Summary: STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 7021 AUG I1p 12: 2" STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, vs. DOAH CASE NO. 21-1514 AHCA NO. 2021002860 CONCORDIA OF FLORIDA, INC. d/ b/ a CONCORDIA VILLAGE OF TAMPA, RENDITION NO.: AHCA-21 - ( 8 01.3 - S-OLC Respondent. II FINAL ORDER Having reviewed the Amended 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 $ 5, 500.00. If full payment has been made, the cancelled check acts as receipt of payment and no further payment is required. If full payment has not been made, payment is due within 30 days of the Final Order. Overdue amounts are subject to statutory interest and may be referred to collections. A check made payable to the " Agency for Health Care Administration" and containing the AHCA ten -digit case number should be sent to: Central Intake Unit Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 61 Tallahassee, Florida 32308 ORDERED at Tallahassee, Florida, on this 2021. day of , Kimberly 0. Smoak, Deputy Secretary Agency fo Health Care Administration NOTICE OF RIGHT TO JUDICIAL REVIEW A party who is adversely affected by this Final Order is entitled to judicial review, which shall be instituted by filing one copy of a notice of appeal with the Agency Clerk of AHCA, and a second copy, along with filing fee as prescribed by law, with the District Court ofAppeal 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 ofthe order to be reviewed. CERTIFICATE OF SERVICE I CERTIFY that a true and correct ~y~this Final Order was served on the below-named persons by the method designated on this _12__/YQay of f9l..S b ,2021. Richar oop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3 Tallahassee, Florida 32308 Telephone: (850) 412-3630 Facilities Intake Unit Agency for Health Care Administration (Electronic Mail) Central Intake Unit Agency for Health Care Administration (Electronic Mail) Thomas J. Walsh II, Senior Attorney Office of the General Counsel Agency for Health Care Administration (Electronic Mail) Shaddrick Haston, Esq. 3812 Coconut Palm Drive, Suite 200 Tampa, Florida 33619 shaston@ublawoffices.com (Electronic Mail) Division of Administrative Hearings (Electronic Filing) 2