1. STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
RE: Sample Party,
Facility .,
CASE NO: 2014011872
_______________________________________________________
STATE OF FLORIDA, AGENCY
FOR HEALTH CARE ADMINISTRATION,
Petitioner,
vs.
Sample Party,
Facility .,
Respondent,
_______________________________________________________
RESPONSE TO ADMINISTRATIVE COMPLAINT
COMES NOW ​respondent, Sample Party (hereinafter “Respondent”), by the
undersigned consultant and responses to the Agency’s Administrative Complaint, and alleges:
1. Denied. Respondent was not the last officer or principal of Facility . Respondent was
not aware she was listed as a principal on the incorporation registration with the State
of Florida. The Registered Agent on the Divisions of Corporations registration is
Sample Party 2. Respondent was fraudulently listed without her consent or
knowledge. Respondent was not aware that Facility ., was not licensed by the Agency
for Health Care Administration. Respondent initially agreed to function as the Facility
Administrator under the ownership of Sample Party 2 when Ms. Sample Party 2
initially approached Respondent regarding Facility . and worked in that capacity for the

2. duration of the operations of the facility. Ms. Sample Party 2 approached Respondent
regarding a partnership when she could not qualify for the lease of the facility
independently. Ms. Sample Party 2 advised that she would have her attorney prepare
a partnership agreement for both partners to sign to make the partnership official. Ms.
Sample Party 2 advised Respondent that Facility ., was licensed by the State of
Florida Agency of Health Care Administration and asked Respondent to procure an
Occupational License . Respondent procured an Occupational License as requested
by Ms. Sample Party 2 (Exhibit A). Respondent also signed the lease to procure the
property (Exhibit B) but was never presented with the promised partnership agreement
after the lease was signed. Therefore, Respondent continued to operate in the
capacity of Facility Administrator under the ownership of Sample Party 2. The facility
was abandoned by Ms. Sample Party 2 on or about (date) and Respondent continued
to provide care for the residents of Facility . in a desperate attempt to provide interim
care for residents until she could either (1) licence the facility in her name alone or (2)
find suitable placements for the residents and close the facility. Sample Party 2
abandoned Respondent with several months remaining on the lease, which
Respondent honored independently. Respondent was not paid after Ms. Sample
Party 2 abandoned the facility and financed the daily living necessities of residents and
the monthly rent for the property out of her personal funds. Ms. Sample Party 2
wanted to start another business and publicly demanded several times that
Respondent remove her from the lease. The Lessor would not allow Ms. Sample
Party 2 to be removed from the lease. Respondent received payments for residents
from Lutheran Social Services which inclined Respondent to belief Facility . was
licensed by the Agency of Health Care Administration. Respondent based this belief

3. on her previous experience as owner of licensed facility H.H Community Center which
was a vendor of Lutheran Social Services. H.H Community Center was provided the
attached letter after providing licensure proof to become a vendor for Lutheran Social
Services (Exhibit C). Respondent also had consistent communication and interaction
with resident(s) case managers which led her to also believe Facility . was licensed by
the Agency For Health Care Administration because Chapters 429.08 (d) specifically
states “The employer of any person who is under contract with the agency or
department, or the Department of Children and Families, and who knowingly refers a
person for residency to an unlicensed facility; to a facility the license of which is under
denial or has been suspended or revoked;or to a facility that has a moratorium
pursuant to part II of chapter 408 shall be fined and required to prepare a corrective
action plan designed to prevent such referrals.” Respondent had a reasonable
expectation that if Facility . was not licensed with the Agency For Health Care
Administration, that the case managers would not have allowed or referred residents
to be placed in the Facility.
2. Admitted. Respondent was aware of Chapters 429, Part I; and 408, Part II, Florida
Statutes (2013) and Chapters 59A­35 and 58A­5 Florida Administrative Code.
3. Denied. Respondent was not aware that Facility . had been administratively dissolved
by Florida Department of State, Division of Corporations, on September 27, 2013.
4. Denied as alleged above.
5. Admitted as alleged above.
6. Admitted.
7. Admitted.
8. Admitted.

4. 9. Admitted and denied as alleged above.
10. Admitted.
11. Admitted.
12. Admitted.
13. Admitted and denied as alleged above.
14. Admitted and denied as alleged above.
15. Admitted and denied as alleged above. Respondent moved swiftly to find suitable
placements for all residents once she became aware that the facility was not properly
licensed. Respondent should not be punished because several residents were difficult
to place and Respondent was forced to provide care for residents until proper
placement could be found.
16. Admitted and denied as alleged above.
17. Denied.
18. Admitted and denied as alleged above.
19. Admitted and denied as alleged above.
20. Denied.
21. Admitted.
22. Admitted and denied as alleged above.
23. Admitted and denied as alleged above.
24. Denied. Respondent did not admit providing services without a license as she was not
aware that Assisted Living of Jacksonville, Inc., was not licensed by the Agency for
Health Care Administration until she received the call from the Agency surveyor.
25. Admitted.
26. Admitted.

5. 27. Admitted.
28. Admitted.
29. Admitted as alleged above.
30. Admitted.
31. Admitted and denied. Resident B.G. was not expected to return to Facility after
hospitalization.
32. Admitted.
33. Admitted that the Agency has authority to impose fines; denied that a $30,000.00 fine
is appropriate in the case.
34. Admitted that the Agency has authority to impose a survey fee; denied that a survey
fee of $500 is appropriate in this case.
WHEREFORE​, Respondent requests that the Agency reconsider its imposed fine against
Respondent based on the facts presented. Respondent previously owned H.H Community
Center, a licensed facility, and relinquished the license as required by Chapter 408, Florida
Statute due to foreclosure of rental property leased by Respondent. Respondent has past
history of abiding by Florida Statutes and Florida Administrative Law and Respondent request
agency mediate settlement, if possible, prior to imposition of administrative fines, for informal
hearing before an Administrative Judge pursuant to Section 120.57 (2), Florida Statutes, and
for such other relief as the court deems just and proper.
Respectfully submitted,
________________________________________
_
Yolanda M. Tucker, MBA
Tucker Contract Consulting, LLC

6. 5606 Chirping Way West
Jacksonville, Florida 32222
Phone: (904) 469­6741
Fax: (904)
I certify that a copy of the foregoing was furnished by facsimile transmission to (850)
922­6484 and US Mail to Warren J. Bird, Senior Attorney, Agency for Health Care
Administration, 2727 Mahan Drive, Mail Stop #3, Tallahassee, Florida 32308; by fax to (850)
921­0158, Attn: Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive,
Mail Stop #3, Tallahassee, Florida 32308.
________________________________________
_
Yolanda M. Tucker, MBA