STATE OF NEW YORK I DEPARTMENT OF HEALTH IN THE MATTER OF F. MD., as Commissioner of Health of the State of New York, to determine the action to be taken with respect to: QC-MEDI NEW YoRi<, mc. STIPULATION Respondent, AND as operator of ORDER HEALTH SERVICES lei 6 we 5 200 Ellwood Davis Road Liverpool, NY 13088 arising out of alleged vtolations of Articie 36 of the Public Health Law of the State of New York and Title 10 (Health) ofthe Official Compilation of Codes, Roles and Regulations of the State of New York WHEREAS, the New York State Department of Health (the "Department") has conducted surveys and inspections of Gentiva Health Services - Liverpool, and found alleged violations of Article 36 of the Public Health Law and Title 10 (Health) of the Official Compilation of Codes, Roles and Regulations of the State of New York (10 and WH EREAS, a Statement of Deficienctes resulting from the Departments survey and oompteint investigatton completed on December 23, 2006 was issued to the Respondent, together with follow-up surveys dated February 12"' and 2007 and March 19, 2007 (collectively, the "Statement of Defioiencies"}; and WHEREAS, the Respondent submitted a plan of correction to the Department to address the Statement of Deficiencies. By letter dated April 24, 2007, the Department informed the Respondent that the Plan was acceptable; and WHEREAS, prior to the service on the Respondent ofa Notice of Hearing and Statement of Charges and the commencement by the Department of an administrative enforcement action based onthe alleged violations, the Department and the Respondent engaged in settlement discussions; and WHEREAS, the parties now wish to resolve this rnatter by rneans ofa settlement instead of an adversarial administrative hearing. NOW, THEREFORE, lT IS STIPULATED AND AGREED AS FOLLOWS: 1. The matter relating to alleged violations of Article 36 ofthe Public Health Law and 10 as set forth in the Statement of Deficiencies dated December 28, 2006, together with the fotlove-up surveys dated February 12"" and 2007 and March 19, 2007, is hereby settled and discontinued with prejudice upon the terms and conditions set forth in this Stipulation and Order. 2. Solely for the purpose of resolving the instant administrative matter, the Respondent admits the existence of substantial evidence of violations of 10 Policies and procedures of service delivery 763.401) Policies and procedures of service delivery 763.6(b) Patient assessment and plan of care 763.6(e) Patient assessment and plan of care 763.1 1 Governing Authority 763.1 1(b) Governing Authority The Stipulation and Order is not intended for use in any other forum, tribunal or court, including any Medicare or Medicaid enforcement proceeding and including any civil or 2 criminal proceeding in which the issues or burden of proof may differ. The execution of this Stipulation and Order is without prejudice to the Respondents rights, defenses and claims in any other matter, proceeding, action, hearing or litigation not involving the Department. lt is agreed that the Stipulation and Order is not an admission of liability or wrongdoing with respect to any allegations of medical malpractice that may be made in a civil action for monetary damages. 3. Neither the execution of this Stipulation and Order nor the underlying facts alleged in the above-referenced Statement of Deficiencies shall form the sole basis for an adverse determination by the Department in reviewing an application by the Respondent for any permit or approval issued by the Department, as to the character and competence ofthe Respondent. 4. Pursuant to Sections 12 and 206 of the Public Health Law, a civil penalty of $12,000 is assessed against the Respondent. The Respondent shall pay amount within thirty (30) days from the effective date of this Stipulation and Order. 5. Payment shall be made tothe New York State Department of Health, Bureau of Accounts Management, Corning Tower, Room 1258, Empire State Plaza. Albany, New York 12237-0016. Any civil penalty not paid by the date prescribed herein snail be subject to all provisions of law relating to debt collection by the State of New York. This includes but is not limited to the imposition of interest, late payment charges and collection fees; referral to the New York State Department of Taxation and Finance for collection and norerenewal of permits and licenses. [Tax Law ?171(27); State Finance Law ?18; CPLR ?500'l; Executive Law 6. The Respondent consents to the issuance of this Stipulation and Order, 3 accepts its terms and conditions, and waives any right to challenge or review this Stipulation and Order through administrative orjudicial proceedings, including a proceeding pursuant to Article 78 of the_ Civil Practice Law and Rules. 7. This Stipulation and Order shall be effective upon service on Respondent or Respondents attorney or representative of a fully executed copy by personal service or by certified or registered mail. DATED: Liverpool, New York NEW YORK, INC. A sv: President and Chief Operating Officer AGREED AND SO ORDERED: DATED: NEW YORK STATE DEPARTMENT OF HEALTH 2008 ri _f ICHARD F. INES, lVl.D. Commissioner of Health Inquiries to: Gretchen Fantauzzi, Senior Attorney Phone: (518) 473-5174 Fax: (518) 488>>1 858 4 Mail Payment To: New York State Department of Health Bureau of Accounts Management Coming Tower, Room 1258 Empire State Piaza Albany, New York 12237-0016