel records during the
survey and noted as follows:
a, Staff member A: ;
i, The staff member was hired on September 1, 2015.
ii. The staff member’s personnel file reflected no documentation that the staff
member had timely completed required training in facility emergency
procedures including chain-of-command and staff roles relating to
emergency evacuations.
b. Staff member B:
i. The staff member was hired on January 28, 2016.
ii. The staff member’s personnel file reflected a certificate of training on
"resident rights, but lacked any documentation that the staff member had
timely completed required training in recognizing and reporting abuse,
neglect, and exploitation.
c. Staff member C:
i. The staff member was hired on February 3, 2016.
ii. The staff member’s personnel file reflected no documentation that the staff
member had timely completed required training in infection control prior
to the employee provided direct care to residents.
40.
iii. The facility’s staffing schedule reflected the staff member work regularly
as a care giver on the 3:00 PM to 11:00 PM shift.
d. Staff member D:
i. The staff member was hired in December 2015.
ii. The staff member’s personnel file reflected a certificate of training on
resident rights, but lacked any documentation that the staff member had
timely completed required training in recognizing and reporting abuse,
neglect, and exploitation.
138. That Petitioner’s representative interviewed Respondent‘s manager on March 1, 2016, .
regarding the training issues above addressed and the manager indicate that there had been a
turnover in staff and management and the files were being reviewed with some documentation
overlooked. |
139. That the above reflects Respondent’s failure to ensure its staff completed training as
required by law or to obtain or maintain documentation thereof.
140, The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly or
potentially threaten the physical or emotional health, safety, or security of clients.
141. That the same constitutes a Class III offense as defined in Florida Statute 429.19(2)(c)
(2015), and Respondent was cited with a Class II deficient practice.
142. That the same constitutes an uncorrected Class III deficiency as defined by law.
WHEREFORE, the Agency intends to impose an administrative fine in the amount of
five hundred dollars ($500.00) against Respondent, an assisted living facility in the State of
Florida, pursuant to § 429.19(2)(c), Florida Statutes (2015).
41
COUNT X
143, The Agency re-alleges and incorporates paragraphs (1) through (5) and paragraphs one
hundred twenty-six (126) through one hundred forty-two (142) as if fully set forth herein.
144. That Florida law requires that cited deficient practice be corrected within thirty (30) days.
145. That on May 25, 2016, the Agency completed a follow-up to the March complaint survey
of Respondent’s facility. ‘ | |
146, That based upon the review of records and interview, Respondent failed to ensure that its
staff obtained required training within thirty (3) days of employment and or failed to obtain or
maintain required documentation thereof for three (3) of four (4) staff members, the same being
_ contrary to the requirements of law.
147. That Petitioner’s representative reviewed Respondent's personnel records during the
survey and noted the following required staff training were not documented in staff personnel
files for staff members “B,” “C,” and “D,”. all of whom had been in Respondent’s employ in
excess of thirty (30) days:
a. There was no documentation of training in infection control for staff members
“B” and “C.”
b. There was no documentation of training in activities of daily living and behavioral
needs for staff members “B,” and “C,” and “D.”
c. There was no documentation of training in elopement response for staff members
“B ” “Cc ” and “Dp ”
> + .
d. There was no documentation of training in emergency preparedness and
evacuation for staff members “B,” “C,” and “D.”
42
e. There was no documentation of training in incident reporting and resident rights
for staff members “B” and “C.”
f. There was no documentation of training in recognizing and reporting abuse,
neglect, and exploitation for staff members “B,” “C,” and “D.”
g. There was no documentation of training in nutrition and safe food handling for
staff members “B” and “C.
148. That Petitioner’s representative interviewed Respondent's assistant administrator on May
25, 2016, at 3:07 PM, regarding the omitted information regarding staff training and the
individual could not produce and documentation that the above noted training had been provided
to staff members “B,” “C,” or “D.”
149. That the above reflects Respondent’s failure to ensure its staff completed training as
required by law or to obtain or maintain documentation thereof.
150. The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly or
potentially threaten the physical or emotional health, safety, or security of clients.
151. That the same constitutes a Class IIT offense as defined in Florida Statute 429.19(2)(c)
(2015), and Respondent was cited with a Class III deficient practice.
152. That the same constitutes an uncorrected Class Il deficiency as defined by law.
WHEREFORE, the Agency intends to impose an administrative fine in the amount of
five hundred dollars ($500.00) against Respondent, an assisted living facility in the State of
Florida, pursuant to § 429.19(2)(c), Florida Statutes (2015).
COUNT XI
153. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth
43
herein.
154. That Florida law provides: °
(2) STAFF.
(a) Within 30 days after beginning employment, newly hired staff must submit a
written statement from a health care provider documenting that the individual
does not have any signs or symptoms of communicable disease. The examination
performed by the health care provider must have been conducted no earlier than 6
months before submission of the statement. Newly hired staff does not include an
employee transferring without a break in service from one facility to another
when the facility is under the same management or ownership.
1. Evidence of a negative tuberculosis examination must be documented on an
annual basis. Documentation provided by the Florida Department of Health or a
licensed health care provider certifying that there is a shortage of tuberculosis
testing materials, shall satisfy the annual tuberculosis examination requirement.
An individual with a positive tuberculosis test must submit a health care
provider’s statement that the individual does not constitute a risk of
communicating tuberculosis. ;
2, If any staff member has, or is suspected of having, a communicable disease,
such individual must be immediately removed from duties until a written
statement is submitted from a health care provider indicating that the individual
does not constitute a risk of transmitting a communicable disease.
(b) Staff must be qualified to perform their assigned duties consistent with their
level of education, training, preparation, and experience. Staff providing services
requiring licensing or certification must be appropriately licensed or certified. All
staff must exercise their responsibilities, consistent with their qualifications, to
observe residents, to document observations on the appropriate resident’s record,
and to réport the observations to the resident’s health care provider in accordance
with this rule chapter.
Rule 58A-5.019(2)(a and b), Florida Administrative Code.
155. That on October 21, 2015, the Agency completed a complaint survey of Respondent’s
facility.
156. That based upon the review of records and interview, Respondent failed to ensure that it
obtained and maintained required records reflecting freedom from signs and symptoms of
44
communicable disease including tuberculosis for one (1) of eight (8) sampled staff members, the
same being contrary to the requirements of law.
157. .That Petitioner’s representative reviewed Respondent’s personnel records during the .
survey, and noted as follows regarding staff member “B”: |
a. The staff member was hired on September 19, 2015, and was a direct care giver.
b. The personnel record contained a tuberculosis result dated April 8, 2014, well
‘over a year prior to the staff member’s date of employment that reflected the staff
member was negative for tuberculosis.
c. There was no written statement from a health care provider documenting, within
thirty (30) days after beginning employment, that the newly hired staff does not
have any signs or symptoms of communicable disease and that the examination
was performed by the health care provider no earlier than six (6) months before
submission of the statement.
158, That Petitioner’s representative interviewed Respondent‘s administrator on October 21,
2015, at 4:00 PM, regarding the communicable disease statement for staff member “B” and the
administrator indicated the employee had not yet brought in a doctor’s statement.
159. That the above reflects Respondents failure to ensure it’s obtained and maintained timely
certifications of staff freedom from communicable disease.
160. The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly or
potentially threaten the physical or emotional health, safety, or security of clients.
161. That the same constitutes a Class III offense as defined in Florida Statute 429.19(2)(c)
(2015), and Respondent was cited with a Class III deficient practice.
45
162. That Florida law requires that cited deficient practice be corrected within thirty (30) days. ,
163, That on March 1, 2016, the Agency completed a revisit survey of Respondent’s facility.
164; That based upon the review of records and interview, Respondent failed to ensure that it
obtained and maintained required records reflecting freedom from signs and symptoms of
communicable disease including tuberculosis for one (1) of five (5) sampled staff members, the
same being contrary to the requirements of law.
165. That Petitioner’s representative reviewed Respondent's personnel records during the
survey, and noted as follows regarding staff member “D”:
a. The staff member was hired in December 2015 and was a direct care giver.
b. The personnel record contained a tuberculosis result dated February 17, 2014, and
a freedom from communicable disease statement dated February 14, 2014, both
well in excess of six (6) months prior to the staff member employment date,
166. That Petitioner’s representative interviewed Respondent‘s manager on March 1, 2016,
regarding the communicable disease records above referenced and the manager indicated that the
staff member had not brought in the health care provider’s statements and the staff member
would be terminated that day.
167. That the above reflects Respondents failure to ensure it’s obtained and maintained timely —
certifications of staff freedom from communicable disease.
168. The Agency determined that this deficient practice was a condition or occurrence related
to the operation and maintenance of the provider or to the care of clients which indirectly or
potentially threaten the physical or emotional health, safety, or security of clients.
169. That the same constitutes a Class III offense as defined in Florida Statute 429.19(2)(c)
(2015), and Respondent was cited with a Class III deficient practice.
46
170. That the same constitutes an uncorrected Class III deficiency as defined by law.
WHEREFORE, the Agency intends to impose an administrative fine in the amount of
five hundred dollars ($500.00) against Respondent, an assisted living facility in the State of
Florida, pursuant to § 429,19(2)(c), Florida Statutes (2015).
| COUNT XII
171. The Agency re-alleges and incorporates paragraphs (1) through (5) and Counts X and XI
as if fully set forth herein.
172. That pursuant to Section 429.19(7), Florida Statutes (2015), in addition to any
administrative fines imposed, the Agency may assess a survey fee, equal to the lesser of one half
of a facility’s biennial license and bed fee or $500, to cover the cost of conducting initial
complaint investigations that result in the finding of a violation that was the subject of the
complaint or monitoring visits conducted under Section 429.28(3)(c), Florida Statues (2015), to
’ verify the correction of the violations.
173. That Respondent is therefore subject to a survey fee of five hundred dollars ($500.00),
pursuant to Section 429.19(7), Florida Statutes (2015).
WHEREFORE, the Agency intends to impose a survey fee of five hundred
dollars ($500.00) against Respondent, an assisted living facility in the State of Florida, pursuant
to § 429.19(10), Florida Statutes (2015).
. COUNT XIII
174. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth
herein.
175. That Florida law provides:
(1) During the two year licensure period, any change or expiration of any
information that is required to be reported under Chapter 408, Part II, F.S., or
47
authorizing statutes for the provider type as specified in Section 408.803(3), F.S.,
during the license application process must be reported to the Agency within 21
days of occurrence of the change, including:
(a) Insurance coverage renewal;
(b) Bond renewal;
(c) Change of administrator or the similarly titled person who is responsible for
the day-to-day operation of the provider;
(e) Fire inspections; and,
(f) Approval of revisions to emergency management plans.
(2) Electronic submission of information.
(a) The following required information must be reported through the Agency’s
Internet site at http://www.ahca.myflorida.com/reporting/index.shtml:
1. Nursing homes:
a. Semi-annual staffing ratios required pursuant to Section 400.141(1)(0), F.S. and
Rule 59A-4.103, F.A.C.
b. Adverse incident reports required pursuant to Sections 400.147(7) and (8), F.S.
and Rule 59A-4.123, F.A.C,
c. Liability claim reports required pursuant to Section 400.147(10), F.S. and Rule
59A-4.123, F.A.C.
2. Assisted living facilities:
a. Adverse incident reports required pursuant to Sections 429.23(3) and (4), F.S.
and Rule 58A-5.0241, F.A.C.
b. Liability claim reports required pursuant to Section 429.23(5), F.S. and Rule
58A-5,0242, F.A.C.
(b) The licensee must retain the receipt issued from the Internet site indicating
that their transaction was accepted.
(c) If the Agency’s Intetnet site is temporarily out of service, the required reports
may be submitted by mail or facsimile as follows:
1, Semi-annual staffing ratios and liability claim reports are sent to the Agency for
Health Care Administration, Central Systems Management Unit, 2727 Mahan
Drive, MS #47, Tallahassee, FL 32308 or facsimile to (850)487-0470.
2. Adverse incident reports are sent to the Agency for Health Care
Administration, Florida Center for Health Information and Policy Analysis, 2727
Mahan Drive, MS #16, Tallahassee, FL 32308 or facsimile to (850)922-2217.
Rule 59A-35.110, Florida Administrative Code.
iv. That Florida law provides:
(1) Every facility licensed under this part may, as part of its administrative
functions, voluntarily establish a risk management and quality assurance program,
the purpose of which is to assess resident care practices, facility incident reports,
deficiencies cited by the agency, adverse incident reports, and resident grievances
48
and develop plans of action to correct and respond quickly to identify quality
differences. oe .
(2) Every facility licensed under this part is required to maintain adverse
incident reports. For purposes of this section, the term, “‘adverse incident” means:
. (a) Anevent over which facility personnel could exercise control rather than as
a result of the resident’s condition and results in:
1. Death;
2. Brain or spinal damage;
3. Permanent disfigurement;
4. Fracture or dislocation of bones or joints;
5. Any condition that required medical attention to which the resident has not
given his or her consent, including failure to honor advanced directives;
6. Any condition that requires the transfer of the resident from the facility to a
unit providing more acute care due to the incident rather than the resident’s
condition before the incident; or
7. Anevent that is reported to law enforcement or its personnel for
investigation; or
(b) Resident elopement, if the elopement places the resident at risk of harm or
injury. .
(3) Licensed facilities shall provide within 1 business day after the occurrence
of an adverse incident, by electronic mail, facsimile, or United States mail, a
preliminary report to the agency on all adverse incidents specified under this
section. The report must include information regarding the identity of the affected
resident, the type of adverse incident, and the status of the facility’s investigation
of the incident.
(4) Licensed facilities shall provide within 15 days, by electronic mail,
facsimile, or United States mail, a full report to the agency on all adverse
incidents specified in this section. The report must include the results of the
facility’s investigation into the adverse incident.
§ 429.23(1 through 4), Florida Statutes (2015).
That on June 30, 2016, the Agency completed a complaint survey of Respondent’s
That based upon the review of records and interview, Respondent failed to complete and
timely submit an adverse incident report regarding an incident involving law enforcement, the
same being contrary to the requirements of law.
That Petitioner’s representative interviewed resident number one (1), and alert and
oriented individual, on June 30, 2016 at 11:00 AM, who indicated as follows:
49
The resident had concerns about the resident’s pain medications being stolen by.a
staff member.
On Sunday, June 26, 2016, at approximately 12:30 AM, when medications
arrived at the facility from the pharmacy, the resident saw the resident’s pain
medications on the medication cart with Respondent’s unlicensed medication
technician at the cart.
The resident did not want to bother the staff member, so went outside to smoke.
Upon the resident’s return, the medication technician handed the resident the
medication cards containing the pain medication.
The resident signed for the medication, but did not count the medication cards.
When the resident got to the resident’s room, the resident realized the resident had
received only one half of the prescribed number of pills, sixty (60) instead of one
hundred twenty (120) pills.
The resident had observed the tow (2) cards on the medication cart before the
resident decided to have a cigarette.
179. That Petitioner’s representative reviewed the physician order sheets for resident number
one (1) for July 2016 which reflected a prescription for Oxycodone tablet 10 milligrams one (1)
tablet by mouth every four (4) hours as needed.
That Petitioner’s representative interviewed on June 30, 2016, at 1:00 PM, Respondent’s
assistant administrator regarding the medications for resident number one rab) who indicated as
a. The resident self-medicated and kept all prescribed medications in the resident’s
room,
50
b. On June 24, 2016, a Friday, at about 6:00 AM, she received a phone call from
unlicensed staff member “M” regarding the allegation of resident number one (1)
that the resident did not receive all prescribed pain medications.
c. The assistant administrator arrived at the facility and received permission from
resident number one (1) to search the resident’s room for the medications.
d. The assistant administrator could not determine how many pills the resident had
received.
_¢. The assistant administrator called police to investigate
f, The assistant administrator did not have a police report.
g. The assistant administrator confitmed that Respondent had not yet submitted an
adverse incident report.
181. That Petitioner’s -representative telephonically interviewed, on August 2, 2016, a
representative of the pharmacy which dispensed the pain medications for resident number one
(1) who confirmed that one hundred twenty (120) pills of the prescribed medication were
dispensed to Respondent in June.
182. That the above reflects Respondent’s failure to timely complete and submit adverse
incident reports as required by law.
183. The Respondent’s actions or inactions constituted a violation of Sections 429.23, Florida
Statutes (2015), and Rule 59A-35.110, Florida Administrative Code.
184. Under Florida law, the Agency may impose an administrative fine for a violation that is
not designated as a class I, class IJ, class III, or class IV violation. Unless otherwise specified by
law, the amount of the fine may not exceed $500 for each violation. ‘Unclassified violations
31
include: Violating any provision of this part, authorizing statutes, or applicable rules. §
408.813(3)(b), Fla. Stat. (2015).
WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration,
seeks to impose an administrative fine of five hundred dollars ($500.00) against the Respondent,
COUNT XIV
185. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth
herein, |
186. Under Florida law, the Agency shall require level 2 background screening for personnel as
required in Section 408.809(1)(e) pursuant to Chapter 435 and Section 408.809. § 429.174, Fla.
Stat. (2015),
187. Under Florida law, level 2 background screening pursuant to Chapter 435 must be
conducted through the Agency on each of the following persons, who are considered employees
for the purposes of conducting screening under Chapter 435: (a) The licensee, if an individual.
(b) The administrator or a similarly titled person who is responsible for the day-to-day operation
of the provider. (c) The financial officer or similarly titled individual who is responsible for the
financial operation of the licensee or provider. (d) Any person who is a controlling interest if
the Agency has reason to believe that such person has been convicted of any offense prohibited /
by Section 435.04. For each controlling interest who has been convicted of any such offense, the
licensee shall submit to the Agency a description and explanation of the conviction at the time of
license application. (e) Any person, as required by authorizing statutes, seeking employment
with a licensee or provider who is expected to, or whose responsibilities may require him or her
to, provide personal care or services directly to clients or have access to client funds, personal
property, or living areas; and any person, as required by authorizing statutes, contracting with a
52
licensee or provider whose responsibilities require him or her to provide personal care or
personal services directly to clients. Evidence of contractor screening may be retained by the
contractor’s employer or the licensee. § 408.809(1), Fla. Stat. (2015).
188. Under Florida law, every 5 years following his or her licensure, employment, or entry into
a contract in a capacity that under subsection (1) would require level 2 background screening
under chapter 435, cach such person must submit to level 2 background rescreening as a
condition of retaining such license or continuing in such employment or contractual status. For
any such rescreening, the agency shall request the Department of Law Enforcement to forward
the person’s fingerprints to the Federal Bureau of Investigation for a national criminal history
record check unless the person’s fingerprints are enrolled in the Federal Bureau of
Investigation’s national retained print arrest notification program. If the fingerprints of such a
person are not retained by the Department of Law Enforcement under s. 943.05(2)(g) and (h), the
person must submit fingerprints electronically to the Department of Law Enforcement for state
processing, and the Department of Law Enforcement shall forward the fingerprints to the Federal
Bureau of Investigation for a national criminal history record check. The fingerprints shall be
retained by the Department of Law Enforcement under s.943.05(2)(g) and (h) and enrolled in the
national retained print arrest notification program when the Department of Law Enforcement
begins participation in the program. The cost of the state and national criminal history records
checks required by level 2 screening may be borne by the licensee or the person fingerprinted.
Until a specified agency is fully implemented in the clearinghouse created under s. 435.12, the
agency may accept as satisfying the requirements of this section proof of compliance with level 2
screening standards submitted within the previous 5 years to meet any provider or professional
licensure requirements of the agency, the Department of Health, the Department of Elderly
53
Affairs, the Agency for Persons with Disabilities, the Department of Children and Families, or
the Department of Financial Services for an applicant for a certificate of authority or provisional
certificate of authority to operate a continuing care retirement community under chapter 651,
provided that: (a) ‘The screening standards and disqualifying offenses for the prior screening
are equivalent to those specified in s. 435.04 and:this section; (b) The person subject to
screening has not had a break in service from a position that requires level 2 screening for more
than 90 days; and (c) Such proof is accompanied, under penalty of perjury, by an attestation of
compliance with chapter 435 and this section using forms provided by the agency.
§ 408.809(2), Fla. Stat. (2015).
189. Under Florida law, in addition to the offenses listed in Section 435.04, all persons required
to undergo background screening pursuant to this part or authorizing statutes must not have an
arrest awaiting final disposition for, must not have been found guilty of, regardless of ~
adjudication, or entered a plea of nolo contendere or guilty to, and must not have been
adjudicated delinquent and the record not have been sealed or expunged for any of the offenses
or any similar offense of another jurisdiction listed in Section 408.809(4). § 408.8094), Fla.
Stat. (2015). .
190. Under Florida law, if an employer or Agency has reasonable cause to believe that grounds
exist for the denial or termination of employment of any employee as a result of background
screening, it shall notify the employee in writing, stating the specific record that indicates
noncompliance with the standards in this chapter. It is the responsibility of the affected
employee to contest his or her disqualification or to request exemption from disqualification.
The only basis for contesting the disqualification is proof of mistaken identity. § 435.06(1), Fla.
Stat. (2015).
54
191. Under Florida law, (a) an employer may not hire, select, or otherwise allow an employee
to have contact with any vulnerable person that would place the employee in a role that requires
background screening until the screening process is completed and demonstrates the absence of
any grounds for the denial or termination of employment. If the screening process shows any
grounds for the denial or termination of employment, the employer may not hire, select, or
otherwise allow the employee to have contact with any vulnerable person that would place the
employee in a role that requires background screening unless the employee is granted an
exemption for the disqualification by the Agency as provided under Section 435.07. (b) If an
employer becomes aware that an employee has been arrested for a disqualifying offense, the
employer must remove the employee from contact with any vulnerable person that places the
employee in a role that requires background screening until the arrest is resolved in a way that
the employer determines that the employee is still eligible for employment under this chapter.
(c) The employer must terminate the employment of any of its personnel found to be in
noncompliance with the minimum standards of this chapter or place the employee in a position
for which background screening is not required unless the employee is granted an exemption
from disqualification pursuant to Section 435.07. (d) An employer may hire an employee to a
position that requires background screening before the employee completes the screening
process for training and orientation purposes. However, the employee may not have direct
contact with vulnerable persons until the screening process is completed and the employee
demonstrates that he or she exhibits no behaviors that warrant the denial or termination of
employment. § 435.06(2)(a)-(d), Fla. Stat. (2015).
192. Under Florida law, any employee who refuses to cooperate in such screening or refuses to
timely submit the information necessary to complete the screening, including fingerprints if
35
required, must be disqualified for employment in such position or, if employed, must be
dismissed. § 435.06(3), Fla. Stat. (2015).
193. Under Florida law, all staff, who are hired on or after October 1, 1998, to provide personal
services to residents, must be screened in accordance with Section 429.174, F.S. ... Rule 58A-
5.019(3)(a), Florida Administrative Code.
194, Under Florida law, “Staff” means any person employed by a facility; or contracting with a
facility to provide direct or indirect services to residents; or employees of firms under contract to
the facility to provide direct or indirect services to residents when present in the facility. The
term includes volunteers performing any service which counts toward meeting any staffing
requirement of this rule chapter. Rule 58A-5.0131(34), Florida Administrative Code.
195. That on October 21, 2015, the Agency completed a complaint survey of Respondent and
its facility. |
196. Based upon record review and interview, the Respondents failed to ensure that the Facility
staff had the required background screening or exemption for one (1) of eight (8) sampled staff
members, the same being contrary to law.
197. That Petoitioner’s representative interviewed Respondent’ staff member “F” on March 21,
205 at approximately 1:00 PM who indicated as follows:
d. She was hired on September 22, 2015 as a house keeper and did not assist with
medications.
e. She could not help it but she provided assistance to three (3) residents: She helped
one with compression hose; another to sit straight in a wheelchair and with
toileting; and gave water to the hospice resident. The staff member added
something about when being an inmate and the other inmates.
56
f. She moved here from South Carolina.
g. She had not been sent for fingerprinting.
h. The facility owner told her she was in the "registry," but she could not understand
what registry if she had not been fingerprinted.
198. That Petitioner’s representative interviewed Respondent’s administrator on October 21,
2015, regarding criminal background screening for staff member “F” and the administrator
indicated that the staff member came in with a screening, but he was unable to locate it.
199. That providers are required to obtain and maintain such records as criminal history
background screening for Agency review in personnel records. See, Rule 58A-5.024(2)(a),
Florida Administrative Code.
200, The Respondent's actions or inactions constituted a violation of Sections 429.174 and
408.809, Florida Statutes (2015). |
201. Under Florida law, in addition to the requirements of part II of Chapter 408, the Agency
may deny, revoke, and suspend any license issued under this part and impose an administrative
fine in the manner provided in Chapter 120 against a licensee for a violation of any provision of
Part I or Chapter 429, Part II of Chapter 408, or applicable rules, or for any of the following
actions by a licensee, for the actions of any person subject to level 2 background screening under
Section 408,809, Florida Statutes, or for the actions of any facility employee: .. . Failure to
comply with the background screening standards of Chapter 429, Part I, Section 408.809(1), or
Chapter 435, Florida Statutes, § 429.14(1)(f, Fla. Stat. (2015).
202. Under Florida law, the Agency may impose an administrative fine for a violation that is
not designated as a class I, class IJ, class III, or class IV violation. Unless otherwise specified by
law, the amount of the fine may not exceed $500 for each violation. Unclassified violations
57
include: Violating any provision of this part, authorizing statutes, or applicable rules. §
408,813(3)(b), Fla. Stat. (2015).
WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration,
seeks to impose an administrative fine of $500.00 against the Respondent.
COUNT XV
203. The ‘Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth
herein.
204. Under Florida law, the Agency shall require level 2 background screening for personnel as
required in Section 408.809(1}(e) pursuant to Chapter 435 and Section 408.809. § 429.174, Fla.
Stat. (2015).
205. Under Florida law, level 2 background screening pursuant to Chapter 435 rhust be
conducted through the Agency on each of the following persons, who are considered employees
for the purposes of conducting screening under Chapter 435: (a) The licensee, if an individual.
(b) The administrator or a similarly titled person who is responsible for the day-to-day operation
of the provider. (c) The nancial officer o similarly titled individual who is responsible for the
financial operation of the licensee or provider. (d) Any person who is a controlling interest if
the Agency has reason to believe that such person has been convicted of any offense prohibited
by Section 435.04. For each controlling interest who has been convicted of any such offense, the
licensee shall submit to the Agency a description and explanation of the conviction at the time of
license application. (e) Any person, as required by authorizing statutes, seeking employment
with a licensee or provider who is expected to, or whose responsibilities may require him or her
to, provide personal care or services directly to clients or have access to client funds, personal
property, or living areas; and any person, as required by authorizing statutes, contracting with a
58
licensee or provider whose responsibilities require him or her to provide personal care or
personal services directly to clients. Evidence of contractor screening may be retained by the
contractor’s employer or the licensee. § 408.809(1), Fla. Stat, (2015).
206. Under Florida law, every 5 years following his or her licensure, employment, or entry into
a contract in a capacity that under subsection (1) would require level 2 background screening
under chapter 435, each such person must submit to level 2 background rescreening as a
condition of retaining such license or continuing in such employment or contractual status. For
any such rescreening, the agency shall request the Department of Law Enforcement to forward
the person’s fingerprints to the Federal Bureau of Investigation for a national criminal history
record check unless the person’s fingerprints are enrolled in the Federal Bureau of
Investigation’s national retained print arrest notification program. If the fingerprints of such a
person are not retained by the Department of Law Enforcement under s. 943.05(2)(g) and (h), the
person must submit fingerprints electronically to the Department of Law Enforcement for state
processing, and the Department of Law Enforcement shall forward the fingerprints to the Federal
Bureau of Investigation for a national criminal history record check. The fingerprints shall be
retained by the Department of Law Enforcement under s.943.05(2)(g) and (h) and enrolled in the
national retained print arrest notification program when the Department of Law Enforcement
begins participation in the program. The cost of the state and national criminal history records
checks required by level 2 screening may be borne by the licensee or the person fingerprinted.
Until a specified agency is fully implemented in the clearinghouse created under s. 435.12, the
agency may accept as satisfying the requirements of this section proof of compliance with level 2
screening standards submitted within the previous 5 years to meet any provider or professional
licensure requirements of the agency, the Department of Health, the Department of Elderly
59
Affairs, the Agency for Persons with Disabilities, the Department of Children and Families, or
the Department of Financial Services for an applicant for a certificate of authority or provisional
certificate of authority to operate a continuing care retirement community under chapter 651,
provided that: (a) The screening standards and disqualifying offenses for the prior screening
are equivalent to those specified in s. 435.04 and this section; (b) The person subject to
screening has not had a break in service from a position that requires level 2 screening for more
than 90 days; and (c) Such proof is accompanied, under penalty of perjury, by an attestation of
compliance with chapter 435 and this section using forms provided by the agency.
§ 408.809(2), Fla, Stat. (2015).
207, That on October 21, 2015, the Agency completed a complaint survey of Respondent and
its facility.
208. Based upon record review and interview, the Respondents failed to ensure that one (1) of
eight (8) staff personnel records did not contain the required affidavit of compliance with
criminal history standards, the game being contrary to law.
209. That Petitioner’s representatSive reviewed Respondent’s personnel records during the
survey and noted the following related to staff member “C”:
a. The staff member was hired on September 8, 2015.
b. The Level II background screening results was dated February 16, 2015.
c. There was no documentation that the staff member had not had a break in service
from a position that requires level 2 screening for more than ninety (90) days that
was accompanied, under penalty of perjury, by an attestation of compliance with
chapter 435 and this section by using forms that were provided by the agency.
60
210. That Petitioner’s representative interviewed Respondent administrator during the survey
regarding staff member “C” and the administrator confirmed the above recited findings. —
211. The Respondent’s actions or inactions constituted a violation of Sections 429.174 and
408.809, Florida Statutes (2015). |
212. Under Florida law, in addition to the requirements of part II of Chapter 408, the Agency
may deny, revoke, and suspend any license issued under this part and impose an administrative
fine in the manner provided in Chapter 120 against a licensee for a violation of any provision of
Part I or Chapter 429, Part II of Chapter 408, or applicable rules, or for any of the following
actions by a licensee, for the actions of any person subject to level 2 background screening under
Section 408.809, Florida Statutes, or for the actions of any facility employee: ... Failure to
comply with the background screening standards of Chapter 429, Part I, Section 408.809(1), or
Chapter 435, Florida Statutes. § 429.14(1)(f), Fla. Stat. (2015).
213. Under Florida law, the Agency may impose an administrative fine for a violation that is
not designated as a class I, class 1, class III, or class IV violation. Unless otherwise specified by
law, the amount of the fine may not exceed $500 for each violation. Unclassified violations
include: Violating any provision of this part, authorizing statutes, or applicable rules. §
408.813(3)(b), Fla. Stat. (2015).
WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration,
seeks to impose an administrative fine of $500.00 against the Respondent.
. COUNT XVI
214, The Agency re-alleges and incorporates paragraphs (1) through (5) and Counts X and XI
as if fully set forth herein.
61
215. That pursuant to Section 429,19(7), Florida Statutes (2015), in addition to any
administrative fines imposed, the Agency may assess a survey fee, equal to the lesser of one half
of a facility’s biennial license and bed fee or $500, to cover the cost of conducting initial
complaint investigations that result in the finding of a violation that was the subject of the
complaint or monitoring visits conducted under Section 429.28(3)(c), Florida Statues (2015), to
verify the correction of the violations. |
216. That Respondent is therefore subject to a survey fee of five hundred dollars ($500.00),
pursuant to Section 429.19(7), Florida Statutes (2015).
- WHEREFORE, the Agency intends to impose a survey fee of five hundred
dollars ($500.00) against Respondent, an assisted living facility in the State of Florida, pursuant
to § 429.19(10), Florida Statutes (2015).
COUNT XVII
217. The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth
herein.
218. That Florida law provides:
(b) Until such time as the fingerprints are enrolled in the national retained print
arrest notification program at the Federal Bureau of Investigation, an employee
with a break in service of more than 90 days from a position that requires
screening by a specified agency must submit to a national screening if the person
returns to a position that requires screening by a specified agency.
(c) Anemployer of persons subject to screening by a specified agency must
register with the clearinghouse and maintain the employment status of all
employees within the clearinghouse. Initial employment status and any changes in
status must be reported within 10 business days. —
(d) An employer must register with and initiate all criminal history checks
through the clearinghouse before referring an employee or potential employee for
electronic fingerprint submission to the Department of Law Enforcement. The
registration must include the employee’s full first name, middle initial, and last
name; social security number; date of birth; mailing address; sex; and race.
62
Individuals, persons, applicants, and controlling interests that cannot legally
obtain a social security number must provide an individual taxpayer identification
number. ;
§ 435.12(2)(b through d), Fla. Stat. (2015).
. 219. That on June 8, 2016, the Agency completed a complaint survey of Respondent and its
facility.
220. Based upon record review and interview, Respondent failed to ensure that the Facility:
registered and maintained the employment status of all employees within the clearinghouse or
report any changes within ten (10) business days, for twenty-two (22) of twenty-five (25)
employees, the same being contrary to law.
221. That Petitioner’s representative reviewed the Agency's Background Screening
Clearinghouse for this facility and noted it contained the names of seven (7) unique employees.
222. That according to Respondent’s staff roster and Respondent’s assistant administrator on
May 25, 2016, at 2:30 PM, Respondent employed twenty-five (25) persons.
223. That of the staff members listed on the clearinghouse record, three (3) staff members, staff
members “H,” “J,” and “K,” were currently employed by Respondent, and four (4) staff
members listed on the clearinghouse record were no longer employed by Respondent.
224. That twenty-two (22) of Respondent’s current employees were not recorded in the
clearing house as required by law, employees “A,” “B,” “C,” “D,” “E,” “F,” “G,” “L,” “M,” “N,”
“oP “P,Q.” “Ry “S,” “TU,” “V,” “W,” “X,” and “Y.”
225. That Petitioner’s assistant administrator agreed that the clearing house had not been
maintained up to date. .
226. That providers are required to maintain the clearing house records of its staff members.
See, § 435.12(2)(b through d), Fla. Stat. (2015).
63
227. Under Florida law, in addition to the requirements of part II of Chapter 408, the Agency
may deny, revoke, and suspend any license issued under this part and impose an administrative
fine in the manner provided in Chapter 120 against a licensee for a violation of any provision of
Part I or Chapter 429, Part II of Chapter 408, or applicable rules, or for any of the following
actions by a licensee, for the actions of any person subject to level 2 background screening under
Section 408.809, Florida Statutes, or for the actions of any facility employee: ... Failure to
comply with the background screening standards of Chapter 429, Part I, Section 408.809(1), or
Chapter 435, Florida Statutes. § 429.14(1)(#), Fla. Stat. (2015).
228. Under Florida law, the Agency may impose an administrative fine for a violation that is
not designated as a class I, class II, class II, or class IV violation. Unless otherwise specified by
law, the amount of the fine may not exceed $500 for each violation. Unclassified violations
include: Violating any provision of this part, authorizing statutes, or applicable rules. §
408.813(3)(b), Fla. Stat. (2015).
WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration,
seeks to impose an administrative fine of $500.00 against the Respondent.
COUNT XVII
229, The Agency re-alleges and incorporates paragraphs (1) through (5) as if fully set forth
herein.
230. Under Florida law, the Agency shall require level 2 background screening for personnel as
required in Section 408.809(1)(e) pursuant to Chapter 435 and Section 408.809. § 429.174, Fla,
Stat. (2015). 7
231. Under Florida law, level 2 background screening pursuant to Chapter 435 must be
conducted through the Agency on each of the following persons, who are considered employees
64
we
——
for the purposes of conducting screening under Chapter 435: (a) The licensee, if an individual.
(b) The administrator or a similarly titled person who is responsible for the day-to-day operation
of the provider. (c) The financial officer or similarly titled individual who is responsible for the
financial operation of the licensee or provider. (d) Any person who is a controlling interest if
the Agency has reason to believe that such person has been convicted of any offense prohibited
by Section 435.04. For each controlling interest who has been convicted of any such offense, the
licensee shall submit to the Agency a description and explanation of the conviction at the time of
license application. (e) Any person, as required by authorizing statutes, seeking employment
with a licensee or provider. who is expected to, or whose responsibilities may require him or her
to, provide personal care or services directly to clients or have access to client funds, personal
property, or living areas; and any person, as required by authorizing statutes, contracting with a
licensee or provider whose responsibilities require him or her to provide personal care or
personal services directly to clients. Evidence of contractor screening may be retained by the
contractor’s employer or the licensee. § 408.809(1), Fla. Stat. (2015).
232, Under Florida law, every 5 years following his or her licensure, employment, or entry into
a contract in a capacity that under subsection (1) would require level 2 background screening
under chapter 435, each such person must submit to level 2 background rescreening as a
condition of retaining such license or continuing in such employment or contractual status. For
any such rescreening, the agency shall request the Department of Law Enforcement to forward
the person’s fingerprints to the Federal Bureau of Investigation for a national criminal history
record check unless the person’s fingerprints are enrolled in the Federal Bureau of .
Investigation’s national retained print arrest notification program. If the fingerprints of such a
person are not retained by the Department of Law Enforcement under s. 943.05(2)(g) and (h), the
65
person must submit fingerprints electronically to the Department of Law Enforcement for state
processing, and the Department of Law Enforcement shall forward the fingerprints to the Federal
Bureau of Investigation for a national criminal history record check. The fingerprints shall be
retained by the Department of Law Enforcement under s.943.05(2)(g) and (h) and enrolled in the-
national retained print arrest notification program when the Department of Law Enforcement
begins participation in the program. The cost of the state and national criminal history records
checks required by level 2 screening may be bome by the licensee or the person fingerprinted.
Until a specified agency is fully implemented in the clearinghouse created under s, 435.12, the
agency may accept as satisfying the requirements of this section proof of compliance with level 2
screening standards submitted within the previous 5 years to meet any provider or professional
licensure requirements of the agency, the Department of Health, the Department of Elderly
Affairs, the Agency for Persons with Disabilities, the Department of Children and Families, or
the Department of Financial Services for an applicant for a certificate of authority or provisional
certificate of authority to operate a'continuing care retirement community under chapter 651,
provided that: (a) The screening standards and disqualifying offenses for the prior screening
are equivalent to those specified in s. 435.04 and this section; (b) The person subject to .
screening has not had a break in service from a position that requires level 2 screening for more
than 90 days; and (c) Such proof is accompanied, under penalty of perjury, by an attestation of
compliance with chapter 435 and this section using forms provided by the agency.
§ 408.809(2), Fla. Stat. (2015).
233. Under Florida law, in addition to the offenses listed in Section 435.04, all persons required
to undergo background screening pursuant to this part or authorizing statutes must not have an
arrest awaiting final disposition for, must not have been found guilty of, regardless of
66
adjudication, or entered a plea of nolo contendere or guilty to, and must not have been
adjudicated delinquent and the record not have been sealed or expunged for any of the offenses
or any similar offense of another jurisdiction listed in Section 408.809(4). § 408.809(4), Fla.
Stat. (2015).
234. Under Florida law, if an employer or Agency has reasonable cause to believe that grounds
exist for the denial or termination of employment of any employee as a result of background
screening, it shall notify the employee in writing, stating the specific record that indicates
noncompliance with the standards in this chapter. It is the responsibility of the affected
employee to contest his or her disqualification or to request exemption from disqualification.
The only basis for contesting the disqualification is proof of mistaken identity. § 435.06(1), Fla.
Stat. (2015).
235. Under Florida law, (a) an employer may not hire, select, or otherwise allow an employee
to have contact with any vulnerable person that would place the employee in a role that requires
background screening until the screening process is completed and demonstrates the absence of
any grounds for the denial or termination of employment. If the screening process shows any
grounds for the denial or termination of employment, the employer may not hire, select, or
otherwise allow the employce to have contact with any vulnerable person that would place the
employee in a role that requires background screening unless the employee is granted an
exemption for the disqualification by the Agency as provided under Section 435.07. (b) If an
employer becomes aware that an employee has been arrested for a disqualifying offense, the
employer must remove the employee from contact with any vulnerable person that places the .
_ employee ina role that requires background screening until the arrest is resolved in a way that
the employer determines that the employee is still eligible for employment under this chapter.
67
we
—
(c) The employer must terminate the employment of any of its personnel found to be in
noncompliance with the minimum standards of this chapter or place the employee in a position
for which background screening is not required unless the employce is granted an exemption
from disqualification pursuant to Section 435.07. (d) An employer may hire an employee to a
position that requires background screening before the employee completes the screening
process for training and orientation purposes. However, the employee may not have direct
contact with vulnerable persons until the screening process is completed and the employee
demonstrates that he or she exhibits no behaviors that warrant the denial or termination of
employment. § 435.06(2)(a)-(d), Fla. Stat. (2015).
236. Under Florida law, any employee who refuses to cooperate in such screening or refuses to
timely submit the information necessary to complete the screening, including fingerprints if
required, must be disqualified for employment in such position or, if employed, must be
dismissed. §'435.06(3), Fla. Stat. (2015).
237. Under Florida law, all staff, who are hired on or after October 1, 1998, to provide personal
services to residents, must be screened in accordance with Section 429.174, F.S...., Rule 58A-
5.019(3)(a), Florida Administrative Code.
238. Under Florida law, “Staff” means any person employed by a facility; or contracting with a
facility to provide direct or indirect services to residents; or employees of firms under contract to
the facility to provide direct or indirect services to residents when present in the facility. The
term includes volunteers performing any service which counts toward meeting any staffing
requirement of this rule chapter. Rule 58A-5.0131(34), Florida Administrative Code.
239, That on June 8, 2016, the Agency completed a complaint survey of Respondent and its
facility.
68
240, Based upon record review and interview, the Respondents failed to ensure that newly
hired employees did not have contact with any vulnerable persons or were not placed in a role
that requires background screening until the screening process was completed and demonstrated
the absence of any grounds for the denial or termination of employment for two (2) of four (4)
sampled staff members, the same being contrary to law.
241. That Petitioner’s representative reviewed Respondent’s personnel records and the
’ Agency’s criminal background screening data base uring the survey and noted as follows:
a. Staff member “B:”
i. The file did not contain a Level 2 criminal history background screening
eligibility or attestation.
ii. The staff member was not located in the Agency’s criminal background
screening data base.
b. Staff member “C:”
i. The criminal history eligibility record in the employee’s file read “New
Screening Required.”
ii, The same information was noted in the Agency’s criminal background
screening data base.
242. That Petitioner’s representative interviewed Respondent’s assistant administrator on May
25, 2016, at 2:30 PM, who indicated that she was unaware that staff member “B” had not
undergone backgrouns screening and that she believed staff member “C” had gone for a new
screening at one time, but was not aware of any results from that screeing.
69
243. That providers are required to obtain and maintain such records as criminal history
background screening for Agency review in personnel records. See, Rule 58A-5.024(2)(a),
Florida Administrative Code.
244, The Respondent’s actions or inactions constituted a violation of Sections 429.174 and
408.809, Florida Statutes (2015).
245. Under Florida law, in addition to the requirements of part IT of Chapter 408, the Agency
may deny, revoke, and suspend any license issued under this part and impose an administrative
fine in the manner provided in Chapter 120 against a licensee for a violation of any provision of
Part I or Chapter 429, Part II of Chapter 408, or applicable rules, or for any of the following
actions by a licensee, for the actions of any person subject to level 2 background screening under
Section 408.809, Florida Statutes, or for the actions of any facility employee: ... Failure to
comply with the background screening standards of Chapter 429, Part I, Section 408.809(1), or
Chapter 435, Florida Statutes. § 429.14(1)(f), Fla. Stat. (2015).
246. Under Florida law, the Agency may impose an administrative fine for a violation that is
not designated as a class I, class II, class III, or class IV violation. Unless otherwise specified by
law, the amount of the fine may not exceed $500 for each violation. Unclassified violations
include: Violating any provision of this part, authorizing statutes, or applicable rules. §
408.813(3)(b), Fla. Stat. (2015).
WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration,
seeks to impose an administrative fine of $500.00 against the Respondent.
COUNT XIX
247, The Agency re-alleges and incorporates paragraphs one (1) through five (5), as if fully set
forth herein
70
248. That pursuant to Florida law, 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... The agency may require
a licensee to provide proof of financial ability to operate. at any time if there is evidence of
financial instability, including, but not limited to, unpaid expenses necessary for the basic
operations of the provider. §.408.810(8), Fla. Stat. (2014).
249. That Florida law provides the following: “ A controlling interest may not withhold from
the agency any evidence of financial instability, including, but not limited to, checks returned
due to insufficient funds, delinquent accounts, nonpayment of withholding taxes, unpaid utility
expenses, nonpayment for essential services, or adverse court action conceming the financial
viability of the provider or any other provider licensed under this part that is under the control of
the controlling interest. Any person who violates this subsection commits a misdemeanor of the
second degree, punishable as provided in s. 775.082 or s. 775.083. Each day of continuing
violation is a separate offense.” § 408.8109), Fla. Stat. (201 4).
250. That Florida law provides: .
... If an applicant or licensee has shown signs of financial instability, as provided
in Section 408.810(9), F.S., at any time, the Agency may require the applicant or
licensee to provide proof of financial ability to operate by submission of:
(a) AHCA Form 3100-0009, July 2009, Proof of Financial Ability Form, that
includes a balance sheet and income and expense statement for the next 2 years of
operation which provide evidence of having sufficient assets, credit, and projected
revenues to cover liabilities and expenses, and
(b) Documentation of correction of the financial instability, including but not
limited to, evidence of the payment of any bad checks, delinquent bills or liens. If
complete payment cannot be made, evidence must be submitted of partial
payment along with a plan for payment of any liens or delinquent bills. If the lien
71
is with a government agency or repayment is ordered by a federal or state court,
an accepted plan of repayment must be provided.
Rule 59A-35.062(7), Florida Administrative Code.
251. That Florida law provides:
Financial instability” means the provider cannot meet its financial obligations. Evidence
such as the issuance of bad checks, an accumulation of delinquent bills, or inability to
meet current payroll needs shall constitute prima facie evidence that the ownership of the
provider lacks the financial ability to operate. Evidence shall also include the Medicare or
Medicaid program’s indications or determination of financial instability or fraudulent
handling of government funds by the provider. Rule 59A-35.062(3)(e), Florida
Administrative Code
252. That on June 2, 2016, the Agency completed a complaint survey of Respondent and its
facility.
253. That based upon the review of financial account reviews and interviews, Respondent
failed to demonstrate financial stability to continue the e provision of care and services to
residents.
254, That Petitioner’s representatives interviewed several of Respondent's staff members on
May 24 and 25, 2016, who indicated the following:
a. Staff pay checks were being denied for insufficient funds.
b. The food vendor refused to deliver further food supplies until the account was
paid.
c. Staff were buying food and supplies from their own monies.
d. There was a concern some staff would not arrive for work schedules when they
are not getting promptly compensated.
255. That Petitioner’s representative interviewed Respondent’s staff member “K on May 24,
2016 at 2:00 PM who indicated as follows:
72
g.
h.
He worked five. (5) days a week in the kitchen.
The facility ran out of deserts about three (3) weeks ago and he had to go to
Publix and purchase the deserts - he did get reimbursed.
The food delivery truck was late and for four (4) days there were no deserts.
The check that was written to the food vendor bounced and that was why the
truck didnot deliver.
He was to be paid on Friday and did not get paid.
He was there on May 24, 2016, to get his check, got upset, and was not going to
leave until he got paid.
He was owed around five hundred dollars ($500.00).
His paycheck was late two (2) times since his employment.
256. That on May 24, 2016 at 3:00 PM, Respondent’s administrator was asked to provide his
monthly financial records that included all income and expenses and he said at the time he did
not have them and was informed that he needed to have them available on May 25, 2016.
257. That on May 25, 2016, Respondent's 5/25/16, administrator only provided some of the
facility bills and the quick book bank statements. He said he had hired a bookkeeper to get the
books together. He said she was on leave until Tuesday because of the holiday and could get the
information on Tuesday.
258. That Petitioner’s representative reviewed the presented bank statement and noted: -
i.
On March 2, 2016, there were six (6) checks written and on May 9, 2016, there
were seven (7) checks written while the record reflects the account did not contain
enough money in the account to cover the checks.
The bank used the overdraft protection to cover the checks.
73
259. That Petitioner’s representative reviewed Respondent's Waste Management bill dated
May 1, 2016 which reflected he bill was overdue by thirty (30) days and the invoice amount
covered two (2) months of service.
260. That Petitioner’s representative interviewed Respondent’s administrator on May 25,
2016, who indicated as follows:
k, The administrator was asked for the book keeper’s name and telephone number.
i.
iii.
He gave two names and then said the new bookkeeper was going to be
starting Tuesday.
He was informed at the time that the financial records are due now.
He said that he would go into quick books and do them himself and get
them to the surveyors via email
lL 6:15 PM:
The administrator said there were no financial problems.
He had a bookkeeper that he had just terminated because she did not pay
the bills on time and did not make him aware of when the bills were due.
He at first stated there were no bounced checks, but then after he was
questioned about his negative bank statement he said on his bank
statement there were Non-Sufficient Funds (NSF) for some of the checks
and the account was negative.
He said he realized that and on the bank statements deposits were made
the same day or the next day to cover the check, he had overdraft
protection to cover the checks.
74
v. He said the employees did not understand the payroll with close out dates
of the 1 and the 15" with pay dates on the 6 and the 21".
vi. They use a machine when clocking in where you had to use your gn
finger, and place it on a pad.
vii. If it was not done correctly it may not count correctly the hours that the
employee may have worked and that was why some of the checks were
short and he would have to correct them later.
viii. When asked why some of the employees did not get paid at all, he did
provide an answer but said again possibly something went wrong with
them placing their finger on the clock on the in and out pad.
ix. When asked why some of the bills were past due and why the food
distributor did not get paid on time, he again blamed it on the bookkeeper
that he had that was fired. |
261. That Petitioner’s representative reviewed an invoice for advertising dated May 29, 2016,
and noted it was marked one hundred twenty (120) plus days overdue.
262. An email received by the agency revealed Staff L was upset because she did not receive
all of her pay. She had also purchased supplies for activities and was not reimbursed.
263. That Petitioner’s representative reviewed a salary check received by the Agency that was
written for staff member “L” on May 22, 2016 for the weeks May 1 through 16, 2016, and the
check was stamped on top "NSF Ist."
264. That Petitioner’s representative interviewed Respondent’s staff member “J” on May 24,
2016 at 2:15 PM who indicated that paychecks were late at times, there was nothing she could do
but wait, and sometimes she had to wait a few days after the payday to get the check.
75
265, That Petitioner’s representative interviewed Respondent’s staff member “I” on May 24,
2016 at 3:00 PM who indicated as follows:
a. At times her paycheck was short hours.
b. Her check bounced (returned by bank/insufficient funds) sometime in January
or February.
c. She used TD bank the same as Cristal Palace and was told the check had
insufficient funds or a hold.
d. The facility told her that was impossible; it had to be an error.
e. On the last payday, she did not get a pay stub; just a check.
d. Management would not give her an explanation as to why.
e. Whenever she questioned her paycheck, the reason given to her was she must
have made an error on her timesheet; clocking in and out.
266. During an interview at 2:40 PM on 5/24/16 with staff F who said she should have gotten
paid on Tuesday 5/21 because paydays are the 6th and 21st, but she did not. When she asked,
they (management) give her the run-around and tell you to wait.
267. On 5/25/16 at 9:15 AM staff F approached the Agency representative and said "Thank
you for all your help I got paid today. I don't know what you did but thanks"
268. On 5/25/15 at 10 AM staff K provided a copy of a paycheck dated 5/6/16 for weeks 4/15
to 4/30/16. The check was from TD Bank. The account name and account number were not listed
on the check, nor did it have a stub.
716
269, That Petitioner’s representative interviewed Respondent’s staff member “E” on May 24,
2016 at 3:30 PM who indicated as follows:
a. She began working at the facility on April 18, 2016.
b. Both paychecks so far have been short by approximately two hundred seventy-
five dollars ($275.00).
c. She had not received the back pay as of May 24, 2016.
f. She has not been asked to buy any supplies out of pocket, but they do often run
out of trash bags and diapers/pull ups.
270. That Petitioner’s representative interviewed Respondent’s staff member “F” on May 24,
2016 at 3:45 PM who indicated as follows:
a, Her paycheck was sometimes short.
-b. One time she only received one week of pay for the two (2) weeks of hours she
had worked.
c. Her husband had also been a medication technician at the facility and was paid
thirteen (13) hours short and has never received the back pay.
g. Supplies are often short, usually toilet paper, trash bags and pull ups.
h. On May 25, 2016 at 11:10AM she reported to Agency personnel that she
received her paycheck that morning and thanked the Agency for being there.
271. That Petitioner’s representative interviewed Respondent’s staff member “G” on May 25,
2016 at 11:00 AM who indicated as follows:
a. She was the dietary manager.
b. She has worked at the facility for three (3) months.
77
c. She cannot always work with what is on the facility menu provided by the
dietician, .
d. She often submits the grocery list for the week, but if the dollar amount is
too high, the owner has rejected it, so she has to work with what she has.
e. She strives to meet the nutritional needs of the residents, but also wants to
make sure they have food they like and want to eat.
f. Some residents complain of too much chicken.
g. Food deliveries are supposed to come every Monday.
h. = They did not receive a food delivery this Monday because the vendor was
not paid.
i. The food did arrive this morning (Wednesday, 5/25).
j. Today's lunch was supposed to be chicken, but could not be prepared
because it was still frozen.
272. That on May 25, 2016 at 1:15 PM, Respondent’s Assistant Administrator verified that the
food deliveries have not come on time because the vendors are not being paid.
273. That Respondent’s administrator said that he would email the Agency personnel the
, facility’s financial records, but they were never received.
274, That the above reflects Respondent’s inability to demonstrate financial ability to operate.
275. Under Florida law, in addition to the requirements of part IT of Chapter 408, the Agency
may deny, revoke, and suspend any license issued under this part and impose an administrative
fine in the manner provided in Chapter 120 against a licensee for a violation of any provision of
Part J or Chapter 429, Part II of Chapter 408; or applicable rules, or for any of the following
actions by a licensee, for the actions of any person subject to level 2 background screening under
7
Section 408.809, Florida Statutes, or for the actions of any facility employee: ... Failure to
comply with the background screening standards of Chapter 429, Part I, Section 408.809(1), or
Chapter 435, Florida Statutes. § 429.14(1)(f), Fla. Stat. (2015).
276. Under Florida law, the Agency may impose an administrative fine for a violation that is
not designated as a class I, class Il, class Il, or class IV violation. Unless otherwise specified by
law, the amount of the fine may not exceed $500 for each violation. Unclassified violations
include: Violating any provision of this part, authorizing statutes, or applicable rules. §
408.813(3)(b), Fla. Stat. (2015).
WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration,
seeks to impose an administrative fine of $500.00 against the Respondent.
COUNT XX
277. The’ Agency re-alleges and incorporates paragraphs one (1) through five (5), and the
entirety of this Administrative Complaint as if fully set forth herein
278. That pursuant to Florida law, 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... The agency may require
a licensee to provide proof of financial ability to operate at any time if there is evidence of
financial instability, including, but not limited to, unpaid expenses necessary for the basic
operations of the provider. § 408.810(8), Fla. Stat. (2014).
279. That Florida law provides the following: “ A controlling interest may not withhold from
the agency any evidence of financial instability, including, but not limited to, checks returned
due to insufficient funds, delinquent accounts, nonpayment of withholding taxes, unpaid utility
expenses, nonpayment for essential services, or adverse court action concerning the financial
719
viability of the provider or any other provider licensed under this part that is under the control of
the controlling interest. Any person who violates this subsection commits a misdemeanor of the
second degree, punishable as provided in s. 775.082 or s. 775.083. Each day of continuing
violation is a separate offense.” § 408.810(9), Fla. Stat, (2014).
280. That Florida law provides:
... If an applicant or licensee has shown signs of financial instability, as provided
in Section 408.810(9), F.S., at any time, the Agency may require the applicant or
licensee to provide proof of financial ability to operate by submission of:
(a) AHCA Form 3100-0009, July 2009, Proof of Financial Ability Form, that
includes a balance sheet and income and expense statement for the next 2 years of
operation which provide evidence of having sufficient assets, credit, and projected
revenues to cover liabilities and expenses, and
(b) Documentation of correction of the financial instability, including but not
limited to, evidence of the payment of any bad checks, delinquent bills or liens. If
complete payment cannot be made, evidence must be submitted of partial
payment along with a plan for payment of any liens or delinquent bills. If the lien
is with a government agency or repayment is ordered by a federal or state court,
an accepted plan of repayment must be provided.
Rule 59A-35.062(7), Florida Administrative Code.
281. That Florida law provides the following: “(1) In addition to the requirements of part I
of chapter 408, the agency may deny, revoke, and suspend any license issued under this part and
impose an administrative fine in the manner provided in chapter 120 against a licensee for a
violation of any provision of this part, part II of chapter 408, or applicable rules, or for any of the
following actions by a licensee, any person subject to level 2 background screening under s.
408.809, or any facility staff ... (b) A determination by the agency that the owner lacks the
80
financial ability to provide continuing adequate care to residents... (f) Failure to comply with
the background screening standards of this part, s. 408.809 (1), or chapter 435... (k) Any act
constituting a ground upon which application for a license may be denied.” § 429.14(1)(b, f, and
k), Fla. Stat. (2015).
282. That Florida law provides the following: “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
...b) An intentional or negligent act materially affecting the health or safety of a client of the
provider.; (c) A violation of this part, authorizing statutes, or applicable rules.; (d) A
demonstrated pattern of deficient performance.” § 408.815(1)(b, c, and d), Fla. Stat. (2015).
283. That on May 26, 2016, the Agency demanded Respondent provide proof of financial
ability to operate as authorized by law. See, Attachment “A.”
284. That the information provided in response by Respondent failed to demonstrate the
Respondent had the financial ability to operate as defined by law.
285. That Respondent has been cited with a total of five (5) violations of law related to the
failure to comply with the background screening standards of Chapter 429, Part I, s. 408.809 (1),
or chapter 435 over the period August 26, 2015 through June 8, 2016.
286. That each violation reflecting the failure to comply with the background screening .
standards of Chapter 429, Part I, s. 408.809 (1), or chapter. 435, constitutes independent grounds
for the revocation of Respondent’s licensure as an assisted living facility.
287. That Respondent has been cited with a total of fifteen (15) violations of law subject to
administrative monetary sanctions over the period August 26, 2015 through June 8, 2016.
288. That these fifteen (15) violations constitute a pattern of deficient practice.
81
289. That Respondent has failed to demonstrate financial ability to operate.
290. That Respondent has violated the minimum requirements of law of Chapters 429, Part II,
and Chapter 58A-5, Florida Administrative Code as described with particularity within this
complaint.
291. That Respondent has a duty to maintain its operations in accord with the minimum
requirements of law and to provide care and services at mandated minimum standards.
292. That Respondent’s actions or inactions as described with particularity within this
complaint constitute intentional or negligent acts which are in violation of the mandates of law
and materially affected the health or safety of residents.
293. That based thereon, individually and collectively, the Agency seeks the revocation of the
Respondent’s licensure, .
WHEREFORE, the Agency intends to revoke the license of the Respondent to operate an
assisted living facility in the State of Florida.
Respectfully submitted this Zi day of September, 2016.
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
Sebring Building
525 Mirror Lake Dr. N., Suite 330
St. Petersburg, Florida 33701
Telephone;/27) 552-1947 / Fax: (727) 552-1440
walshtt myflorida.com
Ela. Bar No. 566365
82
NOTICE
The Respondent is notified that it/he/she 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 foregoing has been served by
U.S. Certified Mail, Return Receipt No. 7010 0780 0001 9835 5772 on September @_, 2016,
to Nuri Dorra, Administrator, Cristal Palace Resort PB LC, 1881 Palm Bay Road, Palm Bay,
Florida 32905, and by Regular U.S. Mail to Nuri Durra, Registered Agent for Cristal Palace
Resort PB LC, 16426 Northeast 32 Avenue, North Miami Beach, Florida 33160.
Copy furnished to:
Theresa DeCanio
Field Office Manager
Agency for Health Care Administration
83
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
RE: Cristal Palace Resort PB LC AHCA Nos: 2015012605
‘ 2016009811
2016009813
2016009815
2016006006
2016008240
2016004117
2016003289
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
retumed 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) 1 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) 1 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.
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 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, .
License Type: (ALF? Nursing Home? Medical Equipment? Other Type?)
Licensee Name: License Number:
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:
Print Name:
Ceitified Mail:
‘File Nuabor: 11068825
‘Lise 560
‘Provitiee Nes ssisted Living Fagility
Pale sain "008
Res Proof of Financial: Ability ‘operate rea for Cristal Palace Resort PB LLC
Bear Mp, Dortas
“The Agenny- has conde
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agof assis Li ing residents,
arose ial ability to-operateat any timed
ie, but not limited w, dipald BaperSeTSSESEy
on 408 $19.
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jidiieg, but not Hivalted te: aheoks setuntiedl due 6.,
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All oftthe requested i dlow must besubmittedwithin 21 days of seeelpt of ale letter,
“THe rie é action, in evocation, against your: Filing facility
nse, iPawe dower meadivettexequested documentation, Please submit.all:-decunrents te the
ATTACHMENT
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Docket for Case No: 17-002149
Issue Date |
Proceedings |
Aug. 20, 2018 |
Agency Final Order filed.
|
Jul. 16, 2018 |
Notice to Correct Filing filed.
|
Jul. 16, 2018 |
Agency for Health Care Administration's Exception to Recommended Order filed.
|
Jul. 05, 2018 |
Transmittal letter from Claudia Llado forwarding Respondent's Exhibits, not admitted into evidence, numbered 8, 18, 19, and 46 to Respondent.
|
Jun. 29, 2018 |
Recommended Order (hearing held February 26-28, 2018). CASE CLOSED.
|
Jun. 29, 2018 |
Recommended Order cover letter identifying the hearing record referred to the Agency.
|
Apr. 24, 2018 |
Cristal Palaces Proposed Recommended Order filed.
|
Apr. 24, 2018 |
Agency's Proposed Recommended Order filed.
|
Apr. 05, 2018 |
Order Granting Motion for Exception to Rule.
|
Apr. 05, 2018 |
Agency's Motion for Exception to Rule 28-106-215 filed.
|
Apr. 04, 2018 |
Transcript of Proceedings Volumes I-V (not available for viewing) filed. |
Feb. 26, 2018 |
CASE STATUS: Hearing Held. |
Feb. 23, 2018 |
Order on Cristal Palace's Motion in Limine.
|
Feb. 22, 2018 |
Agency's Response to Cristal Palace's Motion in Limine filed.
|
Feb. 20, 2018 |
Amended Notice of Taking Depositions filed.
|
Feb. 19, 2018 |
Cristal Palace's Exhibit A of Joint Pre-hearing Stipulation filed.
|
Feb. 19, 2018 |
Joint Pre-hearing Stipulation filed.
|
Feb. 16, 2018 |
Cristal Palace's Amended Motion in Limine filed.
|
Feb. 16, 2018 |
Cristal Palace's Motion in Limine filed.
|
Feb. 06, 2018 |
Notice of Taking Depositions filed.
|
Feb. 06, 2018 |
Notice of Taking Depositions filed.
|
Feb. 06, 2018 |
Notice of Unavailability filed.
|
Jan. 10, 2018 |
Notice of Taking Deposition (Woods) filed.
|
Dec. 04, 2017 |
Order Rescheduling Hearing (hearing set for February 26 through March 1, 2018; 9:00 a.m.; Titusville, FL).
|
Dec. 01, 2017 |
Joint Status Report filed.
|
Nov. 28, 2017 |
Order on Pending Motions, Granting a Continuance, and Requiring a Status Report (parties to advise status by December 4, 2017).
|
Nov. 28, 2017 |
Agency's Notice of Availability for Final Hearing filed.
|
Nov. 27, 2017 |
CASE STATUS: Motion Hearing Held. |
Nov. 27, 2017 |
Response to AHCAs Emergency Motion for Continuance and Supplemental Motion for Continuance filed.
|
Nov. 22, 2017 |
Agency's Motion to Supplement Emergency Motion for Continuance filed.
|
Nov. 21, 2017 |
Amended Order Granting Motion to Amend Petition for Hearing.
|
Nov. 20, 2017 |
Response to AHCA's Motion to Compel Cristal Palace's Responses to Agency's Second Set of Interrogatories filed.
|
Nov. 20, 2017 |
Response to AHCA's Motion to Compel Cristal Palace's Responses to Agency's Second Request for Production filed.
|
Nov. 20, 2017 |
Order Granting Motion to Amend Petition for Hearing.
|
Nov. 20, 2017 |
Exhibit A (Agency's Emergency Motion for Continuance; medical records not available for viewing) filed. 
 Confidential document; not available for viewing. |
Nov. 20, 2017 |
(Agency's) Emergency Motion for Continuance filed.
|
Nov. 17, 2017 |
Notice of Taking Depositions filed.
|
Nov. 13, 2017 |
Agency's Motion to Compel Cristal Palace's Response to Agency's Second Set of Interrogatories filed.
|
Nov. 13, 2017 |
Agency's Motion to Compel Cristal Palace's Response to Agency's Second Request for Production of Documents filed.
|
Nov. 13, 2017 |
Notice of Service of Agency's Motion to Compel Cristal Palace's Responses to Agency's Second Request for Production of Documents and Second Set of Interrogatories filed.
|
Nov. 09, 2017 |
Cristal Palace's Motion to Amend Petition for Hearing in Case 17-3849 filed.
|
Oct. 23, 2017 |
Order Granting AHCA's Motion to Amend Notice of Intent to Deny for Renewal.
|
Oct. 18, 2017 |
Response to AHCA's [Second] Motion to Amend Notice of Intent to Deny Renewal filed.
|
Oct. 11, 2017 |
Second Amended Notice of Intent to Deny for Renewal filed.
|
Oct. 11, 2017 |
Agency's Motion to Amend Notice of Intent to Deny for Renewal filed.
|
Oct. 03, 2017 |
Order on Pending Motions.
|
Sep. 28, 2017 |
Notice of Service of Cristal Palace's Responses to AHCA's "First" Request for Production and "First" Set of Interrogatories filed.
|
Sep. 26, 2017 |
CASE STATUS: Motion Hearing Held. |
Sep. 25, 2017 |
Cristal Palace's Motion to Dismiss Notice of Intent to Deny Renewal filed.
|
Sep. 18, 2017 |
Amended Notice of Hearing (hearing set for December 5 through 8, 2017; 9:00 a.m.; Titusville, FL; amended as to Hearing room location).
|
Sep. 15, 2017 |
Order Granting Continuance and Rescheduling Hearing (hearing set for December 5 through 8, 2017; 9:00 a.m.; Titusville, FL).
|
Sep. 14, 2017 |
Joint Motion for Continuance filed.
|
Sep. 13, 2017 |
Response to AHCA's Motion to Amend Notice of Intent to Deny Renewal filed.
|
Sep. 13, 2017 |
Notice of Service of Cristal Palace's Response to AHCA's "First" Request for Admissions filed.
|
Sep. 07, 2017 |
Amended Response to AHCA's First Request to Produce filed.
|
Sep. 01, 2017 |
First Amended Notice of Intent to Deny for Renewal filed.
|
Sep. 01, 2017 |
Agency's Motion to Amend Notice of Intent to Deny for Renewal filed.
|
Aug. 30, 2017 |
Notice of Service of Agency's Response to Cristal Palace's Second Set of Interrogatories and Second Request for Production filed.
|
Aug. 10, 2017 |
Notice of Service of Agency's First Set of Interrogatories, Request for Admissions and Request for Production of Documents to Respondent filed.
|
Aug. 09, 2017 |
Notice of Service of Cristal Palace's Second Set of Interrogatories and Second Request to Produce filed.
|
Jul. 28, 2017 |
Order Granting Continuance and Rescheduling Hearing (hearing set for September 26 through 29, 2017; 9:00 a.m.; Titusville, FL).
|
Jul. 25, 2017 |
Order of Consolidation (DOAH Case Nos. 17-2149, 17-2164, and 17-3849).
|
Jul. 24, 2017 |
Respondent's Motion to Consolidate Cases and Continue Final Hearing (filed in Case No. 17-002164).
|
Jul. 18, 2017 |
Notice of Substitution of Counsel (John Terrel) filed.
|
Jul. 18, 2017 |
Notice of Substitution of Counsel (John Terrel; filed in Case No. 17-002164).
|
Jul. 12, 2017 |
Notice of Appearance (Nicola Brown) filed.
|
Jul. 06, 2017 |
Notice (Of Agency Referral) filed.
|
Jul. 06, 2017 |
Agency action letter filed.
|
Jun. 30, 2017 |
Respondent's Response to Agency for Health Care Administration's First Request for Production of Documents filed.
|
Jun. 30, 2017 |
Notice of Service of Respondent's Answers to Agency for Health Care Administration's First Set of Interrogatories filed.
|
Jun. 15, 2017 |
Agency's Privilege Log filed.
|
Jun. 15, 2017 |
Notice of Compliance filed.
|
Jun. 07, 2017 |
Respondent's Responses to AHCA's First Request for Admissions filed.
|
May 30, 2017 |
Order Granting Continuance and Re-scheduling Hearing (hearing set for August 9 through 11, 2017; 9:00 a.m.; Titusville, FL).
|
May 23, 2017 |
Joint Motion for Continuance (filed in Case No. 17-002164).
|
May 11, 2017 |
Cristal Palace's First Request for Production of Documents to the Agency for Health Care Administration filed.
|
May 05, 2017 |
First Interrogatories to Agency for Health Care Administration filed.
|
May 05, 2017 |
Notice of Service of Respondent's First Set of Interrogatories to Agency for Health Care Administration filed.
|
Apr. 25, 2017 |
Notice of Service of Agency's First Set of Interrogatories, Request for Production, and Request for Admissions to Respondent filed.
|
Apr. 19, 2017 |
Order of Pre-hearing Instructions.
|
Apr. 19, 2017 |
Notice of Hearing (hearing set for June 28 and 29, 2017; 9:00 a.m.; Titusville, FL).
|
Apr. 19, 2017 |
Order of Consolidation (DOAH Case Nos. 17-2149 and 17-2164).
|
Apr. 18, 2017 |
Joint Response to Initial Order and Joint Motion to Consolidate filed.
|
Apr. 11, 2017 |
Initial Order.
|
Apr. 10, 2017 |
Order on Unopposed Motion to Consolidate and Continue Abeyance filed.
|
Apr. 10, 2017 |
Request for Formal Administrative Proceeding filed.
|
Apr. 10, 2017 |
Administrative Complaint filed.
|
Apr. 10, 2017 |
Notice (of Agency referral) filed.
|
Orders for Case No: 17-002149
Issue Date |
Document |
Summary |
Aug. 14, 2018 |
Agency Final Order
|
|
Jun. 29, 2018 |
Recommended Order
|
The Agency proved a limited number of class III and unclassified violations warranting fines and a survey fee. The Agency did not complete its statutory obligation with respect to the license renewal.
|