11-006339MPI
Agency For Health Care Administration vs.
Jumerolis Home Care, Corp.
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Monday, February 6, 2012.
Settled and/or Dismissed prior to entry of RO/FO on Monday, February 6, 2012.
1STATE OF FLORIDA FIL"ED r.\\-WA
7AGENCY FOR HEALTH CARE ADMINISTRATION A.GENCl C'lERr\\
14STATE OF FLORIDA, AGENCY FOR 1011 APR 20 A 8: lllt
25HEALTH CARE ADMINISTRATION,
28Petitioner, Case No. 11-6339MPI
32Provider No. 142533100
35vs. C.I. No. 12-0804-000
39JUMEROLIS HOME CARE, CORP.,
43Respondent.
44----------------_./
45FINAL ORDER
47This cause came before me for issuance of a Final Order. In a sanction letter dated
63November 9, 2011, Respondent, Jumerolis Home Care Corp. was informed the Agency was
76seeking to impose a fine in the amount of eight thousand dollars ($8,000.00). The letter was sent
94certified mail, return receipt requested to Jumerolis Home Care Corp. (hereinafter
"105PROVIDER").
107The letter contained full disclosure and notice regarding the PROVIDER'S administrative
118hearing and due process rights. The PROVIDER filed a petition for hearing. Upon review of
133documents subsequently submitted by the PROVIDER to the Agency, it was determined the
146sanction should be recalculated and the fine was adjusted to one thousand dollars ($1,000.00). A
162copy of the correspondence reflecting the recalculated fine is attached hereto and incorporated by
176reference herein.
178The PROVIDER paid the fine of $1,000.00 to the Agency's Finance and Accounting
192Department on February 21,2012. Copies of the check(s) and final agency action report(s) are
207also incorporated by reference herein. The PROVIDER withdrew the Petition.
217AHCA v Jumerolis Home Care Corp.
223Page I of3
226Filed April 20, 2012 9:54 AM Division of Administrative Hearings
236The PROVIDER paid the fine of $1,000.00 to the Agency's Finance and Accounting
250Department on February 21, 2012. Copies of the check( s) and final agency action report( s) are
267also incorporated by reference herein. The PROVIDER withdrew the Petition.
277Based on the foregoing, the sanction has beenpaid and the file is CLOSED.
290DONE AND ORDERED this of April, 2012, in Tallahassee, Florida .
301
302Agency for Health Care Administration
307A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED
319TO A JUDICIAL REVIEWWHICH SHALL BE INSTITUTED BY FILING ONE COPY
330OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A
343SECOND COpy ALONG WITH FILING FEE AS PRESCRIBED BY LAW, WITH THE
355DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE
365AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES.
374REVIEW PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE
383FLORIDA APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED
393WITHIN 30 DAYS OF RENDITION OF THE ORDER TO BE REVIEWED.
404Copies furnished to:
407Allan Cao Beverly H. Smith, Esquire
413Jumerolis Home Care Corp. Assistant General Counsel
420956 Southwest 143 Place Agency for Health Care Administration
429Miami, Florida 33184 2727 Mahan Drive, MS #3
437(U.S. Mail) Tallahassee, Florida 32308
442(Interoffice Mail)
444Claude B. Arrington Mike Blackburn, Bureau Chief, Medicaid
452Administrative Law Judge Program Integrity
457Division of Administrative Hearings (Interoffice Mail)
463The DeSoto Building
4661230 Apalachee Parkway
469Tallahassee, Florida 32399-3060
472(U.S. Mail)
474Finance and Accounting Health Quality Assurance
480AHCA v Jumerolis Home Care Corp.
486Page 2 of3
489CERTIFICATE OF SERVICE
492I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished
507to the above named addresses by U.S. Mail on this the -zh y of April, 2012.
523Agency Clerk
525State of Florida
528Agency for Health Care Administration
5332727 Mahan Drive, MS #3
538Tallahassee, Florida 32308-5403
541(850) 412- 3630/FAX (850) 921-0158
546AHCA v Jumerolis Home Care Corp.
552Page 3 of3
555JwcA flORIDA AGENCY FOR HEALTH CARE ADMINISTRATION
562RICK SCOTT Better Health Care for all Floridians ELIZABETH DUDEK
572GOVERNOR SECRETARY
574CERTIFIED MAIL RETURN RECEIPT NO.
579January 17,2012
582c.1. No: 120804000
585Provider No: 142533100 Provider License No: 9687
592Jumerolis Home rd Care Corporation
597956 SW 143 Place
601Miami, Florida, 33184
604In Reply Refer to: Sanction
609Dear Provider:
611In accordance with Section 409.913, Florida Statutes (F.S.), and Rule 590-9.070, Florida
623Administrative Code (F.A.C.), the Agency for Health CareAdministration (Agency), shall apply
634sanctions for violations of federal and state laws, including the following violation of Medicaid
648policy:
649 Failure to maintain a current Health Assessment and Service plan in one recipient record.
664This letter shall serve as notice ofthe following sanction(s):
673A fine of$1000.00 for violation(s) of7(e) under Rule Section 590-9.070, F.A.C.
684Furthermore, this letter serves as notice that the agency, upon entry of a final agency order, a
701judgment or order of a court of competent jurisdiction, or a stipulation or settlement, may collect
717the moneys owed by all means allowable by law, including, but not limited to, notifying any
733fiscal intermediary of Medicare benefits that the state has a superior right of payment. Upon
748receipt of such written notification, the Medicare fiscal intermediary shall remit to the state the
763sum claimed. This is in accordance with Section 409.913, (25) (d) F.S.
775Please remit a certified check in the amount of$1000.00. The check must be payable to the
791Florida Agency for Health Care Administration. Questions regarding procedures for
801submitting payment should be directed to Medicaid Accounts Receivable, (850) 488-5869. To
813ensure proper credit, be certain yourprovider number and the investigation case number
825(120804000) are shown on your check. Please mail payment to:
835Medicaid Accounts Receivable - MS # 14
842Agency for Health Care Administration
8472727 Mahan Drive Bldg. 2, Ste. 200
854Tallahassee, FL 32308
8572727 Mahan Drive, MS# 6 Visit AHCA online at
866Tallahassee, Florida 32308 http://ahca.myflorid a. com
872Jumerolis Home Care Corporation
876142533100
877File 78604 or Case 120804000
882January 17,2012
885Page 2 of 4
889If payment is not received, or arranged for, within 30 days of receipt of this letter, the Agency
907may withhold Medicaid payments or impose additional sanctions, which include, but are not
920limited to, fines, suspension and termination from the Medicaid Program.
930You have the right to request a formal or informal hearing pursuant to Section 120.569, F.S. If a
948request for a formal hearing is made, the petition must be made in compliance with Section 28
965106.201, F.A.C. and mediation may be available. If a request for an informal hearing is made,
981the petition must be made in compliance with rule Section 28-106.301, F.A.C. Additionally, you
995are hereby informed that if a request for a hearing is made, the petition must be received by the
1014Agency within twenty-one (21) days of receipt of this letter. For more information regarding
1028your hearing and mediation rights, please see the attached Notice of Administrative
1040Hearing and Mediation Rights.
1044Any questions you may have about this matter should be directed to: Heberto A. Blandino,
1059Inspector; Agency for Health Care Administration, Medicaid Program Integrity, P.O. Box
107052-2804, Miami, Florida 33152-2804, telephone (305) 718-5900, facsimile (305) 718-5944.
1080Sincerely,
1081Horace Dozier
1083Field Office Manager
1086Office of Inspector General
1090Medicaid Program Integrity
1093Enclosures
1094cc: AHCA Bureau of Finance and Accounting
1101Attn: Katrina Derico-Harris
1104Health Quality Assurance (HQA)
1108(Ex.1)
1109Jumerolis Home Care Corporation
1113142533100
1114File 78604 or Case 120804000
1119January 17,2012
1122Page 3 of 4
1126NOTICE OF ADMINISTRATIVE HEARING AND MEDIATION RIGHTS
1133You have the right to request an administrative hearing pursuant to Sections 120.569 and 120.57,
1148Florida Statutes. If you disagree with the facts stated in the foregoing Final Audit Report (hereinafter
1164FAR), you may request a formal administrative hearing pursuant to Section 120.57(1), Florida Statutes.
1178If you do not dispute the facts stated in the FAR, but believe there are additional reasons to grant the relief
1199you seek, you may request an informal administrative hearing pursuant to Section 120.57(2), Florida
1213Statutes. Additionally, pursuant to Section 120.573, Florida Statutes, mediation may be available if you
1227have chosen a formal administrative hearing, as discussed more fully below.
1238The written request for an administrative hearing must conform to the requirements of either Rule
125328-106.201(2) or Rule 28-106.301(2), Florida Administrative Code, and must be received by the Agency
1267for Health Care Administration, by 5:00 P.M. no later than 21 days after you received the FAR. The
1285address for filing the written request for an administrative hearing is:
1296Richard J. Shoop, Esquire
1300Agency Clerk
1302Agency for Health Care Administration
13072727 Mahan Drive, Mail Stop #3
1313Tallahassee, Florida 32308
1316Fax: (850) 921-0158
1319The request must be legible, on 8 lh by II-inch white paper, and contain:
13331. Your name, address, telephone number, any Agency identifying number on the FAR, if known,
1348and name, address, and telephone number of your representative, if any;
13592. An explanation of how yoursubstantial interests will be affected by the action described in the
1375FAR;
13763. A statement of when and how you received the FAR;
13874. For a request for formal hearing, a statement of all disputed issues of material fact;
14035. For a request for formal hearing, a concise statement of the ultimate facts alleged, as well as the
1422rules and statutes which entitle you to relief;
14306. For a request for formal hearing, whether you request mediation, if it is available;
14457. For a request for informal hearing, what bases support an adjustmentto the amount owed to the
1462Agency; and
14648. A demand for relief.
1469A formal hearing will be held if there are disputed issues of material fact. Additionally, mediation
1485may be available in conjunction with a formal hearing. Mediation is a way to use a neutral third party to
1505assist the parties in a legal or administrative proceeding to reach a settlement of their case. If you and the
1525Agency agree to mediation, it does not mean that you give up the right to a hearing. Rather, you and the
1546Agency will try to settle your case first with mediation.
1556If you request mediation, and the Agency agreesto it, you will be contacted by the Agency to set
1574up a time for the mediation and to enter into a mediation agreement. If a mediation agreement is not
1593reached within 10 days following the request for mediation, the matter will proceed without mediation.
1608The mediation must be concluded within 60 days of having entered into the agreement, unless you and the
1626Agency agree to a different time period. The mediation agreement between you and the Agency will
1642include provisions for selecting the mediator, the allocation of costs and fees associated with the
1657mediation, and the confidentiality of discussions and documents involved in the mediation. Mediators
1670charge hourly fees that must be shared equally by you and the Agency.
1683If a written request for an administrative hearing is not timelyreceived you will have waived your
1699right to havethe intended action reviewed pursuant to Chapter 120, Florida Statutes, and the action set
1715forth in the FAR shall be conclusive and final.
1724Jumerolis Home Care Corporation
1728142533100
1729File 78604 or Case 120804000
1734January 17,2012
1737Page 4 of 4
1741Complete this form and send along with your check to:
1751Agency for Health Care Administration
1756Medicaid Accounts Receivable
17592727 Mahan Drive, Mail Stop #14
1765Tallahassee, Florida 32308
1768CHECK MUST BE MADE PAY ABLE TO: FLORIDA AGENCY FOR HEALTH CARE
1780ADMINISTRATION
1781Provider Name: Jumerolis Home Care
1786Provider ID: 142533100
1789MPI Case #: 120804000
1793Overpayment Amount:
1795Fine Amount: $1000.00
1798Total Amount Owed: $1000.00
1802Check Number:
1804Untitled Document Page 1 of 1
1810Payments
1811Balance
1812MAR Number: 14865
1815Balance per F/A: $0.00
1819Balance Last Updated: 03/07/2012
1823Paid in Full:
1826Repayment Status: LEGAL - UNDER APPEAL - DOAH
1834Transactions
1835Trans Type Date Total Trans Amount alP Fine Interest Misc
1845BILLED 02/21/2012 $1,000.01 $0.01 $1,000.00 $0.00 $0.00
1854BILL ADJUSTMENT 02/21/2012 ($0.01) ($0.01) $0.00 $0.00 $0.00
1862COLLECTED 02/21/2012 ($1,000.00) $0.00 ($1,000.00) $0.00 $0.00
1871Balance: $0.00 $0.00 $0.00 $0.00 $0.00
1877Disclaimer: This balance should not be used to quote amount due by provider. Only FI A can verify
1895amounts for this purpose.
1899©1994 Infinity Software Development, Inc. User Documentation
1906http://ahcanet/facts/payments _mar. asp 03/07/2012
![](/images/view_pdf.png)
- Date
- Proceedings
-
PDF:
- Date: 02/06/2012
- Proceedings: Agreed to Motion to Relinquish Jurisdiction and Remand to the Agency for Health Care Administration filed.
-
PDF:
- Date: 12/20/2011
- Proceedings: Petitioner's Notice of Service of First Set of Interrogatories filed.
-
PDF:
- Date: 12/19/2011
- Proceedings: Notice of Hearing (hearing set for March 8 and 9, 2012; 9:00 a.m.; Tallahassee, FL).
Case Information
- Judge:
- CLAUDE B. ARRINGTON
- Date Filed:
- 12/13/2011
- Date Assignment:
- 12/13/2011
- Last Docket Entry:
- 04/20/2012
- Location:
- Tallahassee, Florida
- District:
- Northern
- Agency:
- Other
- Suffix:
- MPI
Counsels
-
Allan Cao
Address of Record -
Beverly H. Smith, Esquire
Address of Record