10-008303 Agency For Health Care Administration vs. Albina Manor, Llc, D/B/A Albina Manor Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Tuesday, October 26, 2010.

rendition of this Order an administrative fine in the sum of three

thousand two hundred fifty dollars 3 250 00 and survey fees in the

sum of one thousand dollars 1 000 00 for total assessments of four

thousand two hundred fifty dollars 4 250 00

3 Checks should be made payable to the Agency for Health Care

Administration The check along with a reference to this case

number should be sent directly to

Agency for Health Care Administration

Office of Finance and Accounting

Revenue Management Unit

2727 Mahan Drive MS 14

Tallahassee Florida 32308

4 Unpaid amounts pursuant to this Order will be subject to

statutory interest and may be collected by all methods legally

available

5 The Respondent s requests for Administrative proceedings are

hereby withdrawn

6 Each party shall bear its own costs and attorney s fees

7 The above styled cases are hereby closed

DONE and ORDERED this 11 day of 20

in Tallahassee Leon County Florida

EIizab t D dek nt rim Secretary

Agency or Health Care Administration

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

Copies furnished to

Richard M Sebek Esq Thomas J Walsh II Senior Attorney

Banker Lopez Gassler P A Agency for Health Care Admin

Counsel for Respondent 525 Mirror Lake Drive N 330H

501 East Kennedy Blvd Suite 1500 St Petersburg Florida 33701

Tampa FL 33602 Interoffice Mail

U S Mail

Jan Mills Agency for Health Care Admin

Agency for Health Care Admin Office of Finance and Accounting

2727 Mahan Drive Bldg 3 MS 3 Revenue Management Unit

Tallahassee Florida 32308 2727 Mahan Drive MS 14

Interoffice Mail Tallahassee Florida 32308

Interoffice Mail

Hon J D Parrish Hon William F Quattlebaum

Administrative Law Judge Administrative Law Judge

Division of Administrative Hearings Division of Administrative Hearings

1230 Appalachee Parkway 1230 Appalachee Parkway

Tallahassee Florida 32399 3060 Tallahassee Florida 32399 3060

Interoffice Mail Interoffice Mail

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of this Final Order was

served on the above named person s and entities by U S Mail or the

method designated on this the day of 2O

Richard Shoop Agency Clerk

Agency for Health Care Administration

2727 Mahan Drive Building 3

Tallahassee Florida 32308 5403

850 3630 412