20-000094 Agency For Health Care Administration vs. Concordia Of Florida, Inc., D/B/A Concordia Village Of Tampa Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Tuesday, August 11, 2020.

Central Intake Unit

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 61

Tallahassee, Florida 32308

3. The Administrative Complaint in AHCA No. 2019001114 is withdrawn.

ORDERED at Tallahassee, Florida, on this / day of --'1'"1j "'"---'yl:-1----- 1 , 2021.

. Smoak, Deputy Se retary

Agency for 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 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-G!WY of this Final Order was served on the below-named

persons by the method designated on this of .-- J , 2021.

. hoop, Agency Clerk

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone: [phone]

Facilities Intake Unit Central Intake Unit

Agency for Health Care Administration Agency for Health Care Administration

(Electronic Mail) (Electronic Mail)

Maurice Boetger, Senior Attorney Shaddrick A. Haston, Esquire

Office of the General Counsel Ullman Bursa Law

Agency for Health Care Administration 3812 Coconut Palm Drive, Suite 200

(Electronic Mail) Tampa, Florida 33619

[e-mail]

(Electronic Mail)

Jodi-Ann V. Livingstone J. Bruce Culpepper

Administrative Law Judge Administrative Law Judge

Division of Administrative Hearings Division of Administrative Hearings

1230 Apalachee Parkway 1230 Apalachee Parkway

Tallahassee, Florida 32399-3060 Tallahassee, Florida 32399-3060

(Electronic Filing) (Electronic Filing)

STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION,

Petitioner,

DOAH No.: 20-0094

vs. AHCA No. 2019003368

CONCORDIA OF FLORIDA, INC. d/b/a

CONCORDIA VILLAGE OF TAMPA,

Respondent.

STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION,

Petitioner,

DOAH No.: 20-1 063

vs. AHCA No. 2019001114

JOHN KNOX VILLAGE OF TAMPA BAY, INC.

f/d/b/a JOHN KNOX VILLAGE MED CENTER,

Respondent.

SETTLEMENT AGREEMENT

The Petitioner, State of Florida, Agency for Health Care Administration ("the Agency"),

and the Respondents, Concordia of Florida, Inc. d/b/a Concordia Village of Tampa and John Knox

Village of Tampa Bay, Inc. f/d/b/a John Knox Village Med Center ( coJiectively or individually

"the Respondent"), pursuant to Section 120.57(4), Florida Statutes, enter into this Settlement

Agreement ("Agreement") and agree as follows:

WHEREAS, the Agency is the licensing and regulatory authority over the Respondent

pursuant to Chapter 408, Part II, and Chapter 400, Part II, Florida Statutes; and

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EXHIBIT 2

WHEREAS, the Respondent is a nursing home licensed pursuant to Chapter 408, Part II,

Chapter 400, Part II, Florida Statutes, and Chapter 59A-4, Florida Administrative Code; and

WHEREAS, the Agency issued the Respondent an Administrative Complaint (AHCA No.

2019003368) seeking to impose an administrative fine of $3,000.00 and to assign conditional

licensure status effective January 28, 2019 and ending January 28, 20 19; and

WHEREAS, the Agency issued the Respondent an Administrative Complaint (AHCA No.

2019001114) seeking to impose an administrative fine of $1,000.00 and to assign conditional

licensure status effective November 27, 2017 and ending November 30, 20 17; and

WHEREAS, the parties have agreed that a fair, efficient, and cost effective resolution of

these disputes would avoid the expenditure of substantial sums to litigate these disputes; and

WHEREAS, the parties have negotiated in good faith and agreed that the best interest of

all the parties will be served by a settlement of these proceedings;

NOW THEREFORE, in consideration of these mutual promises and recitals, the parties,

intending to be legally bound, agree as follows:

I. All of the above recitals are true and correct and are expressly incorporated into

this Agreement.

2. The above "whereas" clauses are binding findings on the parties.

3. Upon full execution ofthis Agreement, the Respondent waives any and all appeals

and proceedings to which it may be entitled including, but not limited to, informal proceedings

under Subsection 120.57(2), Florida Statutes, formal proceedings under Subsection 120.57(1),

Florida Statutes, appeals under Section 120.68, Florida Statutes; and further waives compliance

with the form of the Final Order (findings of fact and conclusions of law) to which it may be

entitled. Provided, however, this Agreement shall not be deemed a waiver by any party of its right

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to the judicial enforcement ofthis Agreement.

4. Upon full execution of this Agreement, in AHCA No. 2019003368, the Respondent

agrees to pay the Agency $3,000.00 within 30 days ofthe entry of the Final Order adopting this

Agreement.

5. Upon full execution ofthis Agreement, in AHCA No. 2019003368, the Respondent

is assigned conditional licensure status effective January 28, 2019 and ending January 28, 20 I 9.

6. Upon full execution of this Agreement, the Agency agrees to withdraw the

Administrative Complaint in AHCA No. 2019001 I 14.

7. Venue for any action brought to interpret, enforce, or challenge the terms of this

Agreement and adopting Final Order shall lie solely in the Circuit Court of Leon County, Florida.

8. By entering into this Agreement, the Respondent continues to deny the allegations

set forth in the Administrative Complaints, but recognizes that the Agency continues in good faith

to assert the validity of the allegations. This Agreement shall not preclude the Agency from

imposing any penalty against the Respondent for any other deficiency identified in any other

survey of the Respondent. This Agreement shall not preclude the Agency from using the deficiencies

from the surveys identified in the Administrative Complaint (AHCA # 2019003368) in any decision

regarding licensure of the Respondent. In the event the Agency takes such action in the future,

nothing in this Agreement shaH serve as a waiver of the Respondent's rights under Chapter 120,

Florida Statutes, or other applicable law. In addition, this Agreement shall not preclude or estop

any federal, other state agency, or local agency from taking any action against the Respondent

based upon, in whole or in part, the allegations set forth in the Administrative Complaints.

9. Upon full execution of this Agreement, the Agency shall enter a Final Order

adopting and incorporating this Agreement and closing the above-styled cases.

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10. Each party shall bear its own costs and attorney's fees.

1 I. This Agreement shall become effective on the date upon which it is fully executed

by all parties designated below.

12. The Respondent, for itself and for its related or resulting organizations, entities,

successors, and transferees, attorneys, and heirs, discharges the Agency, its agents, representatives,

and attorneys, from all claims, demands, actions, causes of action, suits, damages, losses, and

expenses, of any and every nature whatsoever, arising out of or in any way related to this matter

and the Agency's actions, including, but not limited to, any claims that were or may be asserted in

any federal or state court or administrative forum, including any claims arising out of this

Agreement, by or on behalf of the Respondent or related entities.

13. This Agreement is binding upon all parties and those persons and entities that are

identified in the above paragraph of this Agreement.

14. In the event that the Respondent was a Medicaid provider at the time of the

occurrences alleged in the Administrative Complaints, this Agreement does not prevent the

Agency from seeking Medicaid overpayments related to the subject issues or from imposing any

further sanctions pursuant to Rule 59G-9.070, Florida Administrative Code. This Agreement does

not settle any pending or potential federal issues against the Respondent. This Agreement does not

prohibit the Agency from taking any action regarding the Respondent's Medicaid provider status,

conditions, requirements or contract, if applicable.

15. The undersigned have read and understand this Agreement and have the authority

and legal capacity to bind their respective principals. The Respondent acknowledges the right to

retain independent counsel and has either obtained its own counsel or voluntarily waived the right

to counsel. The Respondent understands that counsel for the Agency represents solely the Agency

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and that counsel for the Agency has not provided any legal advice to, or influenced, the Respondent

in the decision to enter into this Agreement.

16. This Agreement contains the entire understandings and agreements of the parties.

This Agreement supersedes any prior oral or written agreement that may have existed between the

parties. This Agreement may not be amended except in writing. Any attempted assignment of this

Agreement shall be void.

17. All parties agree that an electronic or facsimile signature suffices for an original

signature, that an electronic or facsimile copy suffices for an original document, and that this

agreement may be executed in counterparts.

18. This Agreement shall be effective upon full execution by all parties and adoption

into a Final Order. After full execution of this Agreement, the Agency will enter a Final Order

adopting this agreement and closing this case.

The following representatives acknowledge that they are duly authorized to enter into this

Agreement.

imberly . Sm ak, Deputy Secretary HopeR dayal

Health Quality Assurance Concordia of Florida, Inc. /a Concordia

Agency for Health Care Administration Village of Tampa (Licensee at the time

2727 Mahan Drive, Building #3 of the Agency action commenced)

Tallahassee, Florida 32308 41 00 E. Fletcher Ave

Tampa, Florida 33613

DATED: Hlzt

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James D. Varna General Counsel Shaddrick A Haston, Esquire

Office of the Geb raJ Counsel Ullman Bursa Law

Agency for Healf Care Administration 3812 Coconut Palm Drive, Suite 200

2727 Mahan Drive, Mail Stop #3 Tampa, Florida 33619

Attorney for Concordia Village

Tallahassee, 3t3l8' .

DATED:__ I '·. I I · ' I DATED: ___ 7_/1_4/_2_1 ____ _

Maurice T. Boetger, Senior Attorney

Office of the General Counsel

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop #3

Tallahassee, Florida 32308

DATED: !) /)h., I

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