Findings Of Fact Richard Templeton is a registered nurse holding license #RN 137921-2 issued by the State Board through the Department of Professional Regulation. At all times pertinent to this case, Respondent was employed at Morton Plant Hospital, Clearwater, Florida. On the night of 19/20 July, 1983 Respondent was charge nurse on ward Bernard 5 at Morton Plant Hospital, and was responsible for the administering of medications to include controlled substances, to David Johnson. There were approximately 45 patients on the ward, and Respondent was responsible for at least one third of them. The narcotic sign out sheets reflect that Respondent signed out for 100 mg Demerol at 1:15 A.M. & 4:15 A.M. for David Johnson on said night. Johnson's nursing notes in his medical chart for 7:00 A.M. reflect that Johnson was given 2 pain medicines at 1:15 & 4:15. Johnson's charts reflect he got sleeping medicines at 11:50 P.M. and was sleeping at 2:00 A.M. & 6:00 A.M. 2/ Johnson testified as to the medicines he received while a patient at Morton Plant Hospital in July 1983. Johnson stated he did not receive any injections prior to his pre op medicines which were administered at approximately 1-2:00 P.M. on 20 July, 1983. Johnson's testimony is very concrete and reflects a good recollection of events. His testimony is borne out by the records and is credible. On April 2, 1984 the Respondent entered a plea of nolo contendere to criminal charges that he had violated Chapter 893.13(3)(a)1, Florida Statutes. See Petitioner's Exhibit 2. The court found the Respondent guilty of said charges. Registered nurses have a legal obligation to administer or waste properly controlled substances which they sign out, and to chart the administration of drugs they administer. Mepheridine is the generic name for Demerol, and is a controlled substance pursuant to Chapter 893, Florida Statutes.
Recommendation Having found the Respondent guilty of violating Sections 464.018(1)(c), Florida Statutes, it is recommended the Respondent's license be revoked; however, it is recommended that the revocation be suspended and the Respondent's license be suspended for one year and placed upon probation for two years thereafter during which time the Respondent would be required to submit regular drug screening tests and adhere to any other reasonable conditions imposed by the Board. Having found the Respondent guilty of violating Section 464.018(1)(f), Florida Statutes, it is recommended the Respondent's license be suspended for three years; however, it is recommended that the final two years of the suspension be abated and the Respondent be placed upon probation the final two years during which time the Respondent would be required to submit regular drug screening tests and adhere to any other reasonable conditions imposed by the Board. DONE and ORDERED this 28th day of June, 1985, in Tallahassee, Florida. STEPHEN F. DEAN Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 28th day of June, 1985.
Conclusions 1. The STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA”), was notified by Centers of Medicare & Medicaid Services that the Medicare billing number for the above-referenced provider was revoked April 28, 2010. 2. In accordance with Section 409.913(14) if a provider has been suspended or terminated from participation in the Medicaid program or the Medicare program by the Federal Government or any other state, the agency must immediately suspend or terminate, as appropriate, the provider’s participation in the Florida Medicaid program for a period of no less than that imposed by the Federal Government or any other state, and may not enroll such provider in the Florida Medicaid program while such foreign suspension or termination remains in effect. 3. On April 13, 2012, AHCA issued a letter to Respondent, terminating the Respondent’s participation in the Medicaid program. See ATTACHMENT A. AHCA v. C.A.D.C. Corp., d/b/a Miracle Rehab Center (C.1. No: 12-2049-000) Final Order — Page 1 of 4 Filed September 25, 2012 3:12 PM Division of Administrative Hearings A & 33 4. On May 14, 2012, C.A.D.C. CORP., d/b/a MIRACLE REHAB CENTER, (“Respondent”), filed The Request for a Formal Hearing concerning Miracle Rehab Center, with the Division of Administrative Hearings. See ATTACHMENT B. 5. On June 18, 2012, Respondent received a favorable CMS revocation appeal decision. As such, the underlying cause of action which precipitated Florida Medicaid to terminate Respondent is moot, or the revocation was overturned on appeal. See ATTACHMENT C. 6. On July 12, 2012, AHCA issued a letter to Respondent, rescinding the sanctions in the above-styled matter. See ATTACHMENT D. 7. Based on the foregoing, this file is hereby CLOSED. DONE AND ORDERED on this ao* day of opheol , 2012, in Tallahassee, Florida. ; lizabeth ee Secretary Agency for Health Care Administration AHCA v. C.A.D.C. Corp., d/b/a Miracle Rehab Center (C.1. No: 12-2049-000) Final Order — Page 2 of 4 A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A 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 OF APPEAL IN THE APPELLATE DISTRICT WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW 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. Copies furnished to: Christopher A. Parelia, Qualified Representative The Health Law Offices of Anthony C. Vitale, P.A. 2333 Brickell Avenue Suite A-1] Miami, Florida, 33129 Telephone: (305) 358-4500 Facsimile: (305) 358-5113 Email: CParrella@vitalehealthlaw.com (Via Facsimile and Email) Tracie L. Hardin, Esquire Agency for Health Care Administration 2727 Mahan Drive Building 3, Mail Station 3 Tallahassee, Florida 32308 (Interoffice Mail) Agency for Health Care Administration Bureau of Finance and Accounting 2727 Mahan Drive Building 2, Mail Station 14 Tallahassee, Florida 32308 (Interoffice Mail) Bureau of Health Quality Assurance 2727 Mahan Drive, Mail Stop 9 Tallahassee, Florida 32308 (Interoffice Mail) Mike Blackburn, Bureau Chief Medicaid Program Integrity 2727 Mahan Drive Building 2, Mail Station 6 Tallahassee, Florida 32308 (interoffice Mail) Eric W. Miller, Inspector General Medicaid Program Integrity 2727 Mahan Drive Building 2, Mail Station 6 Tallahassee, Florida 32308 (Interoffice Mail) Division of Administrative Hearings The Desoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (Via U.S. Mail) Florida Department of Health Medical License #299992712 (Via Email Only) AHCA v. C.A.D.C. Corp., d/b/a Miracle Rehab Center (C.1. No: 12-2049-000) Final Order — Page 3 of 4 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addressees by facsimile and email, or the method designated, on this the Richard Shoop, Esquire Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 412-3630 AHCA vy. C.A.D.C. Corp., d/b/a Miracle Rehab Center (C.1, No: 12-2049-000) Final Order — Page 4 of 4
Findings Of Fact Based on my observation of the witnesses and their demeanor while testifying, the documentary evidence received and the entire record compiled herein, I hereby make the following findings of fact: By letter dated August 11, 1986, the Respondent advised the Petitioner that her application for supervisor license under the Florida Clinical Laboratory Law, Chapter 483, Florida Statutes, was denied. The letter provided that the application was denied because the Petitioner does "not have a B.S. degree required under Section 10D-41.68(3), Florida Administrative Code." By letter dated September 9, 1986, the Petitioner requested a formal administrative hearing. The Petitioner took and passed the proficiency examination for clinical laboratory technologists given by the U.S. Office of Health and Human Services (formerly Department of Health, Education and Welfare) in 1977. Based in part on the Petitioner's satisfactory grade on the federal examination, she was licensed in the State of Florida as a clinical laboratory technologist in microbiology, clinical chemistry, hematology and histology. The Petitioner has over six years of pertinent clinical laboratory experience. The Petitioner does not have a bachelor's degree.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED: That Charlotte Holton's application for supervisor license under the Florida Clinical Laboratory Law, Chapter 483, Florida Statutes, be DENIED. DONE AND ORDERED this 11th day of May, 1987, in Tallahassee, Florida. W. MATTHEW STEVENSON Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 11th day of May, 1987. APPENDIX TO RECOMMENDED ORDER, CASE NO. 86-4067 The following constitutes my specific rulings pursuant to Section 120.59(2), Florida Statutes, on all of the Proposed Findings of Fact submitted by the parties to this case. Rulings on Proposed Findings of Fact Submitted by Petitioner Rejected as subordinate and/or unnecessary. Adopted in substance in Findings of Fact 1 and 2. Addressed in Conclusions of Law section. Rejected as subordinate and/or unnecessary. Adopted in substance in Finding of Fact 5. Rejected as argument. Addressed in Conclusions of Law section. Rulings on Proposed Findings of Fact Submitted by Respondent Adopted in substance in Finding of Fact 1. Adopted in substance in Finding of Fact 4. Addressed in Conclusions of Law section. Addressed in Conclusions of Law section. Rejected as legal argument. Rejected as legal argument. COPIES FURNISHED: Ms. Charlotte Holton 4200 Northwest 76th Avenue Pompano Beach, Florida 33065 Leonard T. Helfand, Esquire Department of Health and Rehabilitative Services 401 Northwest Second Avenue, Suite 790 Miami, Florida 33128 Sam Power, Clerk Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, Florida 32399-0700 Gregory L. Coler, Secretary Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, Florida 32399-0700 John Miller, Esquire Acting General Counsel Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, Florida 32399-0700
Findings Of Fact Based on the stipulations of the parties, on the exhibits received in evidence, and on the testimony of the witnesses at the hearing, I make the following findings of fact. Petitioner, Department of Professional Regulation, is the state agency charged with regulating the practice of medicine pursuant to Section 20.30, Florida Statutes; Chapter 455, Florida Statutes; and Chapter 458, Florida Statutes. Respondent is, and has been at all times material hereto, a licensed physician in the state of Florida, having been issued license number ME 0036970. Respondent worked at the Cruz Blanca Clinic from approximately February of 1984 through either October or November of 1985. During that time Respondent worked as a general practitioner and was also the medical director of the Cruz Blanca Clinic. As medical director, Respondent was responsible for the supervision and control of all medical practice at the clinic. Respondent's normal working hours at the Cruz Blanca Clinic were from approximately 8:00 or 8:30 in the morning until approximately 2:30 or 3:00 in the afternoon. During those working hours, Respondent was usually the only licensed medical doctor present on the premises of the Cruz Blanca Clinic. The patients who attended the Cruz Blanca Clinic paid a fee for the privilege of attending the clinic and receiving medical services. The monthly fee was between ten and fifteen dollars per family. Patients requiring general medical services attended the clinic during Respondent's working hours. During the afternoon hours, from approximately 2:00 p.m. until 5:30 p.m., certain medical specialists would see clinic patients by appointment. At all times material, Julio Diaz owned the Cruz Blanca Clinic. At all times material, Julio Diaz, Norma Rodriguez, and Magali Acosta were licensed to practice medicine in a foreign country, but they were not licensed to practice medicine in the state of Florida, nor were they licensed as physician's assistants in the state of Florida. Respondent knew that Diaz, Acosta, and Rodriguez were not licensed to practice medicine in the state of Florida. During 1984 and 1985 while Respondent was the medical director at the Cruz Blanca Clinic, Julio Diaz, Norma Rodriguez, and Magali Acosta frequently and regularly held themselves out as, and acted as, medical doctors or physicians at the Cruz Blanca Clinic. Specifically, they regularly saw patients, took medical histories, checked blood pressure, drew blood samples, took urine and fecal samples, and performed physical examinations. Julio Diaz and Norma Rodriguez went far beyond the routine tasks described above and were in total charge of the medical treatment of some of their patients. Patients with gynecological problems were usually assigned to Norma Rodriguez, pediatric patients were usually assigned to Magali Acosta, and Julio Diaz usually saw the general practice patients. Respondent knew that Diaz, Acosta, and Rodriguez were examining, treating, diagnosing, and prescribing for patients at the Cruz Blanca Clinic. Respondent also knew that at least some of the examining, treating, diagnosing, and prescribing activities of Diaz, Acosta, and Rodriguez were being done without Respondent's supervision. During 1984 and 1985, Maria Rodriguez was a frequent patient at the Cruz Blanca Clinic during the time periods when Respondent was the only licensed medical doctor on the premises of the clinic. On only one occasion Maria Rodriguez was seen by Respondent. On all of her other visits the only doctors', she saw were Julio Diaz or Norma Rodriguez. When Maria Rodriguez was being seen by Julio Diaz or Norma Rodriguez, there was no one present supervising either of the "doctors." Maria Rodriguez believed that Julio Diaz was a medical doctor and he treated her for back problems. Thereafter, Maria Rodriguez was usually seen by Norma Rodriguez, who she also believed to be a doctor. In 1985 Norma Rodriguez injected Maria Rodriguez as part of the treatment of the latter's blood pressure problems. On several occasions Maria Rodriguez saw both Julio Diaz and Norma Rodriguez filling out prescriptions, and on several occasions they both diagnosed and treated her. The prescriptions filled out by Julio Diaz and Norma Rodriguez were signed by Respondent. Barbara Socorro was another patient of the Cruz Blanca Clinic during 1984 and 1985. She was treated at the Clinic for such conditions as common colds, stomach flu, viruses, and gynecological problems. The only "doctor" who examined or treated Barbara Socorro at the Cruz Blanca Clinic was Norma Rodriguez. Norma Rodriguez performed at least one gynecological examination on Barbara Socorro at the Cruz Blanca Clinic. Norma Rodriguez wrote several prescriptions for Barbara Socorro. Barbara Socorro never saw Respondent at the Cruz Blanca clinic. Barbara Socorro believed that Norma Rodriguez was a medical doctor and was told by the receptionist at the Cruz Blanca Clinic that Norma Rodriguez was a gynecologist. Marisol Vilato was another patient of the Cruz Blanca Clinic who during 1984 and 1985 was seen several times for gynecological problems. The only "doctor" seen by Marisol Vilato was Norma Rodriguez. Norma Rodriguez examined Marisol Vilato, including internal gynecological examination; diagnosed and treated her condition; and filled out prescriptions for her. While employed as the medical director at the Cruz Blanca Clinic, Respondent frequently and regularly signed prescriptions filled out by Diaz, Acosta, and Rodriguez because as unlicensed doctors their signatures on prescriptions would not be honored by pharmacies. Without this aid and assistance by Respondent, it would not have been possible for Diaz, Acosta, and Rodriguez to prescribe for the patients at the Cruz Blanca Clinic.
Recommendation Based on all of the foregoing, it is recommended that the Board of Medical Examiners enter a Final Order to the following effect: Dismissing the charges alleged in Counts, 2, 3, and 6 of the Administrative Complaint: Finding Respondent guilty of violations of Section 458.331(1)(g), (t), and (w)' Florida Statutes, as alleged in Counts 1, 4, and 5 of the Administrative Complaint, and Imposing on Respondent appropriate penalties authorized by Section 458.331(2), Florida Statutes. In determining the appropriate penalty to recommend, I have given particular consideration to the nature of the violations; to the fact that although unlicensed practice of medicine was permitted, there was no evidence of harm to any patient; and to the fact that Respondent appears to be an elderly man who is not in the best of health. With those considerations in mind, it is recommended that the Board's Final Order include the following specific penalties: (a) A So-day suspension of Respondent's license to practice medicine; |(b) A one-year period of probation to follow the suspension, with a condition of probation that Respondent work under the supervision of another licensed physician and that he attend continuing education courses specified by the Board with an emphasis on the legal duties and responsibilities of physicians; and (c) An administrative fine in the total amount of S. 00 DONE AND ORDERED this 28th day of October, 1986, at Tallahassee, Florida. MICHAEL M. PARRISH, Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 28th day of October, 1986 COPIES FURNISHED: Michael J Cohen, Esquire CO BN & MEE, P A 517 Southwest First Avenue Fort Lauderdale, Florida 33301 Frank Diaz Silveira, Esquire DIAZ SILVEIRA 6 ASSOCIATES, P A 2153 Coral Way, Suite 607 Miami, Florida 33145 Dorothy Faircloth, Executive Director Board of Medical Examiners Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Wings Slocum Benton, Esquire General Counsel Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Fred Roche, Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 APPENDIX The following are my specific rulings on each of the proposed findings of fact submitted by both of the parties. Proposed findings submitted by Petitioner Paragraphs 1, 2, 3, 4, and 5: These paragraphs are accepted. Paragraph 6: The first sentence of this paragraph is rejected as constituting commentary about conflicts in the evidence rather than a proposed finding of fact. The remainder of this paragraph is accepted in substance. Paragraph 7: This paragraph is accepted in substance. Paragraph 8: The first eight sentences of this paragraph are accepted in substance. The last sentence is rejected as argument rather than a proposed finding of fact. (The argument is a correct argument, but it is not a proposed finding.) Paragraphs 9 and 10: These paragraphs are accepted. Paragraph 11 and the five unnumbered paragraphs following paragraph 11: These paragraphs are rejected as primarily constituting arguments rather than proposed findings of fact. (These arguments are essentially correct, but are nevertheless arguments and do not belong in the findings of fact.) Paragraph 12: This paragraph is also rejected as constituting argument rather than proposed findings. Proposed findings submitted by Respondent This paragraph is rejected as constituting a proposed conclusion of law rather than a proposed finding of fact This paragraph is rejected as constituting summaries of testimony (some of which is conflicting) rather than proposed findings of fact. Counsel for all parties are reminded that summaries of testimony may be a useful technique to support an argument in favor of a particular proposed finding, but such summaries do not constitute proposed findings, especially when the summaries include conflicting testimony. The findings of fact in this Recommended Order contain specific findings regarding the activities engaged in by unlicensed physicians, which findings are based on competent substantial evidence and are consistent with the greater weight of the evidence. The first sentence of this paragraph is rejected as constituting a summary of a portion of the testimony rather than proposed finding of fact. The second sentence of this paragraph is rejected as constituting a summary of a portion of the evidence rather than a proposed finding of fact. Further, the details summarized for the most part relate to subordinate details that are irrelevant or unnecessary to the disposition of this case. This paragraph is rejected as constituting a summary of a portion of the evidence, or as constituting argument about the evidence, rather than a proposed finding of fact. Further, the factual assumptions implicit in this paragraph are contrary to the greater weight of the evidence. This paragraph is rejected as constituting argument instead of proposed findings of fact. This paragraph is rejected as constituting a summary of testimony rather than proposed findings of fact. Further the details summarized are subordinate and irrelevant or unnecessary details. This paragraph is rejected as constituting argument instead of proposed findings of fact. ================================================================= AGENCY FINAL ORDER ================================================================= BEFORE THE BOARD OF MEDICINE DEPARTMENT OF PROFESSIONAL REGULATION, Petitioner, PEDRO F. BERNAL, M.D., DPR CASE NOS. 0055322 DOAH CASE NO. 85-1758 Respondent. LICENSE NO. ME 0036970 /
The Issue Whether disciplinary action should be taken against the Respondent's license to practice nursing, based upon alleged violations of Sections 464.018(1)(h), 464.018(1)(I), 464.018(1)(j), and 455.227(1)(q), Florida Statutes, and if so, what discipline is proper.
Findings Of Fact Petitioner is the state agency charged with regulating the practice of pharmacy pursuant to Section 20.42, Florida Statutes; Chapters 455 and 465, Florida Statutes. The Respondent, Fred Leon London, III, a 48-year-old male, and at all times material to this matter, holds active nursing license numbers PN 1089021 and RN 2804642. Respondent has been a registered nurse for approximately five years. In October of 1995, Respondent was employed as a registered nurse at Columbia Park Medical Center in Orlando, Florida, working the 3:00 p.m. to 11:00 p.m. shift. On October 4, 1995, the hospital, at which Respondent worked, had a discrepancy with one of its narcotic systems called the Phyxis machine. The discrepancy was reported by Respondent. A search was conducted to locate the missing drugs and the narcotics could not be located at that time. It was determined that Respondent and one other nurse were the last two nurses who operated the machine. Pursuant to hospital policies, the Respondent and the other nurse were asked to submit to a urine screen for the purpose of determining if they had ingested any drugs. The Respondent submitted to a urine screen as requested by his employer on October 5, 1995. The urine screen was performed by Smith Kline Beecham Laboratories. The test results performed on behalf of the hospital and the subsequent voluntary test taken by Respondent on October 13, 1995, cannot support a finding of fact, since the reports are uncorroborated hearsay. Following the in-house investigation, the Respondent was terminated from his employment and a report was filed with the Board of Nursing. The missing narcotics were subsequently located the following day. They had been misplaced, but not tampered with. They were returned to inventory. Respondent was referred to the Intervention Project for Nurses (IPN). Respondent participated in a psychosocial assessment on October 12, 1995. Respondent has no prior criminal or disciplinary history and denies that he used marijuana or any other controlled substance on October 4 or 5, 1995.
Recommendation Upon the foregoing findings of fact and conclusions of law, it is RECOMMENDED that the Board of Nursing find the Respondent not guilty as to Counts I, II, III, and IV of the Administrative Complaint, dated August 4, 1997, and that the Administrative Complaint be dismissed. DONE AND ENTERED this 8th day of April, 1998, at Tallahassee, Leon County, Florida. DANIEL M. KILBRIDE Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 8th day of April, 1998. COPIES FURNISHED: Craig A. McCarthy, Esquire Agency for Health Care Administration Post Office Box 14229 Tallahassee, Florida 32317-4229 Dr. Xavier C. Pinellas Qualified Representative 211 Broadway, Suite 115 Kissimmee, Florida 34741 Pete Peterson, General Counsel Department of Health 1317 Winewood Boulevard Building 6, Room 102-E Tallahassee, Florida 32399-0700 Angela T. Hall, Agency Clerk Department of Health 1317 Winewood Boulevard Building 6 Tallahassee, Florida 32399-0700 Marilyn Bloss, Executive Director Board of Nursing Department of Health 4080 Woodcock Drive, Suite 202 Jacksonville, Florida 32207
