This case is before the Agency for Persons with Disabilities (“Agency”) for entry of a Final Order concerning the Agency’s revocation of River Run Residential Care Home’s (“Respondent”) license to operate as a group home facility.
The Agency issued an Administrative Complaint against Respondent on November 26, 2019. Respondent timely filed a petition for an administrative hearing and the case was referred to the Division of Administrative Hearings (“DOAH”) on December 17, 2019, where an Administrative Law Judge ("ALJ") was assigned to the case.
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Due to Respondent’s failure to comply with Petitioner’s discovery requests and an Order Granting Motion to Compel Discovery Responses, the ALJ issued an Order Granting Motion to Relinquish Jurisdiction (“Order”) on February 26, 2020. This Order provides:
Given Respondent’s failure to respond to the Request for Admissions, those requested admissions are deemed admitted pursuant to Florida Rule of Civil Procedure 1.370(a); See also, The Fla. Bar v. Eubanks, 752 So. 2d 540, 544 (Fla. 1999); Fla. Dep’t of Fin. Servs. v. Tampa Serv. Co., 884 So. 2d 252, 253 (Fla. 1st DCA 2004). With the request for admissions deemed admitted, there remains no dispute of material fact in this proceeding.
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In short, Respondent has not responded to anything since this case was forwarded to the Division. Although clearly on notice of its responsibility to respond to discovery, it has not done so. It has not filed any request asking to be relieved of the admissions, or any explanation for why it has not responded, either to requests by opposing counsel, or orders from the administrative law judge. Under these circumstances, it must be concluded that no material fact remains, and there is no basis for holding a hearing pursuant to section 120.57(1), Florida Statutes.
Respondent did not request an informal hearing pursuant to section 120.57(2), Florida Statutes. The facts set forth in the following paragraphs were deemed admitted by order of the ALJ.
A River's Journey, LLC, is a registered and active limited liability company.
Respondent's sole limited liability company member is Latrena Thomas (“Ms. Thomas”).
S.A., M.C., and J.B. were foster children under the care and supervision of
Ms. Thomas in a home not licensed by the Agency. S.A. is non-ambulatory,
non-verbal, and requires supervision and assistance with all her daily needs, including feeding through a G-tube. M.C. and J.B. are vulnerable minor children with special needs.
On or about September 11, 2019, the Department of Children and Families ("DCF") received a report that S.A. had ligature marks on both of her wrists. DCF commenced an investigation into the allegations of abuse and neglect of S.A. on or around that same day.
During the investigation, the DCF investigator observed ligature marks on S.A.'s wrists. DCF's investigation revealed that Ms. Thomas used rope, tape, or some other improper restraint on S.A.'s wrists to bind S.A.'s arms.
DCF's investigation also revealed that Ms. Thomas left S.A., M.C., and J.B in the care of a non-licensed and untrained person who was not knowledgeable about caring for children with complex needs. The caregiver was not trained to properly administer food via G-tube or clean a G-tube.
On or about October 29, 2019, DCF closed the investigation with three counts of verified findings of abuse, neglect or abandonment of a vulnerable child against Respondent's sole member, Ms. Thomas.
On or about July 29, 2019, Respondent submitted an application to renew the facility license for its APD licensed group home. Respondent's license was due to expire on August 31, 2019.
Respondent failed to submit a complete application. Thus, on or about August 2, 2019, the Agency notified Respondent via e-mail that the application was incomplete. The Agency also notified Respondent of the items needed to complete the application.
Despite the Agency's written notification that Respondent's application was incomplete, Respondent failed to submit a complete application to the Agency. On or about August 15, 2019, the Agency again notified Respondent via e-mail that the application was incomplete, including notifying Respondent of the items needed to complete the application.
On or about August 26, 2019, the Agency received some documentation from Respondent related to the facility renewal application. However, the documentation received by the Agency was still incomplete and inaccurate.
On or about September 5, 2019, the Agency again received documentation from Respondent related to the facility renewal application. However, the documentation received by the Agency was again incomplete and inaccurate.
Respondent failed to meet all the requirements for licensure. Thus, the Agency issued Respondent a three-month license and an approved plan of correction. The plan of correction informed Respondent that the Agency would provide technical assistance to Respondent upon request.
On or about October 11, 2019, the Agency sent another written notification to Respondent. This notification detailed the documents Respondent needed to submit to complete the application for renewal licensure and the plan of correction. This notification again informed Respondent that the Agency would provide technical assistance to Respondent upon request.
Respondent failed to timely and sufficiently complete the plan of correction, failed to complete its application for renewal licensure, and failed to contact the Agency for technical assistance.
CONCLUSIONS OF LAW
Section 393.0674, Florida Statutes, provides the following with respect to licenses granted under chapter 393:
The agency may revoke or suspend a license or impose an administrative fine, not to exceed $1,000 per violation per day, if:
The licensee has:
Falsely represented or omitted a material fact in its license application submitted under s. 393.067;
Had prior action taken against it under the Medicaid or Medicare program; or
Failed to comply with the applicable requirements of this chapter or rules applicable to the licensee; or
The Department of Children and Families has verified that the licensee is responsible for the abuse, neglect, or abandonment of a child or the abuse, neglect, or exploitation of a vulnerable adult.
In addition, Rule 65G-2.0041, Florida Administrative Code, provides as follows with respect to disciplinary actions against licensees:
Determination of disciplinary action involving abuse, neglect, or exploitation. In determining whether to pursue disciplinary action in response to verified findings by the Department of Children and Families of abuse, neglect, or exploitation involving the licensee or direct service providers rendering services on behalf of the licensee, the Agency will consider the licensee’s corrective action plan and other actions taken to safeguard the health, safety, and welfare of residents upon discovery of the violation. Considerations shall include the following:
Whether the licensee properly trained and screened, in compliance with section 393.0655, F.S., the staff member(s) responsible for the violation;
Whether, upon discovery, the licensee immediately reported any allegations or suspicions of abuse, neglect, or exploitation to both the Florida Abuse Hotline as well as the Agency;
Whether the licensee fully cooperated with all investigations of the violation;
Whether the licensee took immediate and appropriate actions necessary to safeguard the health, safety and welfare of residents during and after any investigations.
Whether the occurrence is a repeat violation and the nature of such violation.
The specific facts and circumstances before, during, and after the violation.
Factors considered when determining sanctions to be imposed for a violation. The Agency shall consider the following factors when determining the sanctions for a violation:
The gravity of the violation, including whether the incident involved the abuse, neglect, exploitation, abandonment, death, or serious physical or mental injury of a resident, whether death or serious physical or mental injury could have resulted from the violation, and whether the violation has resulted in permanent or irrevocable injuries, damage to property, or loss of property or client funds;
The actions already taken or being taken by the licensee to correct the violations, or the lack of remedial action;
The types, dates, and frequency of previous violations and whether the violation is a repeat violation;
The number of residents served by the facility and the number of residents affected or put at risk by the violation;
Whether the licensee willfully committed the violation, was aware of the violation, was willfully ignorant of the violation, or attempted to conceal the violation;
The licensee’s cooperation with investigating authorities, including the Agency, the Department of Children and Families, or law enforcement;
The length of time the violation has existed within the home without being addressed; and,
The extent to which the licensee was aware of the violation.
Additional considerations for Class I violations, repeated violations or for violations that have not been corrected.
Subject to the provisions of subsection 65G-2.0041(1), F.A.C., in response to a Class I violation, the Agency may either file an Administrative Complaint against the licensee or deny the licensee’s application for renewal of licensure.
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(d) Failure to complete corrective action within the designated timeframes may result in revocation or non-renewal of the facility’s license.
Sanctions. Fines shall be imposed, pursuant to a final order of the Agency, according to the following three-tiered classification system for the violation of facility standards as provided by law or administrative rule. Each day a violation occurs or continues to occur constitutes a separate violation and is subject to a separate and additional sanction. Violations shall be classified according to the following criteria:
Class I statutory or rule violations are violations that cause or pose an immediate threat of death or serious harm to the health, safety or welfare of a resident and which require immediate correction.
Class I violations include all instances where the Department of Children and Families has verified that the licensee is responsible for abuse, neglect, or abandonment of a child or abuse, neglect or exploitation of a vulnerable adult. For purposes of this subparagraph, a licensee is responsible for the action or inaction of a covered person resulting in abuse, neglect, exploitation or abandonment when the facts and circumstances show that the covered person’s action, or failure to act, was at the direction of the licensee, or with the knowledge of the licensee, or under circumstances where a reasonable person in the licensees’ position should have known that the covered person’s action,
or failure to act, would result in abuse, neglect, abandonment or exploitation of a resident.
Class I violations may be penalized by a moratorium on admissions, by the suspension, denial or revocation of the license, by the nonrenewal of licensure, or by a fine of up to $1,000 dollars per day per violation. Administrative sanctions may be levied notwithstanding remedial actions taken by the licensee after a Class I violation has occurred.
Rule 65G-2.003(3), Florida Administrative Code, also provides as follows:
(4) A three month license shall be issued to an existing facility which does not have any ongoing Class I violations, but fails to meet all requirements necessary for license renewal, for which no waiver has been approved by the Agency. A three month license shall be accompanied by an approved plan of correction. Failure to complete the actions specified in the plan of correction within the time limit specified in the plan shall result in the denial of the facility’s application for license renewal.
Section 393.0674 authorizes the Agency to revoke a license if DCF has verified that the licensee is responsible for the abuse, neglect, or abandonment of a child or the abuse, neglect, or exploitation of a vulnerable adult. Rule 65G- 2.0041(1), Florida Administrative Code requires consideration of several factors when determining whether to pursue disciplinary action in cases involving DCF verified findings of abuse, neglect, or exploitation. These are discussed in the following paragraphs. See paragraph 19 of this Order.
River Run Residential Group Home is owned and operated solely by Ms.
Thomas. Ms. Thomas left her three foster children, S.A., M.C., and J.B., in the care of a non-licensed and untrained person who was not knowledgeable about caring for
children with complex needs. This caregiver was not trained in how to properly use and clean a G-tube, which S.A. requires to survive.
Ms. Thomas did not report any allegations or suspicions of abuse, neglect, or exploitation but did cooperate with the investigation. However, the investigation revealed that Ms. Thomas used rope, tape, or some other improper restraint on S.A. that resulted in ligature marks on her wrists, i.e. injury to her person. The DCF investigator closed the investigation with three counts of verified findings of abuse, neglect, or abandonment of a vulnerable child.
Rule 65G-2.0041(2) and (4), Florida Administrative Code requires the Agency to consider additional factors when determining sanctions for violations, generally. See paragraph 19 of this Order. One consideration is the gravity of the violation. Id. In the instant case, three vulnerable children were abused or neglected. Although it does not appear that permanent or irrevocable injuries resulted, serious injury could have resulted from the lack of adequately trained staff and improper restraint.
It is worth noting that the DCF verified findings refer to foster children residing in a home not licensed by the Agency. Although there are no verified findings relating to Respondent’s residents, Ms. Thomas’s obligations to care for the minor children are similar to her obligations to care for the vulnerable adult residents in the group home. Since Ms. Thomas is the sole owner and operator of River Run
Residential Group Home, the verified findings against her suggest residents of the group home are also at risk.
Although it is possible that Ms. Thomas was unaware that she was committing violations, she had personal knowledge of all actions resulting in the DCF verified findings. These were not instances where a facility owner failed to sufficiently train and monitor an employee; the owner was responsible for the violations. She had the authority to make decisions concerning the health, safety, and welfare of residents and failed to make appropriate decisions.
In addition, Rule 65G-2.0041(4)(a)1., Florida Administrative Code specifically designates DCF verified findings of abuse, neglect, or abandonment of a child or abuse, neglect, or exploitation of a vulnerable adult as a Class 1 violation. “Class I violations may be penalized by a moratorium on admissions, by the suspension, denial or revocation of the license, by the nonrenewal of licensure, or by a fine of up to $1,000 dollars per day per violation.” Fla. Admin. Code R. 65G- 2.0041(4)(a)2.
Rule 65G-2.003(3), Florida Administrative Code also provides that “[f]ailure to complete the actions specified in the plan of correction within the time limit specified in the plan shall result in the denial of the facility’s application for license renewal.” As discussed in paragraph 15 of this Order, Respondent was issued a three- month license and approved plan of correction when she failed to meet all
requirements necessary for license renewal. Respondent then failed to timely and sufficiently complete the plan of correction.
Collectively, Respondent is responsible for at least three Class 1 violations without even considering the length of time the violations continued. See Fla. Admin. Code R. 65G-2.0041(4) (stating, “Each day a violation occurs or continues to occur constitutes a separate violation and is subject to a separate and additional sanction.”). Respondent also failed to submit a complete application for renewal and, after being granted a three-month license and plan of correction, failed to timely and sufficiently comply with the plan of correction. This constitutes separate and additional grounds to deny an application for license renewal.
Considering the type and severity of the violations for which Respondent is responsible, the Agency concludes that revocation of Respondent’s license is appropriate.
Based on the foregoing Findings of Fact and Conclusions of Law, Respondent’s license (15-IV-197) to operate as a group home facility is hereby REVOKED.
I HEREBY CERTIFY that a copy of this Final Order was provided by regular US or electronic mail to the above individuals at the addresses listed on
Danielle Thompson, Esq.
