97-004464 Broadview Retirement Home vs. Agency For Health Care Administration Status: Closed Recommended Order on Tuesday, February 3, 1998.

Summary: ALF failed to meet nutritional needs or provide for safety of residents. Two residents required nursing home. Records not maintained.

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

BROADVIEW RETIREMENT HOME, )

)

Petitioner, )

)

vs. ) Case No. 97-4464

)

AGENCY FOR HEALTH CARE )

ADMINISTRATION, )

)

Respondent. )

__________________________________)

AGENCY FOR HEALTH CARE )

ADMINISTRATION, )

)

Petitioner, )

)

vs. ) Case No. 97-5695

)

BROADVIEW RETIREMENT HOME, )

)

Respondent. )

__________________________________)

RECOMMENDED ORDER

Pursuant to notice, a formal hearing was held in these

consolidated cases on December 17, 1997, at Fort Lauderdale,

Florida, before Claude B. Arrington, a duly designated

Administrative Law Judge of the Division of Administrative

Hearings.

APPEARANCES

For Broadview Pauline Ann Black, Owner

Retirement Home: 1841 Southwest 63rd Terrace

Pomp ano Beach, Florida 33068

For Agency for Jennifer A. Steward, Esquire

Health Care Agency for Health Care Administration

Administration: 1400 West Commercial Boulevard, Suite 110

Fort Lauderdale, Florida 33309

STATEMENT OF THE ISSUES

As to DOAH Case No.97-4464, whether Broadview Retirement

Home is entitled to renewal of its license as an assisted living

facility.

As to DOAH Case No. 97-5695, whether Broadview committed the

offenses alleged in the Administrative Complaint and the

penalties, if any, that should be imposed.

PRELIMINARY STATEMENT

By letter dated July 31, 1997, the Agency for Health Care

Administration (Agency) notified Broadview Retirement Home

(Broadview) that its application for renewal of license as an

assisted living facility (ALF) was denied. The denial was based

on Broadview's alleged failure to document that the facility had

passed a fire safety inspection. Broadview's timely challenge of

the denial was referred to the Division of Administrative

Hearings, where it was assigned DOAH Case No. 97-4464. By notice

dated October 17, 1997, the formal hearing in DOAH Case

No. 97-4464 was set for December 5, 1997. On November 25, 1997,

the agency moved to relinquish jurisdiction on the grounds

asserted in its motion. A telephone hearing was held on the

motion to relinquish jurisdiction. By order dated December 3,

1997, the motion to relinquish jurisdiction was denied and the

matter was rescheduled to December 17, 1997.

On October 28, 1997, the Agency served on Broadview the

Administrative Complaint that underpins DOAH Case No. 97-5695.

The Administrative Complaint in DOAH Case No. 97-5695 was based

on an inspection of the facility on September 23, 1997, by Agency

investigator Ana Garcia-Quevedo. On September 26, 1997,

Broadview was closed by the Agency and the four residents of

Broadview were relocated to other facilities. The Administrative

Complaint contains specific allegations of multiple violations of

the statutes and rules regulating ALFs. Broadview initially

requested an informal hearing to challenge the allegations of the

Administrative Complaint, but later requested a formal hearing.

The matter was thereafter referred to the Division of

Administrative Hearings on December 11, 1997, where it was

assigned DOAH Case No. 97-5695.

On December 16, 1997, the parties filed a Joint Motion to

Consolidate DOAH Case Nos. 97-4464 and 97-5695, and advised that

they were prepared to go to hearing on both cases on December 17,

1997. On December 17, 1997, the formal hearing was convened, the

motion to consolidate was granted (while on the record), and the

consolidated formal hearing was conducted.

At the formal hearing, the Agency presented the testimony of

Ms. Garcia-Quevedo. The Agency presented no exhibits. Broadview

presented the testimony of Mary Palmer-Miller and of Pauline Ann

Black. Ms. Palmer-Miller is employed as the director of nursing

at Plantation Nursing Home and Rehab Center, the nursing home to

which two of Broadview's former residents (Residents 1 and 4)

were transported on September 26, 1997. Ms. Black is the owner

of Broadview. Broadview offered three exhibits, two of which

were admitted into evidence.

A transcript of the proceedings has been filed. At the

request of the parties, the time for filing post-hearing

submissions was set for more than ten days following the filing

of the transcript. Consequently, the parties waived the

requirement that a recommended order be rendered within thirty

days after the transcript is filed. Rule 60Q-2.031, Florida

Administrative Code. Broadview and the Agency filed proposed

recommended orders, which have been duly considered by the

undersigned in the preparation of this Recommended Order.

FINDINGS OF FACT

1. At all times pertinent to these proceedings, Pauline Ann

Black was the owner of Broadview Retirement Home, a licensed

assisted living facility located at 1741-1743 Southwest 70th

Avenue, Pompano Beach, Florida. At all times relevant to these

proceedings, the facility was licensed for six residents.

2. The Agency has jurisdiction over Broadview by virtue of

the provisions of Chapter 400, Part III, Florida Statutes, and

Chapter 58A-5, Florida Administrative Code.

3. Prior to July 31, 1997, Broadview applied for renewal of

its license to operate as an ALF. On July 31, 1997, the Agency

issued to Broadview a letter that denied the application for

renewal for the following specified reason:

The applicant's failure to provide required

ALF license application information pursuant

to section 400.414(2)(g), F.S. and 58A-

5.022(17), F.A.C. The requested information

included a satisfactory fire safety

inspection report.

4. By notice with an effective date of August 29, 1997, the

Agency imposed a moratorium that prevented Broadview from

admitting new residents. Whether the Agency had sufficient

grounds to impose the moratorium was not at issue in this

proceeding.

5. On September 23, 1997, the Agency received a complaint

from a police officer that caused it to conduct an immediate

inspection of Broadview.

6. Ana Garcia-Quevedo, an experienced investigator employed

by the Agency, was assigned the responsibility of conducting the

inspection. Ms. Garcia-Quevedo's job title is Health Facility

Evaluator I. Because there were no other investigators

available, Ms. Garcia-Quevedo was the only Agency employee who

participated in the inspection on September 23, 1997.

7. On September 23, 1997, Broadview did not have posted at

the facility a copy of the letter denying its renewal

application, or the notice imposing the moratorium on admissions.

On September 23, 1997, Broadview did not have available for

inspection a copy of its fire safety inspection report. 1

8. There were four residents of Broadview on September 23,

1997, each of whom was an elderly female. By agreement of the

parties, the residents were referred to by number at the formal

hearing.

9. There was only one staff person on duty at Broadview

when Ms. Garcia-Quevedo conducted her investigation. One of the

residents was wheelchair bound and two other residents were too

confused to react in an emergency. One employee was insufficient

to assure the safety of the residents in the event of an

emergency, such as a fire.

10. Residents 1 and 4 did not meet the criteria for

placement in an ALF as they both required the degree of care and

supervision provided by a nursing home. 2 Both of these residents

were unable to participate in any leisure activities and could

not communicate in a meaningful way. When the residents were

removed from the facility on September 26, 1997, these two

residents were transferred to Plantation Nursing and Rehab

Center, which is a nursing home.

11. Resident 2 suffered Insulin Dependent Diabetes Mellitus

and required administration of insulin twice daily. Resident 2

was not capable of taking her medication without assistance.

Broadview's employee was not aware of the amount of insulin

Resident 2 required, and she was not aware of Resident 2's

dietary restrictions. Although Resident 2 was transferred to

another ALF on September 26, 1997, Broadview was not an

appropriate placement for this resident because Broadview did not

provide this resident with sufficient care and supervision in the

administration of her medicine or the provision of her food.

12. Broadview did not maintain Resident 2's insulin in a

locked area. This medicine was kept in a refrigerator in the

butter compartment, which did not have a locking system.

13. A review by Ms. Garcia-Quevedo of the records made

available to her by the Broadview employee on September 23, 1997,

revealed that Broadview did not maintain current records of the

condition of the respective residents. The last entries in the

records for Residents 1, 2, and 3 were made in September of 1996.

Resident 4 was admitted to Broadview from a skilled nursing

facility on June 4, 1997. A discharge summary prepared by that

nursing home was the only record for Resident 4. There were no

records describing the condition for Resident 4 subsequent to her

admission to Broadview.

14. As of September 23, 1997, Broadview was unable to

document that it was providing its four residents with services

appropriate to their needs. The records for these residents did

not contain documentation by Petitioner regarding the level of

care or personal supervision needed.

15. As of September 23, 1997, there was no health

assessment of Resident 4 in Broadview's records.

16. Broadview did not have available for inspection on

September 23, 1997, records of the weights of the residents. 3

17. All four residents required special diets. Residents

1, 2,and 3 had orders for restricted diets documented in their

health assessments. Resident 4 did not have a health assessment,

but the discharge summary from the skilled nursing home from

which she had been transferred ordered a therapeutic diet.

18. The posted menu on the date of the survey was dated for

the week of October 31, 1996. The posted menu documented an

evening meal that was not the meal that was actually served.

Broadview did not document the changes in the menu or provide a

nutritional substitute for one of the menu items (fruit

cocktail). There were insufficient foods in storage to prepare

the planned meals for the week. The employee on duty on

September 23, 1997, did not know when additional food items would

be purchased.

19. As of September 23, 1997, the diets offered by

Broadview did not meet the nutritional needs of the four

residents.

20. The last recorded weight of Resident 1, in the amount

of 122 pounds, was on the date of her admission, which was

December 31, 1994. When she was weighed by Ms. Garcia-Quevedo on

September 23, 1997, her weight was 96 pounds. When Resident 1

was weighed upon transfer to the skilled nursing home on

September 26, 1997, her weight was 94.5 pounds. The last

documented weight for Resident 2, in the amount of 180 pounds,

was entered on July 8, 1996. Ms. Garcia-Quevedo was unable to

weigh this resident because she could not slide back on the chair

scale. The last documented weight for Resident 3, in the amount

of 136 pounds, was entered on March 20, 1996. When she was

weighed by Ms. Garcia-Quevedo on September 23, 1997, her weight

was 122 pounds. The last recorded weight for Resident 4, in the

amount of 105, was reflected in the discharge summary when she

was transferred from the skilled nursing home to Broadview on

June 4, 1997. When she was weighed by Ms. Garcia-Quevedo on

September 23, 1997, her weight was 86 pounds. When Resident 4

was weighed upon transfer to the skilled nursing home on

September 26, 1997, her weight was 102 pounds. 4 The Agency

established that Residents 1 and 4 suffered weight losses while

residing at Broadview. The evidence was insufficient to

establish that Residents 2 and 3 had also suffered weight losses.

21. Residents 1 and 4 were dressed in clothing stained with

food particles.

CONCLUSIONS OF LAW

22. The Division of Administrative Hearings has

jurisdiction of the parties to and the subject of this

proceeding. Section 120.57(1), Florida Statutes.

23. Part III of Chapter 400, Florida Statutes, is the

Florida Assisted Living Facilities Act. See Section 400.401(1),

Florida Statutes.

24. Section 400.401(3), Florida Statutes, provides as

follows:

(3) The principle that a license issued

under this part is a public trust and a

privilege and is not an entitlement should

guide the finder of fact or trier of law at

any administrative proceeding or in a court

action initiated by the Agency for Health

Care Administration to enforce this part.

25. Section 400.414, Florida Statutes, provides, in

pertinent part, as follows:

(1) The agency may deny, revoke, or

suspend a license issued under this part or

impose an administrative fine in the manner

provided in chapter 120. At the chapter 120

hearing, the agency shall prove by a

preponderance of the evidence that its

actions are warranted.

(2) Any of the following actions by a

facility or its employee shall be grounds for

action by the agency against a licensee:

(a) An intentional or negligent act

seriously affecting the health, safety, or

welfare of a resident of the facility.

* * *

(3) Proceedings brought under paragraphs

(2)(a), (c), (e), and (j) shall not be

subject to de novo review.

26. The Agency established that Broadview did not provide a

fire safety report with its application to renew its license and

failed to have a fire safety report available for inspection on

September 23, 1997. Section 400.417(1), Florida Statutes,

requires that a fire safety report accompany an application for

renewal of license. The failure of Broadview to attach a copy of

the fire safety report to its renewal application justified the

Agency's initial decision to deny the renewal application.

Broadview produced at the formal hearing a fire safety inspection

report that was accepted into evidence without objection. This

report established that the facility passed a fire safety

inspection on March 18, 1997. Consequently, it is concluded that

the failure of Broadview to attach a copy of the fire inspection

report should not be a grounds for denying Broadview's renewal

application. If such grounds exist, they must be found in the

allegations of the Administrative Complaint in DOAH Case

No. 97-5695.

27. In its Administrative Complaint, the Agency alleged

that Broadview's failure to produce a copy of the fire inspection

report on September 23, 1997, constituted a violation of the

provisions of Section 400.441(1)(a)2m, Florida Statutes, and/or

Rule 58A-023(18)(a), Florida Administrative Code. [The Agency

alleged in its Administrative Complaint that Broadview violated

Rule 58A-023(18)(a), which does not exist. This reference is

apparently a scrivener's error, and it is assumed that the

intended reference was to Rule 58A-5.023(18), Florida

Administrative Code.] These provisions relate to the fire-

prevention requirements of the physical plant. Broadview

established that its facility met those requirements.

Consequently, it is concluded that the Agency failed to establish

that Broadview violated the provisions of Section

400.441(1)(a)2m, Florida Statutes, and/or Rule 58A-023(18)(a),

Florida Administrative Code, as alleged by the Agency.

28. Rule 58A-5.024, Florida Administrative Code, provides

the following requirement pertaining to records:

The owner or administrator of a facility

shall maintain the following written records

in a place, form and system ordinarily

employed in good business practice. All

records required by this chapter shall be

accessible to department and agency staff.

All resident contracts shall be retained for

five years after expiration.

30. Rule 58A-5.024(2)(c)3, Florida Administrative Code,

requires that an ALF maintain the following health information:

a. A copy of the physical examination by a

health care provider as required by 58A-

5.0181(4).

b. Name, address, and telephone number of

the resident's health care provider.

c. Description of resident's overall

condition and level of care required, updated

as needed.

d. Reports of resident illness and medical

attention provided.

e. Record of height and weight which is

initiated on admission. Information may be

taken from the resident's physical

examination. Residents receiving individual

assistance with activities of daily living

shall have their weight recorded semi-

annually.

31. Rule 58A-5.024(6), Florida Administrative Code,

requires the following:

(6) When a moratorium is placed on a

facility or notification of denial,

revocation or suspension of the license has

been received, that notice shall be posted

and visible to the public at the facility.

32. The Agency established that Broadview violated the

foregoing provisions of Rule 58A-5.024, Florida Administrative

Code, as alleged in the Administrative Complaint, by failing to

post the notice of the moratorium and the notice that its renewal

application was denied, by failing to maintain health assessments

for the residents, and by failing to have the recorded weights of

the residents available for inspection.

33. In addition, the Agency established that Broadview's

failure to have a health assessment for Resident 4 violated the

following provisions of Rule 58A-5.0181(3), Florida

Administrative Code:

(3) Admission procedures are as follows:

(a) Residents not placed by the

department, by HRS, or by an agency under

contract with the department or HRS.

1. Each resident, in accordance with

Section 400.426(4), F.S., shall be examined

by a health care provider within 60 days

before admission to the facility. The

medical examination report shall be submitted

to the administrator of the facility, who

shall use the information therein to assist

in the determination of the appropriateness

of admission of the resident to the facility.

2. If a medical examination has not been

completed within 60 days prior to the

resident's admission to the facility, a

health care provider shall examine the

resident and complete an assessment report

using the Health Assessment for Assisted

Living Facilities, DOEA Form 1823, dated

October 1995, which is hereby incorporated by

reference, within 30 days following the

resident's admission to the facility, to

enable the administrator to determine the

appropriateness of admission. A copy of DOEA

Form 1823 may be obtained from the Assisted

Living Coordinator, Department of Elder

Affairs, 4040 Esplanade Way, Tallahassee,

Florida 32399-7000. Assessment reports using

the previous edition of this form which were

completed prior to October 30, 1995, shall be

considered valid. In lieu of Form 1823, the

Comprehensive Assessment Form Part II, DOEA

Form 111B, July 1992, or the CARES Mini

Assessment Form Part III, DOEA Form 111C,

February 1992, may be used if signed by a

health care provider.

34. Rule 58A-5.0181, Florida Administrative Code, set forth

the following admission criteria pertinent to this proceeding:

(1) In order to be admitted to any

facility, an individual shall meet the

following criteria:

(a) The individual is able to perform the

activities of daily living, with supervision

or assistance if necessary.

* * *

(c) The individual is in sufficient health

so as not to require 24-hour nursing

supervision.

(d) With respect to medication, the

individual:

1. Is capable of taking his own medication

with or without supervision by trained staff,

or

2. Requires administration of medication,

and the facility has a nurse to provide this

service when the service is needed, or the

resident or the resident's legal

representative, designee, surrogate,

guardian, or attorney-in-fact contracts with

a licensed third party to provide this

service.

* * *

(f) The individual's special dietary

needs, if any, can be met by the facility.

(g) The individual is able to participate

in social and leisure activities.

(h) The individual is capable of self-

preservation in an emergency situation

involving the immediate evacuation of the

facility, with assistance with transfer as

defined in Rule 58A-5.0131, if necessary.

* * *

(2) Even if an individual meets the

criteria in subsection (1), the individual

may not be appropriate for admission to a

particular facility. The determination of

the appropriateness of the admission to a

particular facility of a particular

individual who has the characteristics

enumerated in subsection (1) is the

responsibility of the administrator of the

facility. The administrator shall base his

decision on an assessment of the strengths,

needs, and preferences of the individual,

especially as revealed by the medical

examination report required pursuant to

subsection (3), in relation to the

environment and services offered or arranged

by the facility in accordance with facility

policy.

35. The Agency established that three of the four residents

did not meet the criteria for residency at Broadview. Ms. Black,

the owner of Broadview, knew or should have known that Residents

1 and 4 needed more care than her facility could provide. In

addition, Ms. Black knew or should have known that Resident 2

required insulin, but the employee on duty on September 23, 1997,

did not know how to administer insulin to Resident 2.

Consequently, Broadview was not an appropriate placement for

Resident 2. Based on the foregoing, it is concluded that the

Agency established that Broadview violated the provisions of Rule

58A-5.0181, Florida Administrative Code, as alleged in the

Administrative Complaint.

36. The Agency established that Broadview violated the

provisions of Rule 58A-5.0182(6)(d)3, Florida Administrative

Code, by maintaining centrally stored medicine, the insulin for

Resident 2, in a refrigerator that did not have a locking system.

Rule 58A-5.0182(6)(d)3, Florida Administrative Code, provides, in

pertinent part, as follows:

3 Centrally stored medications shall be:

a. Kept in a locked cabinet or other

locked storage receptacle or area at all

times.

b. Accessible only to the staff responsible

for supervision of self-administration and

for administration of medication. Such staff

shall have ready access to keys to medication

storage areas at all times.

c. Located in an area free of dampness and

abnormal temperature, except that a

medication requiring refrigeration shall be

refrigerated. Refrigerated medications shall

be secured by being kept in a locked

container within the refrigerator, by keeping

the refrigerator locked, or by keeping the

area in which refrigerator is located locked.

37. The Agency established that Broadview failed to meet

the dietary requirements of the residents, thereby violating the

provisions of Rule 58A-5.0182(2)(a), Florida Administrative Code,

which provide the following standards:

(2) Facilities shall offer personal

supervision, as appropriate for each

resident, including the following as needed:

(a) Supervision of diets as to quality and

quantity . . .

38. The Agency established that Broadview did not have

adequate staff on duty on September 23, 1997. The one employee

who was on duty was unfamiliar with the special diets that had

been ordered for the residents, did not know how to administer

medicine to Resident 2, and could not have protected the

residents in the event of a fire or similar emergency. Based on

the foregoing, it is concluded that Broadview violated the

following provisions of Rule 58A-5.0182(1), Florida

Administrative Code:

(1) The administrator shall provide staff

and services appropriate to the needs of the

residents living in the facility.

39. In addition, the Agency established that Broadview

violated the provisions of Rule 58A-5.019(5)(a)1-4 and (6)(a),

which provide as follows:

(5) The administrator of a facility shall:

(a) Employ staff in accordance with Rule

58A-5.019(6), F.A.C., and based on the

following criteria to assure the safety and

proper care of residents in the facility:

1. The physical and mental condition of the

residents,

2. The size and layout of the facility,

3. The capabilities and training of the

employees, and

4. Compliance with all minimum standards in

this chapter.

* * *

(6) Staffing Ratio.

(a) Notwithstanding the minimum staffing

ratio specified herein, all administrators of

facilities, including those composed of

apartments, shall have sufficient staff to

provide or arrange services for residents as

required consistent with the level of care

offered and to evacuate residents identified

through the assessment required under Rule

58A-5.0181(6), F.A.C., as needing assistance

if an emergency evacuation is required.

40. The Agency established that Broadview failed to comply

with the following portions of Rule 58A-5.20(1)(h), Florida

Administrative Code:

(h) Menus.

1. Menus shall be dated and planned at

least one week in advance for regular and

therapeutic diets and shall match the menus

reviewed pursuant to paragraph (e) or be of

equal nutritional value. Substitutions shall

be recorded before or when the meal is

served. Menus as served shall be kept on

file in the facility for 6 months.

2. Planned menus shall be conspicuously

posted or easily available to residents.

Residents shall be encouraged to participate

in menu planning.

(i) A one-week supply of non-perishable

food, based on the number of weekly meals the

facility has contracted with residents to

serve, shall be on hand at all times. . . .

41. In Paragraph 4.h. of the Administrative Complaint, the

Agency alleged that Broadview violated the provisions of Rule

58A-5.020(2)(f), Florida Administrative Code, a rule that could

not be located by the undersigned. Consequently, no conclusions

are based on that alleged violation.

42. Based on the foregoing violations, it is concluded that

Broadview failed to provide for the health, safety, and welfare

of the residents of its facility. The license of Broadview

should be revoked pursuant to the Agency's authority. See

Section 400.414(1) and (2)(a), Florida Statutes.

RECOMMENDATION

Based on the foregoing Findings of Fact and Conclusions of

Law, it is RECOMMENDED that the Agency enter a final order

revoking Broadview's license as an assisted living facility.

DONE AND ENTERED this 3rd day of February, 1998, in

Tallahassee, Leon County, Florida.

____________ _______________________

CLAUDE B. ARRINGTON

Administrative Law Judge

Division of Administrative Hearings

The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060

[phone] SUNCOM 278-9675

Fax Filing [phone]

Filed with the Clerk of the

Division of Administrative Hearings

this 3rd day of February, 1998

ENDNOTES

1/ Ms. Black testified, credibly, that her facility was required

to install an expensive fire sprinkler system before the facility

could pass the fire inspection. As of March 18, 1997, the

facility had passed the fire safety inspection, but the

documentation was kept by Ms. Black at her home and was not

available for inspection at the facility. The letter reflecting

that the facility had passed the inspection on March 18, 1997,

from a Deputy Fire Marshall for Broward County, was dated

August 29, 1997.

2/ Resident 1 was described by Ms. Garcia-Quevedo as being

frail, disoriented, and unresponsive to verbal interaction.

Broadview's employee told Ms. Garcia-Quevedo on September 23,

1997, that Resident 1 required total assistance with showering,

grooming, dressing, and toileting. Resident 1 needed assistance

walking and would require assistance in the case of an emergency.

Resident 1 would not be able to take her own medications without

assistance. Broadview did not have staff licensed to administer

medications. Ms. Palmer-Miller described Resident 1 as being

alert, but confused and oriented to name only.

Resident 4 was observed by Ms. Garcia-Quevedo on September 23,

1997, to be frequently exposing her diaper by lifting her skirt.

Broadview's employee made no effort to redirect this behavior.

Resident 4 was described by Ms. Garcia-Quevedo as being frail

with contracted knees. Her clothing was stained and her hair had

not been brushed. Resident 4 was described by Ms. Garcia-Quevedo

as being unresponsive on September 23, 1997, and by Ms. Palmer-

Miller as being very confused and oriented to name and day only.

The discharge summary from the nursing home in which she resided

before being transferred to Broadview reflects that Resident 4

needed assistance with all activities of daily living, except

eating, and that she required a diet with pureed consistency.

Broadview's employee was not aware that Resident 4's food needed

to be pureed.

3/ There was a conflict in the evidence as to whether weight

records existed. Ms. Black, the owner of Broadview, testified

that the residents were weighed on standard bathroom scales every

six months, but that the record of their weight was maintained

separately from other records pertaining to residents. Ms. Black

testified that the employee who was on duty on September 23,

1997, was new and did not know Broadview's practices. She

further testified that the employee did not know where the

bathroom scale was kept. According to Ms. Black, the chair scale

did not work and was not used by the facility. Rule 58A-5.024,

Florida Administrative Code, requires that such records be

available for inspection. Regardless of whether weight records

were separately kept, weight records were not made available to

the Agency investigator as required by rule.

4/ This discrepancy corroborates Ms. Black's testimony that the

chair scale was not accurate. That testimony is also

corroborated by Broadview's Exhibit 2, which is an estimate for

the cost of repairing the chair scale. Because of the

questionable accuracy of the chair scale, no findings or

conclusions are based on the weights ascertained by

Ms. Garcia-Quevedo on September 23, 1997. The weights taken of

Residents 1 and 4 at the nursing home are considered accurate and

establish that Residents 1 and 4 had lost weight while a resident

of Broadview.

COPIES FURNISHED:

Jennifer A. Steward, Esquire

Agency for Health Care Administration

1400 West Commercial Boulevard, Suite 110

Fort Lauderdale, Florida 33309

Pauline Ann Black, Owner

Broadview Retirement Home

1841 Southwest 63rd Terrace

Pompano Beach, Florida 33068

Sam Power, Agency Clerk

Agency for Health Care Administration

Fort Knox Building 3, Suite 3431

2727 Mahan Drive

Tallahassee, Florida 32308-5403

Jerome W. Hoffman, General Counsel

Agency for Health Care Administration

2727 Mahan Drive

Tallahassee, Florida 32308-5403

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written exceptions within 15

days from the date of this Recommended Order. Any exceptions to

this Recommended Order should be filed with the agency that will

issue the final order in this case.

1 Ms. Black testified, credibly, that her facility was required to install an

expensive fire sprinkler system before the facility could pass the fire

inspection. As of August 29, 1997, the facility had passed the fire safety

inspection, but the documentation was kept by Ms. Black at her home and was

not available for inspection at the facility.

2

Resident 1 was described by Ms. Garcia-Quevedo as being frail, disoriented,

and unresponsive to verbal interaction. Broadview's employee told Ms. Garcia-

Quevedo on September 23, 1997, that Resident 1 required total assistance with

showering, grooming, dressing, and toileting. Resident 1 needed assistance

walking and would require assistance in the case of an emergency. Resident 1

would not be able to take her own medications without assistance. Broadview

did not have staff licensed to administer medications. Ms. Palmer-Miller

described Resident 1 as being alert, but confused and oriented to name only.

Resident 4 was observed by Ms. Garcia-Quevedo on September 23, 1997, to be

frequently exposing her diaper by lifting her skirt. Broadview's employee

made no effort to redirect this behavior. Resident 4 was described by Ms.

Garcia-Quevedo as being frail with contracted knees. Her clothing was stained

and her hair had not been brushed. Resident 4 was described by Ms. Garcia-

Quevedo as being unresponsive on September 23, 1997, and by Ms. Palmer-Miller

as being very confused and oriented to name and day only. The discharge

summary from the nursing home in which she resided before being transferred to

Broadview reflects that Resident 4 needed assistance with all activities of

daily living, except eating, and that she required a diet with pureed

consistency. Broadview's employee was not aware that Resident 4's food needed

to be pureed.

3 There was a conflict in the evidence as to whether weight records existed.

Ms. Black, the owner of Broadview, testified that the residents were weighed

on standard bathroom scales every six months, but that the record of their

weight was maintained separately from other records pertaining to residents.

Ms. Black testified that the employee who was on duty on September 23 1997,

was new and did not know Broadview's practices. She further testified that

the employee did not know where the bathroom scale was kept. According to Ms.

Black, the chair scale did not work and was not used by the facility. Rule

58A-5.024, Florida Administrative Code, requires that such records be

available for inspection. Regardless of whether weight records were

separately kept, weight records were not made available to the Agency

investigator as required by rule.

4 This discrepancy corroborates Ms. Black's testimony that the chair scale

was not accurate. That testimony is also corroborated by Broadview's Exhibit

2, which is an estimate for the cost of repairing the chair scale. Because of

the questionable accuracy of the chair scale, no findings or conclusions are

based on the weights ascertained by Ms. Garcia-Quevedo on September 23, 1997.

The weights taken of Residents 1 and 4 at the nursing home are considered

accurate and establish that Residents 1 and 4 had lost weight while a resident

of Broadview.