20-002638 Agency For Health Care Administration vs. Richland Retirement Senior Home, Inc. Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Tuesday, September 22, 2020.

STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION,

Petitioner,

v AHCA No. 2020012170

RICHLAND RETIREMENT SENIOR

HOME, INC.,

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 Complaints, Notice of Intent to Deny

Renewal Application, and Election of Rights forms to the Provider. ( 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 Provider' s license renewal application and the Agency' s Notice of Intent to Deny

Renewal Application are withdrawn effective January 31, 2021, or upon the issuance of a provisional

license to a change of ownership applicant, whichever occurs first. Should a change of ownership fail,

the Provider' s license shall be cancelled effective January 31, 2021, without any further agency action and

the Provider shall be required to comply with the requirements of facility closure.

3. The Provider shall pay the Agency $ 6, 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 ( 1 day of , 2020.

Molly McKfnstry, Deputy Secretary

Agency for Health Care Administration

PA

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 ARCA, 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 c y o his Final Or was served on the below - named

persons by the method designated on this day of / , 2020.

Richard- op, Ag6ncy Clerk

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone: ( 850) 412- 3630

Facilities Intake Unit Central Intake Unit

Agency for Health Care Administration Agency for Health Care Administration

Electronic Mail) Electronic Mail)

Keisha Woods, Unit Manager Arlene Mayo Davis, Field Officer Manager

Licensure Unit Local Field Office

Agency for Health Care Administration Agency for Health Care Administration

Electronic Mail) Electronic Mail)

Mary J. Howard, Senior Attorney Rickey Strong, Esq.

Diana M. Giraldo, Senior Attorney Jeffrey S. Howell, P. A.

Office of the General Counsel 2898- 6 Mahan Drive

Agency for Health Care Administration Tallahassee, Florida 32308

Electronic Mail) Counsel for Provider

U. S. Mail)

Division of Administrative Hearings

Electronic Filing)

STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR

HEAL' 111 CARE ADMIN STRATTON,

Peti[ Foner, DOAIi No: 20- 0562

V. Agency Nos, 2014005087

2019010945

20190[ 0449

RICHLAND RETIREMENT SF. Xiolt HOME, INC_ 2019010955

Respondent.

r

RICH LAND RETIRE' 4IF= 1TSFNIORHOME, INC:.

DOAH No: 20- 0562

i' ctitioner, Agency Nos. 201901 0j;

V.

STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMIT ISTRATIOW.

Respondent_

STATE OF FLORIDA, AGkNCY FOR

HEALTH CARE ADMINISTRATION,

DOAH No:

Petitioner, Agency Nos 2020012170 20- 0562

V.

RIC14LAND RETIREMENT SENIOR TTOME,. INC.,

Respondent.

Page I of 8

EXHIBIT 2

STATF. OF FLORIDA, AGENCY I. OR

HEALTH CARE ADMIw1STRATION,

Petitioner, Agency Nes. 2019017715

V.

R1CHLAND RETIREMENT SKNIOR HOME, INC.,

Respondent.

i

SETTLEMENT AGREEMENT

The State of Florida, Agency for Health Care Administration ( hereinafter the " Agenic;

through its undersigned representatives, and Richland Retirement Senior Home, Inc. ( hereinaller

Richland"), pursuant to Section 120. 57( 4), Florida Statutes, each individually, a " party."

collectively as " parties," hereby enter into this Settlement Agreement (" Agrecment") and aarcc:

as follnws:

WHEREAS, Richland wars at all times relevant an assisted living facility licensed

pursuant to Chapters 429, Part 1, and 408, Part 11, Florida Slatuws, Section 20. 42, Florida

Stinnes and Chapter - 59A- 36, Florida Administrative Code; and

WHEREAS, the Agency has jurisdiction by virtue of ( wing the regulatory and licensing

authority over Richland, puTsuant to Chapters 429, fart I, and 408, Part Il, Florida Statutes. and

WHEREAS, the Agency issued an Adminibtrative Complaint can October 25, 2019,

At ICA Case Numbers 2019005087, 2019010945, 20190104149, and 2419410955 seeking throe

thou and five hundred dollars ( 53, 500. 00); and

WHEREAS, the Agency issued an Administrative Complaint on January 9, 2020,

AHC A Case Number 2019017715 socking $ 1, 000. 04 in administrative lines; and

Page 2 of 8

WHEREAS, the Agency issued an Amended Notice of Intent to Deny the Renawd

Application for An Assisted Living thereinalter " NOIQ") AHC: A (.: attic dumber 2019015055 tier

the Ricl lauid' s fiacility on March S. 2020.

WHEREAS. the A- P m; y completed a survey of the Richland and its facility on July '.

201- 0 ! hereinafter " Survcx' A"). . MIC' A case number 2020012170, during which delic: ient

practices were cited; tmd

WHEREAS, the citation of the above referenced deficient practice in Survey A subjects

Richland to the imposition of administrative sanctions of one thousurid live hundred dollars

S l , 500. 00 ): and

WHEREAS, the Parties have agreed to an amicable resolution of these cases.

VOW ' M RFFORE. 1br goad and valuable consideration. the sufEicicncy of which is

hcreby agreed to and confirmed, tic Richland and the Agency agree as ibilows:

1. All of the above recitals aro true and correct and are cxpresslti incorporated into

the Aereement.

2. The Parties agree that the alxive recitals arc binding findings of the Parties.

Upon full execution of this Agreement, the Richl< lnd="" agrccs="" to="" waive="" tiny="" acid="">

appends and proocedinLis to % vhicll they may he entitled, including but nut limited to, tin intOnnal

proceeding under Subsection 120. 57( 2). Florida Statutes. a formal procL- eding router Sub« ctiun

120. 5- 7( 1), F' loridli Statutes. appeals under Section 120. 6$, Florida Statutes: and declaratory and

all writs of relief in any court or quasi - court of corntxtent _ jurisdiction: and agrees In tiVWr, e

Compliance with the firm of the Final Order ( findings of fact and conclusions of law) to Which

they niay be entitled. provided, however, that nu a8Merrrcnt herein shall Ue deemed a waiver by

anp part; of its right tea judicial cnl' arcement al' this Agreement or the Ageney' s rights under

The tindingc of the survey mere rLdluxd ui a stoic fimn 3420.

Pate 3 ( if 8

Scetion 120.( ). Ficirida Statute~ ( 2019). Richland slx: c: ific: ally waives the necessity of the

drai' tine of or scrvic,; of an s' dmii istrativC Complaint liar the irlief stipuluied to in this

Agree. nient a. The sante relates to tllL- Survey A ( hereinafter " Sun• ey").

4, Upon full execution of the Agreement:

a. Richland shall pay administrative tines in the amount of six thousand dollitrs

1') x6. 000. 00). Richland small pay the Agency the suns of$ G. 000, 00 bciiwc the iir:, t

occurring ot: issuance of change of ownership licensure to a third - party applicant

or by January 11, 2021.

b. ' t' ttc tall UTC: of the Richland to timely remit the administrative fines purbunnt to the

Provisions of z; ub- paragraph ( 4)( a) above shall constitute grounds for the deninl of

any third - party application for change ol' owiurship licensure.

C. Riehinrid withdraw~ its application for renewal of licensure, assisted llvlllg facility

license number 9475. c[' fcctivc 14nuary 31, 2021. unless change cit' ownership

licensure has been arantod to a third - party applicant prior thereto.

d. All residents in Richland' s assisted living facility. license number 9475, shall he

Jischarucd on or Velure January 31. 2021 unless change o ownership licensure

has been - ranted to a third - party applicant prior thereto,

e. Richland shrill comply with all Pf0' Visiun5 cif" Chapter 408, Part ll. I- Ion' da

Stalutcs. C hapicr 41- 9. Part 1_ Florida Statutes. and Chapter~ 59; 1- 35 acid 59A- 36.

T Iorida Administrative Code thrcwughnut the discontinuation of Operntlotls

irtcluciing, but not limited to. compliance with provishms related to the timtAy

provision of statutory or contractual notice of discharge it) n- sidenm the timely

distribution ofclient records: and the timely provision ofrel' tmcis to residents and

the return of resident personal property. Nothing in this Agrcenivnt cslups or

1' agca( if 8

prewrlts the . agency from seeking sane; lionn against the Richland for any non-

compliance which Richland rnav he cited liar based upon the acts or omis, iuns- of

WiAand including. but not limited tO, rapprupriute: disclzargC. timer. msidrnt

refund;: and the Timely return ofresident property,, and

V. Effective January I. 2. 021, or the issuance of change of ownership licensure%

whichever may occur first, the NOIR is deemed denied as moot.

f. Effective January 31. 2021, or the issuance of the Previsional license to a third -

party chung: c of ownership applicant, whichever shall first occur. Richland shall

he divestcd of any right, ( itle; or uvkmership interest in license number 94745.

5. VOMIe fuT WIV action brought to eItforce the terms ol' thi5 Agrwrticat or the Final

thile: r 4ntered pursuant hereto shall lie in Circuit Court in Lcon County. Florida.

ti. By executing this Aurc; etnent. Richland denies, and the Agency a5xerls tl- e

validity of the . allegations raised in the Administrative Complaints, NOIT) and Survey ret' crenr. 4d

herein. No agrecrncnt made herein shall preclude the Agency from imposing a penalty against

Richland loan} deliciencylviolation of statute or rule identified in a hriurc survey oilRichland.

which constitutes a " repeat" or " wtcorrected" deficiency from surveys identilied in the

administrative, complaint. In said cvtmt. Richland jvtains thr right to challenge the tactual

allegations mlaled to the deficient practicesfviolations alleged in the; imMant cause.

7. No tigrecment m adc herein shall preclude the Agency trom using the deficiencies

from the surveys identified in the administrative complaint in any decision regarding licensure of

Richbuid, including. but not lintiled to. licensure fbr limited menial health, limited nursing

services. extended congregale mare. or a demonstrated pattern of deficient performance. The

Aacncy is tint precluded from wing the tiuhje ct events fior any purpose within thc_ jurisdiction of

the Agency. Further, Richland acknowledges and agrees that this Aglevrrient shall not preclude:

Pa¢ c 3 of K

or estOp any tether federal, state, or local agency or office from prarsuin€ ally cause of anion ( Ir

along any action, even it' based on or nrising from. in whole or in part, the fuels raised in the

administrative complaints, N' UlU, tuid survey. ' t' ltis agreement docs, not prohibit the Agency

from taking action regarding the Richland' s Medicaid provider status, conditions. requirements

or contract.

8. 1" pon full execution ofthis Agreement, the Agency shall enter Final Order

adapting and incorporating the terms of this Agreement and elusing the above - styled case.

9. U- ch party shall be ar ib, ower ousts and attorney' s kes_

I U. This Agreement shall become effective on the date upon which it is fully ettc el ted

by all the parties.

11. Richland ti) r its rclatcd or resulting organizations. its successors or transferees,

attorneys. Heirs. and executors or administrators, docs hereby discharge the 5bati of Florida,

rlgcnep For Hcalth Care Adminiatralion, anal its agents. representatives. and attorneys ofarlJ

from tall clairns. demands. actions, causes of action, suits, damages, losses, and expenses. of an

and every nature whtatswever, arising out of car in any way related to this matter and the Agency' s

Acii arts, including. but riot limited to, any claims that weri or may be tswrwd in any lccler< at="">

stall' eourr or administrative fOWT11. including any ciuim. S arising out of thi` 3 agorcpmcnt. by or on

beluilfofRichland or related facilitics.

1?. This, Agrtem4nt iti hinding upon all parties herein and those identified in

paragraph cicv- en ( 11 ) of this Agreement.

13. In tate event that Richland was a Medicaid provider at the subject lime of the

e' n' CurrenC. C% alleged in the complaint herein. this settlement docs not prevent the Agency trorn

seeking . 11cdicttid u4erpa. rn: rats related to the sunject issues or from imposing any . sanctions

puretu= t to Rule 59G 9. 070, Florida Administr4 ivi Cade.

Page 6 M' S

14. Richland agrees that if any funds to be paid under this agreement to the Agency

are not paid by the: date the (` 11OW application is approv( A or by January 31, 2021. Whichever

may ( vcur v* ner. the Agency may deduct the amounts assessed against Richland, or any portion

thereof. owed hv Riehland to the Agency frotn any present or future funds owed to Richland by

Ole A- Cr1q, and that tllc Agency shall hold a Gen against present raid futtuiv funds oxcd to

Richl. vid by the A£ ency for said amounts until paid.

15. The undersigned have read and understand this Agreement and have the authority,

to hind their respective pri eipals to it. Richland has the capacity to execute this Agreement.

I& This Agroement contains and incorporates the entire taiderstalklings and

agreements ofthe parties.

1. 7. This Aizreemenl supersedes any prior oral or 4%- ritten agreements heLWecn the

parties.

18. This Agreement may not be ainendcd except in writing. Any attempted

assignmcrit of this grccrncnt shall be void.

19. All panics agree that a facsimile signature suffices 11or an Original sigrtaturr.

20. The fol ] owing repre- sentatives hereby acknowledge that they are duly autbori zed

to enter into this Agreenlert.

1

M Ily cK strk, T) eputp Secrztur; Rickey Strom, I. sq.

I le Hty ,, sSNUrLutrc C uuuscl tor Richland Rutircnimi Senior

i me" 1'& r l• lcalth Care Adminis tratinn I tome. In(;.

2727 Malum Drivc. Building 41 Jeffrey S. How - ch, P. A.

Tallahassee. Florida 32308 2898- 6 Mahan Drive

Tallahassee, Florida 32308

Rick( uijsh- paxom

DATED. I) A' I' I" D: 71felzo Ze)

William Roberts, ( Tencral C' OLUISCI Car

iiice ol' the General C' oun- 5, 01 1Y C. 51r} en t

Agencv for Health Care Adinhiistrabun land Retirement Senior I tome, Inc.

27 Mahan Drive. \\ 1S ;;

lalkiia sec. Florida 32308

Florida Rur No. 554617

11ATED; _ 911` 11 2U

1):' 1* FED: u (;,'

Diane! Xf. Gb- aldr), F. su.

Diana M. Ciraldo, Senior Atlurney Tatian, Perez

011' ce Of the General C' OMSC1 Title: .\\% VIC V, Prf' k, t

Agency for Health Cure Administration Richland elirementSeniorlLome. Inc.

52, Mirror Lake Drive Korth. Suite 330F.

St. Petersburg, Florida 33101

Florida Dar No. 1132 1

DATED:

DATED: Septernbu 17. 2020

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