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STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION 2021 MAR 25 P 12: 0°

STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION

Petitioner, DOAH No.: 21-0165

AHCA No.: 2020012272

RENDITION NO.: AHCA- 2.l - 1- 9 6 -S-OLC

V.

PCM HEALTH CARE OF PINELLAS COUNTY, INC.

d/b/a SHADY GLEN I,

Respondent.

/

FINAL ORDER

Having reviewed the Administrative Complaint, and all other matters of record, the Agency for Health Care Administration finds and concludes as follows:

1. The Agency issued the attached Administrative Complaint and Election of Rights form to the Respondent. (Ex. 1). The parties have since entered into the attached Settlement Agreement, which is adopted and incorporated by reference into this Final Order. (Ex. 2).

   
   

2. The Respondent shall pay the Agency $3,404.99. If full payment has been made, the cancelled check acts as receipt of payment and no further payment is required. If full payment has not been made, payment is due within 30 days of the Final Order. Overdue amounts are subject to statutory interest and may be referred to collections. A check made payable to the "Agency for Health Care Administration" and containing the AHCA ten-digit case number should be sent to:

Central Intake Unit

Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 61

Tallahassee, Florida 32308

ORDERED at Tallahassee, Florida, on this ,zc; day of_;th--,1_2 -d

, 2021.

M ll Mc · stry, Deputy Secretary Agency for Health Care Administration

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Filed April 7, 2021 8:51 AM Division of Administrative Hearings

NOTICE OF RIGHT TO JUDICIAL REVIEW

A party who is adversely affected by this Final Order is entitled to judicial review, which shall be instituted by filing one copy of a notice of appeal with the Agency Clerk of A.HCA, and a second copy, along with filing fee as prescribed by law, with the District Court of Appeal in the appellate district where the Agency maintains its headquarters or where a party resides. Review of proceedings shall be conducted in accordance with the Florida appellate rules. The Notice of Appeal must be filed within 30 days of rendition of the order to be reviewed.

CERTIFICATE OF SERVICE

I CERTIFY that a true and correct f this Final Order was served on the below-named

persons by the method designated on this of

, ?.--""'=-----' 2021.

Richaro--+-;,,;-r,rnop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone: (850) 412-3630

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Docket for Case No: 21-000165

Orders for Case No: 21-000165