STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,
Petitioner, vs.
REHABILITATION CENTER AT HOLLYWOOD HILLS, LLC,
Respondent.
/
211? SEP
MPI Case No.: 2017-0007728 Provider No.: 015452500 License No.: 1238096 NPI No.: 1487039392
IMMEDIATE SUSPENSION FINAL ORDER THIS CAUSE is before me for issuance of an immediate Final Order. Pursuant to Sections 409.913(15)(p) and 409.913(16)(d), Florida Statutes (F.S.), and Rule 59G-9,070(7)(p), Florida Administrative Code (F.A.C.), the Agency shall impose a sanction of immediate suspension from participation in the Florida Medicaid program on a provider if the Agency has received reliable information of patient abuse or neglect. The Agency for Health Care Administration (Agency), Office of Medicaid Program Integrity (MPI) has received information of patient abuse or neglect. Specifically, Rehabilitation Center at Hollywood Hills, LLC's (Respondent's) facility presents a threat to the health, safety, or welfare of clients, as is further described in an Immediate Moratorium on Admissions (moratorium) dated September 13, 2017 (Ex.1).
FINDINGS OF FACTS 1. The Respondent is a nursing home, which practices in the State of Florida under license number 1238096. 2. The Respondent is an enrolled Medicaid provider In the State of Florida under provider number 015452500. 3. Between 1:30 a.m. and 5:00 a.m., on September 13, 2017, several residents suffered respiratory or cardiac distress. Eight (8) of those residents ultimately expired. 4. Shortly after 4:00 a.m. on September 13, 2017, the City of Hollywood Police Department and Hollywood Fire Rescue responded to a call for service at the Respondent's facility. Several patients were found in varying degrees of medical distress, three patients were found deceased, and others were in need of immediate transport. 5. Due to the conditions of the facility, Hollywood Police Department and Hollywood Fire Rescue mobilized nine (9) rescue units to evacuate all of the remaining patients. 6. Respondent's address is 1200 North 35th Avenue, Hollywood, Florida 33021. The facility is located directly across the street from a hospital, located at 3501 Johnson Street, Hollywood, Florida 33021. 7. The hospital located at 3501 Johnson Street, Hollywood, Florida 33021, was operational and able to receive patients. 8. On September 13, 2017, the Agency commenced a survey of the Respondent's facility. 9. The Agency determined that the practices and conditions at the Respondent's facility present (1) a threat to the health, safety, or welfare of residents of the facility, (2) a threat to the health safety, or welfare of a client, (3) an immediate serious danger to the public health, safety, or welfare, and (4) an immediate or direct threat to the health, safety, or welfare of the residents. 10. The Agency's findings of facts as set forth In the moratorium are hereby attached and incorporated by reference herein; they are deemed adopted by the Agency and form the factual basis for the determination of there being patient abuse or neglect. 11. The matter remains under active criminal investigation.
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STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION
CONCLUSIONS OF LAW 1. The Medicaid Act, Title XIX of the Social Security Act, 42 U.S.C. 1396, is a cooperative federal-state program designed to allow states to receive matching funds from the federal government to finance necessary services to qualified low-income individuals. 2. In each state, a "single state agency" is responsible for administering the Medicaid program. 42 C.F.R. 431.10. 3. In Florida, the Agency for Health Care Administration (AHCA) is designated as the single state agency. 4. The Agency shall impose a sanction of immediate suspension from participation in the Florida Medicaid program pursuant to Section 409.913, F.S., and Rule 59G-9.070, F.A.C. 5. The Agency has authority to issue an immediate final order pursuant to Section 409.913, F.S., in accordance with Section 120.569(2)(n), F.S. 6. The sanction as set forth in this Final Order is final.
ORDER BASED on the foregoing, it is ORDERED and ADJUDGED that the Respondent is IMMEDIATELY SUSPENDED from participation in the Florida Medicaid program pursuant to Section 409.913, F.S., and Rule 59G-9.070, F.A.C. The respondent is prohibited from performing any action that results in a claim for payment to the Medicaid program as a result of furnishing, supervising a person who is furnishing, or causing a person to furnish goods or services. DONE AND ORDERED this / ^ day of $ o riff!b $ ,'r , 2017, in Tallahassee, Florida.
Justin ivy Senior, Secretary Agency for Health Care Administration
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CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing has been served on the above-
named persons by U.S. Mail or interoffice mail as indicated on this the / ^ d a y of
2017.
Richard J. Shoop, Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850)412-3630
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:
Rehabilitation Center at Hollywood Hills, LLC 1200 N 35th Ave Hollywood, Florida 33021 (U.S. mail)
Kelly Bennett, Chief Medicaid Program Integrity (Interoffice mail)
Bureau of Financia! Services (Interoffice mall)
Division of Health Quality Assurance (E-mail)
Shawn McCauley Medicaid Fiscal Agent Operations (E-mail)
Warren Moore Medicaid Plan Management Operations (E-mail)
Tracy Jeter-Cummings Medicaid Plan Management Operations (E-mail)
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ni./
STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATJ f
Itf' A
CLERK
STATE OF FLORIDA, AGENCY FOR
2011 SEP 13 P b- 5 !
HEALTH CARE ADMINISTRATION,
Petitioner,
vs,
REHABILITTION CENTER AT HOLLYWOOD HILLS, LLC,
AHCA NO, 2017010404 License No. 1238096 File No. 100611
Provider Type: Nursing Home
Respondent. /
IMMEDIATE MORATORIUM ON ADMISSIONS
THIS CAUSE came before the Secretary of the Agency for Health Care Administration,
or Ills duly appointed designee, who after careful review of the record and being otherwise fully
advised, finds and concludes as follows:
THE PARTIES
1. The Agency for Health Care Administration (hereinafter "the Agency"), is the
licensure and regulatory authority that oversees nursing homes in Florida and enforces the
applicable state statutes and rules governing nursing homes. Chs. 408, Part II, and 400, Part II,
Fla. Stat, (2017), Ch. 59A-4, Fla. Admin. Code. As part of its statutory oversight
responsibilities, the Agency has the authority to impose emergency orders, including a limitation
of license, a moratorium on admissions and an emergency suspension order, when circumstances
dictate such action. 120.60(6), 408.814, Fla. Stat. (2017).
2. The Respondent, Rehabilitation Center at Hollywood Hills, LLC (hereinafter "the
Respondent"), was issued a license by the Agency (License Number 1238096) to operate a
nursing home (hereinafter "the Facility") located at 1200 North 35th Avenue, Hollywood, Florida
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33021, The licensed capacity of the Facility is one hundred fifty-two (152) residents. 3. As the holder of such a license, the Respondent is a licensee. "Licensee" means
"an individual, corporation, partnership, firm, association, or governmental entity, that is issued a permit, registration, certificate, or license by the Agency." 408.803(9), Fla. Stat. (2017). "The licensee is legally responsible for all aspects of the provider operation," 408.803(9), Fla. Stat. (2017). "Provider" means "any activity, service, agency, or facility regulated by the Agency and listed in Section 408.802," Florida Statutes (2017), 408.803(11), Fla. Stat, (201.7), Nursing homes are regulated by the Agency under Chapter 400, Part II, Florida Statutes (2017), and listed in Section 408.802, Florida Statutes (2017). 408.802(12), Fla. Stat. (2017). Nursing home residents are thus clients. "Client" means "any person receiving sendees from a provider." 408.803(6), Fla. Stat. (2017). The Respondent holds itself out to the public as a nursing home that fully complies with state laws governing such providers.
4. The current census o f the Respondent as of this date is zero (0) residents. THE AGENCY'S MORATORIUM ON ADMISSIONS AUTHORITY
5. Under Florida law, the Agency may impose an emergency suspension order or immediate moratorium on admissions as defined in section 120,60, Florida Statutes (2017), on any provider if the Agency determines that any condition related to the provider or licensee presents a threat to the health, safety, or welfare of a client. 408.814(1), Fla. Stat. (2017).
6. Under Florida law, if the Agency finds that an immediate serious danger to the public health, safety, or welfare requires emergency suspension, restriction, or limitation of a license, the Agency may take such action by any procedure that is fair under the circumstances. 120.60(6), Fla. Stat. (2017).
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LEGAL DUTIES OF A NURSING HOM E
7. Under Florida law: "Every licensed facility shall comply with all applicable
standards and rules of the agency and shall ,,, Maintain the facility premises and equipment and
conduct its operations in a safe and sanitary manner." 4Q0.141(l)(h), Fla. Stat. (2017),
8. Under Florida law: "In addition to the grounds listed in part II of chapter 408, any
of the following conditions shall be grounds for action by the agency against a licensee ... (1)
An intentional or negligent act materially affecting the health or safety of residents of the
facility." 400.102(1), Fla. Stat. (2017).
FACTS JUSTIFYING AN IMMEDIATE MORATORIUM ON ADMISSIONS
9. On September 13, 2017, the Agency commenced a survey o f the Respondent and
its Facility.
10. Based upon the above survey, the Agency makes the following findings:
a. On September 10, 2017, Respondent became aware that its air conditioning equipment had ceased to operate effectively, b. In addition to contacting the local electrical power provider, Respondent situated eight (8) portable air coolers throughout the facility and equipped the halls with fans. c. Between 1:30 AM and 5:00 AM on September 13, 2017, several residents suffered respiratory or cardiac distress. Eight (8) o f those residents ultimately expired. d. Emergency personnel and law enforcement responding to these multiple emergency medical events directed Respondent, as a result of the heat in the building, to evacuate the second floor of the Facility. e. Respondent ultimately evacuated the entire building,
11. In this instance, after careful and due consideration, the Agency determines that
the practices and conditions at the Respondent's Facility, as set forth more specifically above,
present (1) a threat to the health, safety or welfare o f residents of the Facility, (2) a threat to the
health, safety or welfare of a client, (3) an immediate serious danger to the public health, safety
or welfare, and (4) an immediate or direct threat to the health, safety, or welfare of the residents
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that constitutes sufficient factual and legal grounds justifying the imposition of an Immediate Moratorium on Admissions to this nursing home,
NECESSITY FOR AN IMMEDIATE MORATORIUM ON ADMISSIONS 12. The Agency is charged with the responsibility of enforcing the laws enacted to protect the health, safety and welfare of residents and clients in Florida's nursing homes. Ch. 400, Part II, Fla. Stat. (2017), Ch. 408, Part II, Fla. Stat, (2017); Ch. 59A-4, Fla. Admin. Code. In those instances where the health, safety or welfare o f a nursing home resident is at risk, the Agency will take prompt and appropriate action. 13. A nursing home must ensure it maintains facility premises and equipment and conduct its operations in a safe and sanitary manner." 400.141(1 )(ta), Fla. Stat. (2017). Residents of nursing homes suffer from disease or disability, are frail, elderly, or vulnerable. By law, the Respondent has been licensed and entrusted to provide care and services to this special class of people, and as such, must comply with the regulations, statutes and rules that have been enacted for the special needs o f these residents. 14. Based upon the foregoing, (1) an immediate serious danger to the public health, safety, or welfare presently exists at the Respondent's Facility which justifies an immediate moratorium on admissions, and (2) the present conditions related to the Respondent and its Facility present a threat to the health, safety, or welfare o f a resident, which requires an immediate moratorium on admissions. 15. The Respondent's deficient conduct is widespread and places all future residents at immediate threat to their health, safety and welfare. The Respondent has demonstrated that its physical plant cannot currently provide an environment where residents can be provided care and services in a safe and sanitary manner.
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16. The above-stated conditions present an immediate serious danger to public health, safety, or welfare and constitute a direct threat to the health, safety or welfare of residents and/or potential residents of the Facility, No resident of a nursing home should be placed in a hazardous environment,
17. The Respondent's deficient practice exist presently; have existed in the past, and more likely than not will continue to exist if the Agency does not act promptly.
18. An Immediate Moratorium on Admissions to this nursing home is necessary to protect the residents from (1) the unsafe conditions and deficient practices that currently exist in the facility, (2) being placed at risk of living in an environment ill-equipped to provide for resident health, safety and welfare, and (3) being placed in a nursing home where the statutory and regulatory mechanisms enacted for their protection have been breached.
CONCLUSIONS OF LAW 19. The Agency has jurisdiction over the Respondent pursuant to Chapters 408, Part II, 400, Part II, Florida Statutes, and Chapter 59A-4, Florida Administrative Code. 20. Based upon the above stated provisions of law and findings of fact, the Agency concludes that: (1) an immediate serious danger to the public health, safety, or welfare presently exists at the Respondent's Facility which justifies an immediate moratorium on admissions to Respondent Facility, and (2) the present conditions related to the Respondent and its Facility present a threat to the health, safety, or welfare of a resident, which requires an immediate moratorium on admissions to the Facility. 21. Based upon the above-stated provisions of law and findings of fact, the Agency concludes that an Immediate Moratorium on Admissions is necessary in order to protect the residents from (1) the unsafe conditions and deficient practices that currently exist, (2) being
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placed at risk of living in an environment ill-equipped to provide a safe and sanitary living environment, and (3) being placed in a nursing home where the regulatory' mechanisms enacted for residents protection have been overlooked,
22. The Respondent's deficient practices exist presently and will more likely than not continue to exist if the Agency does not act promptly. Such deficient practices and conditions justify the imposition o f an Immediate Moratorium on Admissions. Less restrictive actions, such as the assessment of administrative fines, will not ensure that future residents receive the appropriate care, sendees, and environment dictated by Florida law.
23. The emergency action taken by the Agency in this particular instance is fair under the circumstances and the least restrictive action that the Agency could take given the set of facts and circumstances of this particular matter. This remedy is narrowly tailored to address the specific harm in this instance.
IT IS THEREFORE ORDERED THAT: 1. An Immediate Moratorium on Admissions is placed on Respondent's nursing home based upon the above-referenced provisions of law. The Respondent shall not admit for services any individual until such time as this Immediate Moratorium on Admissions is lifted by the Agency in writing. 2. This Immediate Moratorium on Admisions shall be posted and visible to the public at the Respondent's nursing home until the moratorium is lifted. 408.41(4), Fla. Sta. (2017). 3. During the Immediate Moratorium on Admisions, the Agency may regularly monitor the Respondent's Facility, 4. The Agency shall promptly proceed with the filing of an administrative action
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against the Respondent based upon the facts set out within this Order and any other facts that may be discovered during the Agency's continuing investigation. The Agency shall provide notice to the Respondent of the right to a hearing under Section 120,57, Florida Statutes (2017), when the administrative action is brought.
ORDERED in Tallahassee, Florida, this ^ day of September, 2017.
fustin \ i. Seiyor, Secretary Agency for fe aah Care Administration
NOTICE OF RIGHT TO JUDICIAL REVIEW This emergency order is a non-final order subject to facial review for legal sufficiency. See Brov1.es v. State, 776 So.2d 340 (Fla. 1st DCA 2001). Such review is commenced by filing a petition for review in accordance with Florida Rules of Appellate Procedure 9.100(b) and (c). See Fla. R. App. P. 9.190(b)(2). In order to be timely, the petition for review must be filed within thirty (30) days of the rendition of this non-final emergency order.
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RICK SCOTT GOVERNOR JUSTIN M. SENIOR SECRETARY
DELEGATION OF AUTHORITY To Execute Immediate Orders of Moratorium
1specifically delegate the authority to execute Immediate Orders of Moratorium to Molly McKinstry, Deputy Secretary, Health Quality Assurance or her delegate. This delegation of authority shall be valid from the date of October 4, 2016 until revoked by the Secretary.
"'D ati
?2 ? Mahan Drive Mai! Stop 1 Tailshassee, FL 32308 AKCA.MyFiorida.com
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