STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2020-14533 KIMBERLY ZAFFUTO-FURMAN, R.N., RESPONDENT. ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Nursing against Respondent, Kimberly Zaffuto-Furman, R.N., and in support thereof alleges: 1. Petitioner is the state agency charged with regulating the practice of nursing pursuant to section 20.43, Florida Statutes; chapter 456, Florida Statutes; and chapter 464, Florida Statutes. 2. At all times material to this Administrative Complaint, Respondent was a registered nurse (R.N.) within the state of Florida, having been issued license number RN 9459751. 3. Respondent's address of record is 7150 SE 196" Ave., Morriston, Florida 32668. 4. Respondent entered into a Monitoring Contract with IPN beginning on or about April 4, 2017 through on or about April 3, 2022. 5. IPN is the impaired nurses program for the Board of Nursing, designated pursuant to section 456.076, Florida Statutes. IPN is a program that monitors the evaluation, care, and treatment of impaired nurses. IPN also provides for the exchange of information between treatment providers and the Department of Health for the protection of the public. 6. Onor about May 13, 2020, Respondent was terminated from IPN for failure to comply, without good cause, with the terms of her treatment agreement. 7. Section 456.072(1)(hh), Florida Statutes (2019), provides that being terminated from a treatment program for impaired practitioners, which is overseen by an impaired practitioner consultant as described in section 456.076, for failure to comply without good cause, with the terms of the monitoring or treatment contract entered into by the licensee, or for not successfully completing any drug treatment or alcohol treatment program, constitutes grounds for disciplinary action. Department of Health v. Kimberly Zaffuto-Furman, R.N. 2 Case Number 2020-14533 8. Onor about May 13, 2020, Respondent was terminated from IPN for failure to comply, without good cause, with the terms of her Monitoring Contract. 9. Based on the foregoing, Respondent violated section 456.072(1)(hh), by being terminated from a treatment program for impaired practitioners, which is overseen by an impaired practitioner consultant as described in section 456.076, for failure to comply without good cause, with the terms of the monitoring or treatment contract entered into by the licensee, or for not successfully completing any drug treatment or alcohol treatment program. WHEREFORE, the Petitioner respectfully requests that the Board of Nursing enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. Department of Health v. Kimberly Zaffuto-Furman, R.N. 3 Case Number 2020-14533 SIGNED this 22"? day of _September, 2020. Scott A. Rivkees, M.D. Surgeon General Mare J. Antoine < Assistant General Counsel Florida Bar No. 51912 FILED Florida Department of Health DEPARTMENT OF HEALTH Office of the General Counsel DEPUTY CLERIC 4052 Bald Cypress Way, Bin #C65 CLERK: Oe 2 2020 Tallahassee, FL 32399-3265 DATE Telephone: (850) 558-9891 Facsimile: (850) 245-4662 Email: Marc.Antoine@flhealth.gov /MIA PCP: 9/22/2020 PCP Members: Glymph & Whitson Department of Health v. Kimberly Zaffuto-Furman, R.N. Case Number 2020-14533 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with section 120.569 and 120.57, Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. A request or petition for an administrative hearing must be in writing and must be received by the Department within 21 days from the day Respondent received the Administrative Complaint, pursuant to Rule 28-106,.111(2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule 28-106.111(4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in the Administrative Complaint must conform to Rule 28-106.2015(5), Florida Administrative Code. Mediation under section 120.573, Florida Statutes, is not available to resolve this Administrative Complaint. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to section 456.072(4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed. Department of Health v. Kimberly Zaffuto-Furman, R.N. 5 Case Number 2020-14533

Docket for Case No: 20-005022PL