The Issue Whether the Respondent should be placed on probation or her license #0929202 should be suspended or revoked.
Recommendation Discipline the Respondent, Catherine Barclay, by imposing the judgment of guilt, but suspend enforcement thereof and place the licensee on probation for a period of not less than two years. DONE and ORDERED this 13th day of April, 1979, in Tallahassee, Leon County, Florida. DELPHENE C. STRICKLAND Hearing Officer Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32304 (904) 488-9675 COPIES FURNISHED: Julius Finegold, Esquire 1107 Blackstone Building 233 East Bay Street Tallahassee, Florida 32202 Jerome M. Novey, Esquire 100 Salem Court Tallahassee, Florida 32301
The Issue Whether the Respondent committed the violations alleged in the Administrative Complaint dated May 28, 2000, and, if so, the penalty that should be imposed.
Findings Of Fact Based on the oral and documentary evidence presented at the final hearing and on the entire record of this proceeding, the following findings of fact are made: The Department is the state agency charged with regulating nursing home administrators licensed by the Board of Nursing Home Administrators to practice in Florida. Chapters 455 and 468, Florida Statutes (1997). AHCA is the state agency charged with licensing and regulating nursing homes in Florida. Chapter 400, Florida Statutes (1997). Among its duties, AHCA is required to inspect nursing homes every 15 months "to determine compliance by the licensee with statutes, and with rules promulgated under the provisions of those statutes, governing minimum standards of construction, quality and adequacy of care, and rights of residents." Section 400.19(2), Florida Statutes (1997). Recertification surveys are conducted each 9-to-15 months, are unannounced, and are conducted for both federal certification and Florida nursing home rating and licensure purposes. The surveys are conducted by a team of surveyors each of whom must pass an examination entitled the Surveyor's Minimum Qualification Test before being allowed to participate as an independent member of a survey team. At all times material to this proceeding, Ms. DePonte was a Florida-licensed nursing home administrator, having been licensed in Florida for a period in excess of 28 years. Ms. DePonte's license has never been suspended, revoked, or otherwise sanctioned. Ms. DePonte was employed as the Executive Director/Administrator of Darcy Hall of Life Care ("Darcy Hall") in West Palm Beach, Florida, from July 1989 until September 4, 1998. Darcy Hall is a 220-bed nursing home that was built in 1960 as a 160-bed nursing home; 60 beds were added in 1972, making Darcy Hall one of the oldest and largest nursing homes in Palm Beach County, Florida. Darcy Hall received superior ratings from AHCA for six of the nine years Ms. DePonte was the Executive Director/Administrator, and Darcy Hall received a deficiency-free recertification survey in 1996, during Ms. DePonte's tenure. From July 20 through 24, 1998, an unannounced recertification survey was conducted at Darcy Hall. The survey team identified a number of deficiencies, which deficiencies were itemized in the survey report, commonly referred to as a "Form 2567."4 In an action unrelated to the present proceeding, Darcy Hall challenged the results of the survey, and that challenge was resolved through a settlement agreement.5 The following were observed by the surveyors who inspected Darcy Hall during the July 1998 recertification survey: Call lights were "out of reach" of several residents when the rooms in one wing of the facility were inspected in the pre-dawn hours of July 23, 1998. A totally dependent middle-aged person with multiple schlerosis could not use the pneumatic call light she had been given, because it was not in her hand but was close to her arm, where she was unable to reach it. The nurses' station was located too far away from the resident's room for the resident to be heard at the station if she needed help. An elderly female resident was sitting in a wheelchair outside the facility, about one-half hour after lunch. The resident was in the garden area, close to the nurse's station. The resident, who could understand but not express herself, had lost control of her bladder. A totally dependent resident whose nose was draining was sitting in a wheelchair, with the call light, tissues, and water out of reach. An elderly resident was wearing clothing with what appeared to be burn marks from a cigarette on the front. Dust had accumulated on the filter of an oxygen concentrator. Ceiling tiles were missing from several areas in the facility; some of the rooms contained chipped furniture; a baseboard under an air conditioner was loose; a ceiling tile in a bathroom had a brownish stain; and dust had accumulated in the corners of a bathroom. A geri-chair6 had peeling tape and a black-brown stain on the seat, which the surveyor attributed to a resident becoming incontinent at some point. Approximately 50 ants were found in and around an empty juice cup sitting on a bedside table. Two treatment carts were stained with dried liquid and had an accumulation of debris in the crevices. Hand cranks were protruding from the foot of several beds. Prescription medications were found in the bedside table of one resident; zinc oxide was found on the top of the bedside table of another resident; and a bottle of Caladryl was found on top of the bedside table of a third resident. No physician's orders for these medications were found in the residents' clinical records. A cup left sitting on a bedside table in a room whose residents were cognitively impaired contained a white, thick, creamy ointment. A supply room containing pump sets with pins, syringes, tubing, catheter tips, and special nutritional supplements was found unlocked at approximately 9:00 a.m. on July 22, 1998. During a two-hour period one morning, a nurse dispensed medications to residents by opening the medication and putting the medicine in her bare hands before placing it into a cup and handing it to the resident. The temperature in the medication storage refrigerator was six degrees below the minimum acceptable temperature. The staff member washing pots in the facility's three pot sink obtained from the chemical storeroom a gallon jug of what he thought was dish sanitizer; the chemical was actually Sysco Fry and Grill Cleaner. The fry and grill cleaner was used in the sink in place of sanitizer from 9:00 a.m. on July 22, 1998, until approximately 1:00 p.m. that day, when the error was discovered by a surveyor. All of the pots, pans, and cooking and storage wares were re-washed and sanitized. The residents were monitored for 24 hours, and only one resident had intestinal distress, the source of which was undetermined. During the time that all of the pots and pans were being re-washed and sanitized, a cook washed a pot so that she could begin cooking the soup for the evening meal. She failed to sanitize the pot. Cold food on the tray line in the dining room was not maintained at 41 degrees Fahrenheit or below; applesauce was at 51 degrees, pear halves were at 66.2 degrees, whole milk was at 55.5 degrees, chocolate milk was at 42.8 degrees, and cranberry juice was at 55.2 degrees. All of the items noted in paragraph 7 were identified in the Form 2567 as Class III deficiencies, except for the deficiencies cited regarding the incontinent resident who was sitting outside in the garden area after lunch and the resident who was wearing clothing with cigarette burns on the front, which were designated Class II deficiencies. A Class II deficiency is one that the agency determines has "a direct or immediate relationship to the health, safety, or security of the nursing home facility residents." Section 400.23(9)(b), Florida Statutes (1997). A Class III deficiency is one that the agency determines has "an indirect or potential relationship to the health, safety, or security of the nursing home facility residents." Section 400.23(9)(b), Florida Statutes (1997). As the Executive Director/Administrator of Darcy Hall, Ms. DePonte was responsible for overseeing all operations of the facility, for hiring and firing employees, and for ensuring compliance with all government regulations. At the time of the survey, Darcy Hall employed a dietician, a dietary technician, and a certified dietary manager on staff, who were responsible for running the dietary department. A trained head of maintenance and environmental services, who supervised several full-time employees, and a head of housekeeping services were on staff. Darcy Hall employed two social workers, who were supervised by a director of social services. Darcy Hall was also staffed with a full complement of trained registered nurses, licensed nurses, and certified nurse assistants, who were supervised by a Director of Nursing and Assistant Director of Nursing. It was Ms. DePonte's practice at Darcy Hall not to use nurses provided on a temporary basis by a registry, and all of the nurses employed at Darcy Hall during her time there were employees of the facility. Darcy Hall had written policies and procedures governing the operation of the facility, which were kept both in Ms. DePonte's office and at each unit on the floor. Darcy Hall employed a full-time in-service training coordinator, and Ms. DePonte arranged for outside consultants to conduct in-service training seminars for the staff. Ms. DePonte also made sure that the staff was apprised of any changes in state law and regulations. In-service training was also scheduled whenever Ms. DePonte became aware of an on-going problem. Ms. DePonte personally monitored the facility regularly. Each morning, the first thing she did was visit each nurses' station to determine the staffing levels for the day. She stopped and spoke with residents and family members in the hall, and she entered some of the residents' rooms. She spoke daily with the professional staff of the dietary department and checked with housekeeping and maintenance to make sure there was adequate staff. She also would let the maintenance department know of any problems she found during her morning rounds and would follow up each day to make sure the problems had been corrected. Each afternoon, around 3:30 p.m. or 4:00 p.m., after the change of shift, Ms. DePonte would again visit each nurses' station to follow-up on any issues that had arisen during the day. In addition to personally monitoring the floor twice each day, Ms. DePonte assigned responsibility for monitoring a particular area of the facility to each department head. The department heads were expected to go through their assigned areas at least twice a day to make sure, among other things, that the residents' needs were being met, that call bells were answered timely, that call bells were within reach of residents, and that bed cranks were underneath the beds. Any maintenance problems were also noted. Any problems observed by the department heads were to be reported. Ms. DePonte's policy was to see that problems were addressed within 24 hours. It was the policy at Darcy Hall to discipline staff members who were observed violating an established policy or procedure in accordance with the three-point disciplinary program in place at Darcy Hall. Ms. DePonte had in place at Darcy Hall policies and procedures implementing the requirement that call lights be accessible to residents. The policy required that call lights be positioned within reach of the residents when they were in bed, and the staff was trained to place the call light in accordance with the policy. In addition, Ms. DePonte had every wheelchair equipped with a bell so that the resident could ring the bell if the resident needed help and the call light was out of reach, and there were call lights in all of the residents' bathrooms. As Ms. DePonte made her rounds, she would check the rooms of certain residents to make sure their call lights were accessible. It is not, however, possible to ensure that call lights are within arm's reach of each resident at all times. Ms. DePonte had in place policies and procedures at Darcy Hall regarding the need for staff to recognize and respect the dignity of its residents. Staff training was on-going, and the staff were continually made aware of the residents' rights. Darcy Hall had in place policies and procedures regarding the placement of hand cranks for the residents' beds that required that the staff put away any bed crank they saw sticking out from a bed. Protruding hand cranks were on-going problems because often residents and/or family members would adjust the beds and fail to remove the cranks and place them under the beds. A cleaning schedule was in place for oxygen concentrators and other equipment used in the facility, and cleaning was to be done on a routine basis. Darcy Hall had an on-going program to replace old and worn materials and equipment. Some of the equipment was stained but this did not mean the equipment was not clean. Pursuant to the policy and procedure in place at Darcy Hall during Ms. DePonte's tenure as administrator, nurses were not allowed to dispense medications by placing the pills into their bare hands prior to giving them to residents. Much of the chipped furniture noted in the Form 2567 was furniture belonging to the residents and not furniture owned by Darcy Hall. Because Darcy Hall is an older facility, much needed to be done to maintain the facility. The number of ceiling tiles that were stained constituted a very small percentage of the total number of ceiling tiles in the facility, and ceiling tiles were missing in some places because a new roof was being installed. The baseboard that was coming apart from the wall was located behind an air conditioning unit that was being repaired at the time of the survey. Replacement of ceiling tiles and baseboards was on-going at Darcy Hall. Darcy Hall had a regular extermination service and, if insects were found in the facility, the exterminator would be called immediately and would take care of the problem. The deficiencies identified in the Form 2567 prepared after the July 1998 recertification survey were corrected by September 1, 1998, the time specified by AHCA in the Form 2567. Ms. DePonte left Darcy Hall on September 4, 1998, to take a job as administrator at another nursing home. The evidence presented by the Department is not sufficient to establish with the requisite degree of certainty that the "deficiencies" at Darcy Hall identified by its witnesses in this proceeding were attributable to the negligence, incompetence, or misconduct of Ms. DePonte.7 The position reiterated by the Department's witnesses is that a nursing home administrator is strictly liable for all deficiencies cited on a Form 2567 and that her license is subject to discipline simply because deficiencies were found. The Department has failed to present evidence to establish with the requisite degree of certainty any lack of competence, misconduct, or act or omission on Ms. DePonte's part that caused the deficiencies. Indeed, the Department did not controvert the evidence presented by Ms. DePonte that there were policies and procedures governing the day-to-day operation of Darcy Hall in place, that in-service training was provided to the staff with respect to the policies and procedures on a regular and an as- needed basis, or that Ms. DePonte and her department heads regularly monitored the performance of the staff and their adherence to the policies and procedures.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Health, Board of Nursing Home Administrators, enter a final order dismissing the Administrative Complaint against Eugenia DePonte. DONE AND ENTERED this 30th day of November, 2000, in Tallahassee, Leon County, Florida. PATRICIA HART MALONO 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 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 30th day of November, 2000.
Conclusions THE PARTIES resolved all disputed issues and executed a Settlement Agreement. The parties are directed to comply with the terms of the attached settlement agreement, attached hereto and incorporated herein as Exhibit “1.” Based on the foregoing, this file is CLOSED. DONE and ORDERED on this the aay of Stptember, 2014, in Tallahassee, Florida. Agency for Health Care Administration Final Order Invoice No. NH16752 Page 1 of 3 Filed October 3, 2014 11:44 AM Division of Administrative Hearings 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. Peter A. Lewis, Esquire Peter A Lewis, P.L. 3023 North Shannon Lakes Drive Suite 101 Tallahassee, Florida 32309 palewis@petelewislaw.com (Via Electronic Mail) Bureau of Health Quality Assurance Agency for Health Care Administration (Interoffice Mail) Stuart Williams, General Counsel Agency for Health Care Administration (Interoffice Mail) Shena Grantham, Chief Medicaid FFS Counsel (Interoffice Mail) Agency for Health Care Administration Bureau of Finance and Accounting (Interoffice Mail) Jeffries Duvall, Esquire Assistant General Counsel Agency for Health Care Administration (Interoffice Mail) Zainab Day, Medicaid Audit Services Agency for Health Care Administration (Interoffice Mail) State of Florida, Division of Administrative Hearings The Desoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (Via U.S. Mail) Final Order Invoice No. NH16752 Page 2 of 3 CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addressees by the designated method of delivery on this the i day of C Dla 2014. Richard J. Shoop, Esquire Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 412-3671 Final Order Invoice No. NH16752 Page 3 of 3
Findings Of Fact Since April 23, 1975, Tampa Health Care Center, Inc., d/b/a Habana Villa Health Care Center (the provider), has leased and operated a 150-bed skilled nursing facility which initially opened November 23, 1970. The land and physical plant of Habana Villa Health Care Center are owned by Twin Oaks Realty Company, a New York partnership. In July 1974, prior to the present provider's involvement, the land and physical plant of the present provider were leased and operated by an entity known as Habana Plaza Nursing Center, Inc. In July 1974, the then-operators of Habana Plaza Nursing Center were experiencing a financial crisis. Before, during and after July 1974, the then-operators of Habana Plaza Nursing Center were repeatedly cited for violations of both local laws and federal regulations governing the operation of nursing homes. In early 1975, Habana Plaza Nursing Center filed in bankruptcy in the United States District Court for the Middle District of Florida, Tampa Division (No. 75-241-T) and on April 4, 1975, was adjudicated bankrupt by default. In April 1975, Habana Plaza Nursing Center was providing nursing care for 137 patients of whom at least six (4 percent) were Medicare beneficiaries and at least 96 (70 percent) were beneficiaries of the Medicaid Program. Habana Plaza Nursing Center was located in Hillsborough County, Florida. In April 1975, Hillsborough County and the surrounding area suffered a severe shortage of nursing home beds, making placement of patients from Habana Plaza Nursing Center in other nursing homes very difficult if Habana Plaza Nursing Center was forced to close. Because of the severe shortage of nursing home beds in the Hillsborough County area, the Trustee in Bankruptcy, William Martin, was unable to place the patients of Habana Plaza Nursing Center in other Hillsborough County Nursing homes. Concern that the patients at Habana Plaza Nursing Center not be abruptly displaced and denied nursing care by the facility's impending bankruptcy caused the Bankruptcy Court, the Trustee in Bankruptcy and Twin Oaks Realty Company to vigorously pursue the possibility of finding a lessee for the facility who would be capable of operating it. In February 1975, Twin Oaks Realty Company and Tampa Health Care Center, Inc. negotiated tentative terms for Tampa Health Care Center, Inc. to take over and operate the facility. The tentative agreement was voidable at the option of Twin Oaks if all necessary permits, licenses, and authorizations sufficient to operate the premises as a nursing home facility were not obtained from Florida state officials. Because at least 74 percent of the patients treated at the former Habana Plaza Nursing Center were beneficiaries of either the Medicare or Medicaid Program, capital expenditure reimbursement for treatment of such patients was and is, as a practical matter, essential to continued operation of the premises as a nursing home. Section 1122, 42 USCA Section 1320a-1, approval is not a statutory prerequisite to continued operation of a nursing home. In the Spring of 1975, because of concern that the impending bankruptcy might force Habana Plaza Nursing Center to close, resulting in displacement of 123 patients, state officials form the Department of Health and Rehabilitative Services, but no employees of the Bureau of Community Medical Facilities Planning, assisted and encouraged the representatives of Tampa Health Care Center, Inc. to effect the takeover of the operations of Habana Plaza Nursing Center. Officials of the Florida Department of Health and Rehabilitative Services were intimately involved in and fully and completely informed of the efforts by both the Bankruptcy Court and Twin Oaks Realty Company to transfer and the efforts of Tampa Health Care Center, Inc. to assume operation of Habana Plaza Nursing Center, Inc., but no employees of the Bureau of Community Medical Facilities were ever so involved or advised. On April 14, 1978 Habana Plaza Nursing Center was adjudicated a bankrupt and the Court directed that the receiver transfer both the premises and the operations of Habana Plaza Nursing Center to Tampa Health Care Center, Inc. The lease between Twin Oaks Realty Company and the bankrupt Habana Plaza Nursing Center, Inc. tied rent to the United States Consumer Price Index so that the rent due for 1974 would have been $200,400; for 1975, $214,500 and for 1976, $224,850. The lease entered between Twin Oaks Realty Company and Tampa Health Care Center, Inc. required annual rent of $135,000 per year over a seven year term. (See Exhibits 2-3) As of this date of the lease between Twin Oaks Realty and Tampa Health Care Center, Inc., Tampa Health Care Center, Inc. owned, leased or operated no health care facilities as that term is defined in 42 CFR Section 100.102(e). Generally accepted accounting principles require that the lease of the facility by Tampa Health Care Center, Inc. be classified in the provider's financial statements as an expense of operation. (See Exhibits 5-6) The provider has always classified the rental expense in its financial statements and on its Medicare and Medicaid cost reports as an expense of operation and maintenance. The lease of the subject facility to Tampa Health Care Center, Inc. did not transfer ownership of the property to the lessee at the end of the lease term. The lease of the subject facility did not contain a bargain purchase option. On April 15, 1975, the day on which Tampa Health Care Center, Inc. leased the subject facility from Twin Oaks Realty Co., and at all times prior to April 17, 1975, the Office of Community Medical Facilities Planning, the designated Planning agency for the State of Florida, took the position that a transaction such as the lease between Tampa Health Care Center, Inc. and Twin Oaks Realty Co. was not subject to review under Section 1122, 42 U.S.C. Section 1320a-1, although both HEW and the Office of Community Medical Facilities Planning presently and since April 17, 1975, take the position that said lease transaction is subject to review under Section 1122. Even if personnel in the Bureau (now Office) of Community Medical Facilities Planning had been contacted directly and advised of the lease of the subject facility, that Bureau would have in all likelihood ruled that the transaction was not reviewable under Section 1122, 42 U.S.C. Section 1320a-1, and declined to review the lease under such statute. The lease of the subject facility to Tampa Health Care Center, Inc., resulted in no duplication, growth, expansion or modernization of the provider or health care facilities or services in the planning area. The lease of the subject facility reduces Medicare and Medicaid reimbursable costs by $79,500 in the first year of operation by Tampa Health Care Center, Inc., and by increasingly greater amounts in subsequent years. The subject facility was re-licensed by the Bureau of Health Facilities for 150 skilled and intermediate care beds effective April 23, 1975. The subject facility is located at 2916 Habana Way, Tampa, Hillsborough County, Florida, in health service area IV-1. In January 1978 Medicaid auditors for the State of Florida disallowed the $135,000 rental expense of the provider on the grounds that no Section 1122 approval had been obtained. Disallowance of the rental expense by the Medicaid auditors was the first notification to the provider by state officials that Section 1122 review may have been necessary. On March 23, 1978 the provider completed and returned the required applications for Section 1122 approval. (See Exhibit 7) On June 27, 1978 the Florida Gulf Health Systems Agency unanimously found that the lease of the subject facility conformed to relevant plans, criteria, policies and guidelines and approved the expenditure for reimbursement. The subject facility had an average occupancy rate of 98.3 percent in 1977, 97.5 percent in 1976. The Bureau of Community Medical Facilities Planning of the Department of Health and Rehabilitative Services was in April 1975 the designated planning agency for the State of Florida charged with responsibility for conducting Section 1122 capital expenditure review, pursuant to an agreement with the Federal Department of Health, Education and Welfare, said agreement being attached and made a part of this stipulation. The designated planning agency, the Office of Community Medical Facilities of the Department of Health and Rehabilitative Services, found the lease of the subject facility conformed to relevant plans, criteria policies and guidelines and approved the expenditure. Operation of the facility by Tampa Health Care Center, Inc., and implementation of effective management and cost control techniques resulted in increased utilization and a decrease in cost per patient day from over $25.00 in April 1975 to $22.49 by year end, and to under $20.00 for the six months ended September 30, 1976. The Federal Department of Health, Education and Welfare is aware of Tampa Health Care Center, Inc.'s alleged lack of timely notice to make a capital expenditure under Section 1122, 42 USCA Section 1320a-1 by virture of Atlanta, Georgia Regional HEW officials, John Forrest and Earl Wright, being copied with letters sent to Progressive Medical Group, Inc. and Tampa Health Care Center, Inc. informing them of preliminary determinations that Tampa Health Care Center, Inc. had violated the policy on lack of timely notice, with said letters dated 27 January 1978 and 31 January 1978 being attached and made a part of this stipulation. In order to obtain all necessary permits, licenses, and authorizations necessary for the continued operation of the nursing facility, representatives of Tampa Health Care Center, Inc. met in February 1975 with Joseph Thompson, Charles Carter and Joseph Dowless Licensure and Medicaid - Medicare certification officials of the Florida Department of Health and Rehabilitative Services, but not with employees of the Bureau of Community Medical Facilities Planning. State officials made no mention of the necessity of capital expenditure (Section 1122, 42 USCA Section 1320a-1) review despite numerous inquiries by Tampa Health Care Center, Inc., regarding the licenses, permits and authorizations necessary for continued operation of the premises as a nursing home. Representatives of Tampa Health Care Center, Inc. never specifically mentioned the requirements of Section 1122, USCA Section 1320a-1 in their contacts with State Officials prior to the lease of Habana Plaza Nursing Center. Tampa Health Care Center made a reasonable good faith effort as defined in the policy on lack of timely notice 42 CFR Section 100.108 (note p.1)(1977) to determine prior to leasing the subject facility whether the expenditure was reviewable under Section 1122, 42 USC Section 1320a-1. (See Exhibit 4) On April 23, 1975, contemporaneously with the adjudication of bankruptcy, Tampa Health Care Center, Inc. and Twin Oaks Realty Company, believing that all necessary licenses permits and approvals had been applied for or obtained, entered a lease transferring the premises and operations of Habana Plaza Nursing Center, Inc. to Tampa Health Care Center, Inc. Subsequent to the lease of the facility by Tampa Health Care Center, Inc., the local health planning agencies including the Bureau (now Office) of Community Medical Facilities Planning, at all times considered and treated the beds available in the facility in reviewing and in determining a need for proposals submitted by proponents of capital expenditures subject to Section 1122 42 USCA Section 1320a-1 review. Representatives of Tampa Health Care Center, Inc. met with officials of the Department of Health and Rehabilitative Services but not with any employees of the Bureau of Community Medical Facilities, prior to leasing the facility from Twin Oaks Realty Company and inquired regarding all licenses, permits and approvals necessary to operate the facility as a nursing home.
Recommendation That Respondent report to the Secretary of HEW that Petitioner failed to provide timely notice of its intent to make a capital expenditure, but recommend that reimbursement related to said expenditure not be withheld pursuant to current Department of HEW policy. DONE and ENTERED this 15th day of February, 1979, in Tallahassee, Florida. THOMAS C. OLDHAM Hearing Officer Division of Administrative Hearings 530 Carlton Building Tallahassee, Florida 32304 (904) 488-9675 COPIES FURNISHED: Albert P. Lima, Esquire Dixon Building 620 Twiggs Street Tampa, Florida 33603 Malcolm J. Harkins, III, Esquire 1100 Watergate Office Building 2600 Virginia Avenue, N.W. Washington, D.C. 20037 Eric J. Haugdahl, Esquire Assistant General Counsel Department of HRS 1323 Winewood Boulevard Tallahassee, Florida 32301
