16-001016 Agency For Health Care Administration vs. Palm Gardens Manor, Inc., D/B/A Palm Gardens Manor, Inc., V Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Wednesday, May 4, 2016.

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STATE OF FLORIDA il` c, rrt

AGENCY FOR HEALTH CARE ADMINISTRATION 2017 JAN 2 A 8: 34

STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION,

Petitioner,

NVA DOAH No.: 16 - 1016

AHCA No.: 2015012840

PALM GARDENS MANOR, INC. d/ b / a License No. 10264

PALM GARDENS MANOR, INC. V File No.: 11965893

Provider Type: Assisted Living Facility

Respondent. S- OLC

RENDITION NO.; AHCA- -

FINAL ORDER

Having reviewed the Administrative Complaint, and all other matters of record, the Agency for

Health Care Administration finds and concludes as follows:

1. The Agency issued the attached Administrative Complaint and Election of Rights form to

the Respondent. ( Ex. 1) The parties have since entered into the attached Settlement Agreement, which is

adopted and incorporated by reference into this Final Order. ( Ex. 2)

Based upon the foregoing, it is ORDERED:

2. The Respondent' s license is SURRENDERED.

3. In accordance with Florida law, the Respondent is responsible for retaining and

appropriately distributing all client records within the timeframes prescribed in the authorizing statutes

and applicable administrative code provisions. The Respondent is advised of Section 408. 810, Florida

Statutes.

4. In accordance with Florida law, the Respondent is responsible for any refunds that may

have to be made to the clients.

5. The Respondent is given notice of Florida law regarding unlicensed activity. The

Respondent is advised of Section 408. 804 and Section 408. 812, Florida Statutes. The Respondent should

also consult the applicable authorizing statutes and administrative code provisions. The Respondent is

notified that the cancellation of an Agency license may have ramifications potentially affecting

accrediting, third party billing including but not limited to the Florida Medicaid program, and private

contracts.

ORDERED at Tallahassee, Florida, on this 25th day of Jo..nuar V , 2017.

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 ofthe order to be reviewed.

CERTIFICATE OF SERVICE

I CERTIFY that a true and of this Final Order was served on the below-named

persons by the method designated on of --- , 2017.

oop, Agency

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone: [phone]

Facilities Intake Unit Unit Manager Licensure Unit

Agency for Health Care Administration Agency for Health Care Administration

(Electronic Mail) (Electronic Mail)

Central Intake Unit Arlene Mayo-Davis, Field Office Manager

Agency for Health Care Administration Local Field Office

(Electronic Mail) Agency for Health Care Administration

(Electronic Mail)

Katrina Derico-Harris Teresita A. Viv6, Senior Attorney

Medicaid Accounts Receivable Office of the General Counsel

Agency for Health Care Administration Agency for Health Care Administration

(Electronic Mail) (Electronic Mail)

Shawn McCauley Ana Alvarez, Individually and as President of

Medicaid Contract Management Palm Gardens Manor, Inc.

Agency for Health Care Administration 1232 W 60th Street

(Electronic Mail) Hialeah, Florida 33012-6366

(U.S. Mail)

Y oel Molina, Esquire

Attorney for Palm Gardens Manor, Inc. and

Ana Alvarez

Law Office ofYoel Molina, P.A.

782 NW 42nd Avenue, Ste. 343

Miami, Florida 33126-5550

(U.S. Mail)

NOTICE OF FLORIDA LAW

408.804 License required; display.--

(1) It is unlawful to provide services that require licensure, or operate or maintain a provider that offers

or provides services that require licensure, without first obtaining from the agency a license authorizing

the provision of such services or the operation or maintenance of such provider.

(2) A license must be displayed in a conspicuous place readily visible to clients who enter at the address

that appears on the license and is valid only in the hands of the licensee to whom it is issued and may not

be sold, assigned, or otherwise transferred, voluntarily or involuntarily. The license is valid only for the

licensee, provider, and location for which the license is issued.

408.812 Unlicensed activity.--

(1) A person or entity may not offer or advertise services that require licensure as defined by this part,

authorizing statutes, or applicable rules to the public without obtaining a valid license from the agency.

A licenseholder may not advertise or hold out to the public that he or she holds a license for other than

that for which he or she actually holds the license.

(2) The operation or maintenance of an unlicensed provider or the performance of any services that require

licensure without proper licensure is a violation of this part and authorizing statutes. Unlicensed activity

constitutes harm that materially affects the health, safety, and welfare of clients. The agency or any state

attorney may, in addition to other remedies provided in this part, bring an action for an injunction to

restrain such violation, or to enjoin the future operation or maintenance of the unlicensed provider or the

performance of any services in violation of this part and authorizing statutes, until compliance with this

part, authorizing statutes, and agency rules has been demonstrated to the satisfaction of the agency.

(3) It is unlawful for any person or entity to own, operate, or maintain an unlicensed provider. If after

receiving notification from the agency, such person or entity to fails cease operation and apply for a license

under this and part statutes, authorizing the person or entity shall be subject to penalties as prescribed by

authorizing statutes and applicable rules. Each day of continued operation is a separate offense.

( 4) Any person or entity that fails to cease operation after agency notification may be fined $1,000 for

each day of noncompliance.

(5) When a controlling interest or licensee has an interest in more than one provider and fails to license a

provider rendering services that require licensure, the agency may revoke all licenses and impose actions

under s. 408.814 and a fine of $1 ,000 per day, unless otherwise specified by authorizing statutes, against

each licensee until such time as the appropriate license is obtained for the unlicensed operation.

(6) In addition to granting injunctive relief pursuant to subsection (2), if the agency determines that a

person or entity is operating or maintaining a provider without obtaining a license and determines that a

condition exists that poses a threat to the health, safety, or welfare of a client of the provider, the person

or entity is subject to the same actions and fines imposed against a licensee as specified in this part,

authorizing statutes, and agency rules.

(7) Any person aware of the operation of an unlicensed provider must report that provider to the agency.