15-003162 Agency For Health Care Administration vs. Southeast Senior Care Management Group, Llc D/B/A Memory Lane Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Tuesday, August 18, 2015.

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STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION 2015 " LP 0 0 2: 11

SOUTHEAST SENIOR CARE

MANAGEMENT GROUP, LLC,

d/ a b/ MEMORY LANE,

Petitioner, DOAH NO. 15- 2866

V. AHCA NO. 2014009339

License No. 11887

STATE OF FLORIDA, AGENCY FOR File No. 11967908

HEALTH CARE ADMINISTRATION, Provider Type: Assisted Living Facility

RENDITION NO.: AHCA- IS lQ - S- OLC

Respondent.

STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION,

Petitioner, DOAH NO. 15- 3162

V. AHCA NO. 2014004025

SOUTHEAST SENIOR CARE

MANAGEMENT GROUP, LLC,

d/ a b/ MEMORY LANE,

Respondent.

FINAL ORDER

THESE CAUSES came on for consideration before the Agency for Health Care Administration

the Agency"), which finds and concludes as follows:

1. The Agency issued Southeast Senior Care Management Group, LLC, d/ a b/ Memory

Lane, the attached Amended Notice of Intent to Deny for Renewal Application ( Ex. 1) and the attached

Amended Administrative Complaint. Ex. 2). The parties have since entered into the attached

Settlement Agreement ( Ex. 3), which is adopted and incorporated by reference.

2. The Agency shall grant the Licensee a provisional license with an expiration date of

January 29, 2016. At the conclusion of this period, the provisional license shall expire on its own by

operation of law and neither the Licensee nor any prospective change of ownership (" CHOW")

applicant shall have any privilege, interest or remedy to extend the provisional licensure period any

further than this expiration date.

3. During the provisional licensure period, the Licensee may secure a bona fide purchaser or

purchasers for value with regard to the facility through an arm's length transaction and consent to the

CHOW application for the facility, as set forth in the Settlement Agreement. The CHOW application

must be filed with the Agency by no later than November 1, 2015.

4. An administrative fine of $24,000.00 is imposed against the Licensee, but STAYED in

accordance with the terms of the Settlement Agreement.

5. A voluntary moratorium on admissions is imposed upon the Licensee in accordance with

the terms of the Settlement Agreement.

6. The Amended Notice of Intent to Deny is WITHDRAWN subject to the terms of the

parties' Settlement Agreement.

7. The Amended Administrative Complaint is WITHDRAWN subject to the terms of the

parties' Settlement Agreement.

8. The parties shall comply with all other terms in the Settlement Agreement.

ORDERED in Tallahassee, Florida, on this Z-8 day 2015.

ecretary

Care Administration

NOTICE OF RIGHT TO JUDICIAL REVIEW

A party that is adversely affected by this Final Order is entitled to seek 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 HEREBY CERTIFY that a true and of this Final Order was served on the below-

named persons by the method designated on this M_ , 2015.

Richard J. Shoop, Agency erk

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone [phone]

Facilities Intake Unit Catherine Anne Avery, Unit Manager

Agency for Health Care Administration Licensure Unit

(Electronic Mail) Agency for Health Care Administration

(Electronic Mail)

Central Intake Unit Kriste Mennella, Field Office Manager

Agency for Health Care Administration Local Field Office

(Electronic Mail) Agency for Health Care Administration

(Electronic Mail)

Warren Bird, Presiding Officer JefferyS. Howell, Esquire

Presiding Officer Phipps & Howell

Agency for Health Care Administration P.O. Box 1351

(Electronic Mail) Tallahassee, FL 32302

(U.S. Mail)

David Selby, Assistant General Counsel John Cheney, Individually & as Director

Office of the General Counsel Southeast Senior Care Management Group, LLC

Agency for Health Care Administration d/b/a Memory Lane

(Electronic Mail) P.O. Box 1010

Dade City, FL 33526

(U.S. Mail)

Thomas M. Hoeler, Chief Facilities Counsel Anita Helmig, Individually & as Director

Office of the General Counsel Southeast Senior Care Management Group, LLC

Agency for Health Care Administration d/b/a Memory Lane

(Electronic Mail) P 0 Box 1010

Dade City, FL 33526

(U.S. Mail)

Division of Administrative Hearings

(Electronic Filing)