18-004539 Agency For Health Care Administration vs. Stacey Health Care Centers, Inc., D/B/A Riverside Care Center Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Thursday, September 20, 2018.

STATE OF FLORIDA 2013 FF R 77 0 P 1;

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION,

Petitioner,

V. AHCA NOS.: 2018000326

2016011345

STACEY HEALTH CARE CENTERS, INC. RENDITION NO.: AHCA- ( S- OLC

d/ b/ a RIVERSIDE CARE CENTER, ci . 0 1 1 ` 7 -

Respondent.

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)

2. The Respondent shall pay the Agency $ 1, 000. 00. If full payment has been made, the

cancelled check acts as receipt of payment and no further payment is required. If full payment has not

been made, payment is due within 30 days of the Final Order. Overdue amounts are subject to statutory

interest and may be referred to collections. A check made payable to the " Agency for Health Care

Administration" and containing the AHCA ten - digit case number should be sent to:

Central Intake Unit

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 61

Tallahassee, Florida 32308

ORDERED at Tallahassee, Florida, on this l C1 day of hr u , 2019.

r- r

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 copy of this Final Order was served on the below-named

persons by the method designated on of 0 , 2019.

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)

Carlton Enfinger, Assistant General Counsel John F. Gilroy III, Esquire

Office of the General Counsel John F. Gilroy, III, P.A.

Agency for Health Care Administration P.O. Box 14227

(Electronic Mail) Tallahassee, Florida 32317

(U.S. Mail)