16-000115CON East Florida-Dmc, Inc. vs. Agency For Health Care Administration
 Status: Closed
Recommended Order on Thursday, March 16, 2017.


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Summary: The evidence supported a need for a new hospital to be located in Doral, Miami-Dade County. On balance, East Florida-DMC better satisfied the applicable criteria and should be awarded CON 10394 to construct 80-bed hospital on its site in Doral.

17

2STATE OF FLORIDA AH0A

6AGENCY FOR HEALTH CARE ADMINISTRATION lkGEPCY C L E R K

172018 APR 2b

20KENDALL HEALTHCARE GROUP, LTD. d/ b/ a P 2: 10

30KENDALL REGIONAL MEDICAL CENTER,

34Petitioner, CASE NO. 16- 0112CON

39AHCA NO. 2015013287

42V. RENDITION NO.: AHCA- - aa3S- FOF- CON

50THE PUBLIC HEALTH TRUST OF MIAMI- DADE

57COUNTY, FLORIDA, d/ b/ a JACKSON HOSPITAL

64WEST and STATE OF FLORIDA, AGENCY FOR

71HEALTH CARE ADMINISTRATION,

74Respondents.

75VARIETY CHILDREN' S HOSPITAL d/ b/ a NICKLAUS

83CHILDREN' S HOSPITAL,

86Petitioner, CASE NO. 16- 0113CON

91AHCA NO. 2015013290

94V.

95THE PUBLIC HEALTH TRUST OF MIAMI- DADE

102COUNTY, FLORIDA d/ b/ a JACKSON HOSPITAL

109WEST and STATE OF FLORIDA, AGENCY FOR

116HEALTH CARE ADMINISTRATION,

119Respondents.

120CGH HOSPITAL, LTD. d/b/a CORAL GABLES

126HOSPITAL; TENET HIALEAH HEALTHSYSTEM, INC.

131d/b/a HIALEAH HOSPITAL; and LIFEMARK

136HOSPITALS, INC. d/b/a PALMETTO GENERAL

141HOSPITAL,

142Petitioners, CASE NO. 16-0114CON

146AHCA NO. 2015013292

149v.

150THE PUBLIC HEALTH TRUST OF MIAMI-DADE

156COUNTY, FLORIDA d/b/a JACKSON HOSPITAL

161WEST and STATE OF FLORIDA, AGENCY FOR

168HEALTH CARE ADMINISTRATION,

171Respondents.

172EAST FLORIDA-DMC, INC.,

175CASE NO. 16-0115CON

178Petitioner, AHCA NO. 2016000043

182v.

183STATE OF FLORIDA, AGENCY FOR

188HEALTH CARE ADMINISTRATION,

191Respondent,

192and

193THE PUBLIC HEALTH TRUST OF MIAMI-DADE

199COUNTY, FLORIDA d/b/a JACKSON HOSPITAL

204WEST; CGH HOSPITAL, LTD. d/b/a CORAL GABLES

211HOSPITAL; TENET HIALEAH HEALTHSYSTEM, INC.

216d/b/a HIALEAH HOSPITAL; LIFEMARK HOSPITALS,

221INC. d/b/a PALMETTO GENERAL HOSPITAL; and

227VARIETY CHILDREN'S HOSPITAL d/b/a NICKLAUS

232CHILDREN'S HOSPITAL,

234Intervenors.

235____________________________________ /

237FINAL ORDER

239These cases were referred to the Division of Administrative Hearings (DOAH) where

251they were consolidated and the assigned Administrative Law Judge (ALI), Robert S. Cohen,

264conducted a formal administrative hearing. At issue in this proceeding is whether, on balance,

278Certificate of Need ("CON") application number 10395 by the Public Health Trust of Miami-

294Dade County, Florida d/b/a Jackson West Hospital ("JW") to build a 1 00-bed acute care hospital

312in Miami-Dade County, Florida, AHCA District 11, and/or CON application number 10394 by

325East Florida-DMC, Inc. ("DMC") to build an 80-bed acute care hospital in Miami-Dade County,

341Florida, satisfy the applicable criteria and should be approved. The Recommended Order

353entered on March 16, 201 7 is attached to this final order and incorporated herein by reference,

370except where noted infra.

374RULINGS ON EXCEPTIONS

377JW, Tenet Hialeah Healthsystem, Inc. d/b/a Hialeah Hospital ("Tenet") and Variety

390Children's Hospital d/b/a Nicklaus Children's Hospital ("NCH") all filed exceptions to the

404Recommended Order, JW filed responses to Tenet and NCH's exceptions, Tenet filed a response

418to JW's exceptions, and DMC and Kendall Healthcare Group, Ltd. d/b/a Kendall Regional

431Medical Center ("KMRC") filed joint responses to JW's exceptions, Tenet's exceptions, and

445NCH's exceptions.

447In determining how to rule upon the parties' exceptions and whether to adopt the ALI's

462Recommended Order in whole or in part, the Agency for Health Care Administration ("Agency"

477or "AHCA") must follow section 120.57( 1 )([), Florida Statutes, which provides in pertinent part:

493The agency may adopt the recommended order as the final order of the agency.

507The agency in its final order may reject or modify the conclusions of law over

522which it has substantive jurisdiction and interpretation of administrative rules

532over which it has substantive jurisdiction. When rejecting or modifying such

543conclusion of law or interpretation of administrative rule, the agency must state

555with particularity its reasons for rejecting or modifying such conclusion of law or

568interpretation of administrative rule and must make a finding that its substituted

580conclusion of law or interpretation of administrative rule is as or more reasonable

593than that which was rejected or modified. Rejection or modification of

604conclusions of law may not form the basis for rejection or modification of

617findings of fact. The agency may not reject or modify the findings of fact unless

632the agency first determines from a review of the entire record, and states with

646particularity in the order, that the findings of fact were not based upon competent

660substantial evidence or that the proceedings on which the findings were based did

673not comply with essential requirements oflaw ....

680§ 120.57(1 )(f), Fla. Stat. Additionally, "[t]he final order shall include an explicit ruling on each

696exception, but an agency need not rule on an exception that does not clearly identify the disputed

713portion of the recommended order by page number or paragraph, that does not identify the legal

729basis for the exception, or that does not include appropriate and specific citations to the record."

745§ 120.57(l)(k), Fla. Stat. In accordance with these legal standards, the Agency makes the

759following rulings on the parties' exceptions:

765JW's Exceptions

767Before ruling on the specific exceptions, the Agency notes that JW raises potential

780constitutional issues with the proceeding itself in several of its exceptions. Since there is no

795express authority given to the Agency by section 120.57(1), Florida Statutes, to address and rule

810on constitutional issues in administrative proceedings, the Agency will not address those

822arguments in the rulings on JW's exceptions infra. See also Gulf Pines Memorial Park, Inc. v.

838Oakland Memorial Park, Inc., 361 So. 2d 695 (Fla. 1978).

848In Exception 1, JW takes exception to Paragraphs 13, 14, 15, 23, 29, 34, 40, 42, 45, 46,

86647, 50, 51, 52, 64, 66, 68, 72, 96, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111,

887133,163,166,170,181,183,184,187, 188,206,207,208,209,210,211,213,215,216and217

905of the Recommended Order, arguing that the proceedings on which the findings of fact and

920conclusions of law in these paragraphs are based did not comply with the essential requirements

935of law because the ALJ improperly considered factors that are not part of the statutory review

951criteria of a CON application for a general hospital. Specifically, JW alleges that these

965paragraphs deal with the existing providers and applicants' quality of care, the applicants'

978availability of resources to complete the proposals and the short and long tenn financial

992feasibility of the proposals. The argument JW puts forth in Exception 1 is undermined by the

1008fact that JW clearly put these factors, including its financial viability, at issue by listing them as

1025reasons justifying the "need" for the health care facility being proposed (§ 408.035(1)(a), Fla.

1039Stat.) in its CON application. See JW Exhibit 2, p. 11. Thus, the ALJ correctly considered them

1056under the criterion of need, and did not depart from the essential requirements of law by doing

1073so. Additionally, the findings of fact in Paragraphs 13, 14, 15, 23, 29, 34, 40, 42, 45, 46, 47, 50,

109351, 52, 64, 66, 68, 72, 96,100,101,102,103,104, 105,106,107, 108,109, 110, Ill, 133,163,

1114166, 170, 181, 183, 184, 187 and 188 of the Recommended are based on competent, substantial

1130record evidence. See Transcript, Volume 2, Pages 191, 240-243, 251-252 and 302-304;

1142Transcript, Volume 3, Pages 446, 503 and 504-505; Transcript, Volume 4, Pages 569 and 578-

1157579; Transcript, Volume 6, Page 979; Transcript, Volume II, Pages 1802 and 1865; Transcript,

1171Volume 12, Pages 1929-1930 and 1964-1966; Transcript Volume 13, Pages 2079, 2092 and

11842107; Transcript, Volume 14, Pages 2254-2255,2256-2257,2281,2299-2300,2303,2307-2310,

11952316-2320 and 2323; Transcript, Volume 15, Pages 2460-2461, 2472-2477, 2484-2485, 2492-

12062493, 2495-2496 and 2505; Transcript, Volume 18, Pages 2853-2857, 2858-2867, 2871-2872,

12172874-2875 and 2897; Transcript, Volume 21, Pages 3344-3345, 3378-3379, 3384-3387, 3395-

12283396, 3438-3444 and 3447-3448; Transcript, Volume 23, Pages 3651-3652 and 3685-3686;

1239Transcript, Volume 25, Pages 3923-3945; Transcript, Volume 26, Page 4066; Transcript,

1250Volume 28. Pages 4346-4347 and 4356-4372; Transcript, Volume 30, Pages 4636-4649;

1261Transcript, Volume 33, Pages 4927-4973; DMC Exhibits 1, 22, 24, 27, 161, 162, 163, 164 and

1277167; JW Exhibit 2; NCH Exhibits 2, 28, 41, 42 and 43; and Tenet Exhibits 15 and 19. Thus, the

1297Agency cannot reject or modify them. See§ 120.57(1)(/), Fla. Stat.; Heifetz v. Department of

1311Business Regulation, 475 So. 2d 1277, 1281 (Fla. 1st DCA 1985) (holding that an agency "may

1327not reject the hearing officer's finding [of fact] unless there is no competent, substantial evidence

1342from which the finding could reasonably be inferred"). Furthermore, the Agency finds that,

1356while it has substantive jurisdiction over the conclusions of law in Paragraphs 206, 207, 208,

1371209, 210, 211, 213, 215 and 216 of the Recommended Order because it is the state agency in

1389charge of administering Florida's CON law, it cannot substitute conclusions of law that are as or

1405more reasonable than those of the ALJ. Thus, the Agency denies Exception I as it pertains to

1422these paragraphs. Lastly, in regard to Paragraph 217 of the Recommended Order, the Agency

1436disagrees with the ALI's conclusion of law in the paragraph, but not for the reasons put forth by

1454JW in its exception. Instead, the Agency finds that Paragraph 217 of the Recommended Order

1469contains conclusions of law that are within the Agency's substantive jurisdiction because it is the

1484state agency charged with administering Florida's CON program, and that, based upon the

1497reasoning set forth in the ruling on Tenet's Exception Number One supra, which is hereby

1512incorporated by reference, it can substitute conclusions of law that are as or more reasonable than

1528those of the ALJ. Therefore, the Agency grants Exception 1 to the extent that it rejects

1544Paragraph 217 of the Recommended Order in toto.

1552InException2,JWtakesexceptiontoParagraphs 145,152,153,154,155,156,157,158,

1562159, 189, 190, 208 and 209 of the Recommended Order, arguing the proceedings on which the

1578findings of fact and conclusions of law in these paragraphs are based did not comply with the

1595essential requirements of law because the ALJ improperly considered additional criteria that is

1608outside the scope of the statutory review criteria for a general hospital CON application.

1622Specifically, JW alleges the ALI improperly considered payor mix projections and utilization

1634projections, and erroneously interpreted the requirements of section 408.037(2), Florida Statutes,

1645as it pertains to how a CON applicant should identify its proposed service area. First, the

1661Agency disagrees with JW's argument that the ALI improperly considered payor mix projections

1674and utilization projections because these factors were put forth by JW in its CON application as

1690reasons that justified a finding of "need" for the proposed health care facility, pursuant to section

1706408.035(l)(a), Florida Statutes. Thus, JW consented to these factors being examined by the ALI

1720under the category of need. Specifically, JW stated in its application that a new hospital was

1736needed because "the proposed project will serve a significant portion of patients who historically

1750have care access problems - the indigent and Medicaid populations," because "Jackson Health

1763System already serves residents of the defined 8-Zip Code Primary Service Area (PSA) and 4-

1778Zip Code Secondary Service Area (SSA)," and because "the proposed service area represents a

1792fragmented medical market capable of supporting its own community hospital without impact to

1805existing providers." See JW Exhibit 2, p. 11. Second, payor mix projections and utilization

1819projections may also be properly considered under the statutory review criteria of "[t]he

1832availability, accessibility, and extent of utilization of existing health care facilities and health

1845services in the service district of the applicant" (§ 408.035(l)(b), Fla. Stat.), "[t]he extent to

1860which the proposed services will enhance access to health care for residents of the service

1875district"(§ 408.035(1)(e), Fla. Stat.), "[t]he extent to which the proposal will foster competition

1889that promotes quality and cost-effectiveness"(§ 408.035(l)(g), Fla. Stat.), and "[t]he applicant's

1901past and proposed provision of health care services to Medicaid patients and the medically

1915indigent" (§ 408.035(1 )(i), Fla. Stat.). Thus, JW's argument that payor mix projections and

1929utilization projections are outside the scope of the CON review criteria for general hospitals is

1944erroneous. In regard to JW' s argument concerning the ALJ' s interpretation of section

1958408.037(2), Florida Statutes, as it pertains to how a CON applicant should identify its proposed

1973service area, the Agency finds that, while Paragraph 159 of the Recommended Order is actually

1988a conclusion of law within the Agency's substantive jurisdiction because it involves the

2001interpretation of section 408.037, Florida Statutes, which the Agency is in charge of

2014implementing, the Agency cannot substitute a conclusion of law that is as or more reasonable

2029than that of the ALJ. Additionally, the findings of fact in Paragraphs 145, 152, 153, 154, 155,

2046156, 157, 158, 159, 189 and 190 ofthe Recommended Order are based on competent, substantial

2061record evidence. See Transcript, Volume 19, Pages 3074-3075, 3078, 3080-3083, 3085-3093;

2072DMC Exhibits 1, 22 and 24; and JW Exhibit 2. Thus, the Agency is not at liberty to reject or

2092modify them. See § 120.57(1)(!), Fla. Stat.; Heifetz, 475 So. 2d at 1281. Lastly, the Agency

2108finds that, while it has substantive jurisdiction over the conclusions of law in Paragraphs 208 and

2124209 of the Recommended Order because it is the state agency charged with implementing the

2139regulations of Florida's CON program, it cannot substitute conclusions of law that are as or more

2155reasonable than those of the ALJ. Therefore, for all the reasons set forth above, the Agency

2171denies Exception 2.

2174In Exception 3, JW takes exception to Paragraphs 13, 14, 15, 23, 29, 34, 40, 42, 45, 47,

219250, 51, 52, 64, 66, 68, 72, 96, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 133,

2213163,166,168,170,181,183,184,187, 188,206,207,208,209,210,211,213,216and217of

2230the Recommended Order, arguing the proceedings on which the findings of fact and conclusions

2244of law in these paragraphs are based did not comply with the essential requirements of law

2260because the ALl's considered criteria outside the statutory review criteria for a general hospital

2274CON application. In regard to Paragraphs 13, 14, 15, 23, 29, 34, 40, 42, 45, 47, 50, 51, 52, 64,

229466, 68, 72, 96,100,101,102,103,104,105,106,107,108,109,110,111,133,163,166,170,

2314181, 183, 184, 187, 188, 206, 207, 208, 209, 209, 210, 211, 213 and 216 ofthe Recommended

2331Order, the Agency denies Exception 3 based on the reasoning set forth in the ruling on JW's

2348Exception I supra, which is hereby incorporated by reference. In regard to Paragraph 168 of the

2364Recommended Order, the findings of fact in this paragraph fall under the statutory review

2378criteria of "[t]he availability, accessibility, and extent of utilization of existing health care

2391facilities and health services in the service district ofthe applicant"(§ 408.035(l)(b), Fla. Stat.).

2405Thus, the proceedings on which the findings of fact in these paragraphs are based did not depart

2422from the essential requirements oflaw. Furthermore, the findings of fact in Paragraph 168 of the

2437Recommended Order are based on competent, substantial evidence. See Transcript, Volume 15,

2449Pages 2505-2506. Thus, the Agency cannot disturb them. See § 120.57(1 )(!), Fla. Stat.; Heifetz,

2464475 So. 2d at 1281. Paragraph 217 of the Recommended Order has already been addressed by

2480the Agency in the ruling on JW's Exception I supra, which is hereby incorporated by reference.

2496Therefore, the Agency denies Exception 3.

2502In Exception 4, JW takes exception to Paragraph 145 of the Recommended Order,

2515arguing the proceedings on which the findings of fact in this paragraph are based did not comply

2532with the essential requirements of law because the ALl allowed DMC to use a utilization

2547projection that did not comply with the requirements of section 408.037(2), Florida Statutes.

2560Based on the reasoning set forth in the Agency's ruling on Exception 2 supra, which is hereby

2577incorporated by reference, the Agency denies Exception 4.

2585In Exception 5, JW takes exception to Paragraphs 3, 24, 25, 29, 34, 40, 41, 42, 72, 96,

2603180, 181, 183, 186, 187, 188, 206, 207, 208, 209, 210, 211, 213, 216 and 217 of the

2621Recommended Order, arguing the proceedings on which the findings of fact and conclusions of

2635law are based did not comply with the essential requirements of law because the ALJ

2650impermissibly considered the financial feasibility of the proposals. The Agency denies

2661Exception 5 as it pertains to Paragraphs 29, 34, 40, 42, 72, 96, 100, 102, 103, 104, 105, 106, 107,

2681108, 109, 110, Ill, 133, 163, 181, 183, 187, 188, 206, 207, 208, 209, 210, 211, 213 and 216 of

2701the Recommended Order based on the reasoning set forth in the Agency's ruling on JW's

2716Exception 1 supra, which is hereby incorporated by referenced. Paragraph 217 of the

2729Recommended Order has already been addressed by the Agency in the ruling on JW' s Exception

27451 supra, which is hereby incorporated by reference. In regard to Paragraphs 3, 24, 25, 41, 174,

2762175, I76, I77, I78, I79, 180 and 186 of the Recommended Order, the issues addressed in the

2779findings of fact in these paragraphs fall under the statutory review criteria of "[t]he availability,

2794accessibility, and extent of utilization of existing health care facilities and health services in the

2809service district of the applicant" (§ 408.035( I )(b), Fla. Stat.), "[t]he extent to which the proposed

2826services will enhance access to health care for residents of the service district" ( § 408.035(1 )(e),

2843Fla. Stat.), "[t]he extent to which the proposal will foster competition that promotes quality and

2858cost-effectiveness" (§ 408.035(l)(g), Fla. Stat.), and "[t]he applicant's past and proposed

2869provision of health care services to Medicaid patients and the medically indigent" (§

2882408.035(l)(i), Fla. Stat.). Thus, the proceedings on which the findings of fact in these

2896paragraphs are based did not depart from the essential requirements of law because the ALJ

2911correctly addressed the issues in these paragraphs under the statutory review criteria.

2923Furthermore, the findings of fact in Paragraphs 3, 24, 25, 41, 174, 175, 176, 177, 178, 179, 180

2941and 186 of the Recommended Order are based on competent, substantial evidence. See

2954Transcript, Volume 1, Pages 88-89 and 1 04; Transcript, Volume 2, Pages 240-243 and 246;

2969Transcript, Volume 18, Pages 2872-2878, 2880-2881 and 2884-2886; Transcript, Volume 21,

2980Pages 3384-3385 and 3442-3443; Transcript, Volume 23, Pages 3678-3680; Transcript, Volume

299127, Pages 4198-4200; DMC Exhibits 1, 24, 27 and 167; and Tenet Exhibit 5. Thus, the Agency

3008cannot reject or modify them. See § 120.57(1)(1), Fla. Stat.; Heifetz, 475 So. 2d at 1281.

3024Therefore, for all these reasons, the Agency denies Exception 5.

3034In Exception 6, JW takes exception to Paragraphs 3, 29, 42, 105, 111, 181, 183, 187, 188,

3051206, 211, 213 and 216 of the Recommended Order, arguing the proceedings on which the

3066findings of fact and conclusions of law are based did not comply with the essential requirements

3082of law because it alleges the ALJ had a bias against JW since it is a tax-funded hospital system.

3101The Agency denies Exception 6 as it pertains to Paragraphs 29, 42, 105, 111, 181, 183, 187, 188,

3119206,211,213 and 216 based on the reasoning set forth in the Agency's ruling on JW's Exception

31371 supra, which is hereby incorporated by reference. The Agency denies Exception 6 as it

3152pertains to Paragraph 3 of the Recommended Order based on the reasoning set forth in the

3168Agency's ruling on JW's Exception 5 supra, which is hereby incorporated by reference.

3181In Exception 7, JW takes exception to Paragraphs 13, 14, 15, 23, 40, 45, 47, 50, 51, 52,

319966, 68 and 71 of the Recommended Order, arguing the proceedings on which the findings of

3215facts in these paragraphs are based did not comply with the essential requirements of law

3230because the ALJ impermissibly considered JW's and DMC's ability to provide quality of care

3244and their history of providing quality of care. The Agency denies Exception 7 as it pertains to

3261Paragraphs 13, 14, 15, 23, 40, 45, 47, 50, 51, 52,66 and 68 ofthe Recommended Order based on

3280II

3281the reasoning set forth in the Agency's ruling on JW's Exception 3 supra, which is hereby

3297incorporated by reference. In regard to Paragraph 71 of the Recommended Order, JW's

3310argument fails because the findings of fact in that paragraph do nothing more than provide

3325background information on an existing provider in District 11. Additionally, the findings of fact

3339in Paragraph 71 of the Recommended Order are based on competent, substantial record

3352evidence. See Transcript, Volume 14, Pages 2311-2312. Thus, the Agency cannot disturb them.

3365See§ 120.57(1)(1), Fla. Stat.; Heifetz, 475 So. 2d at 1281. For these reasons, the Agency denies

3381Exception 7 as it pertains to Paragraph 71 of the Recommended Order.

3393In Exception 8, JW takes exception to Paragraphs 64, 68, 99, 101, 133 and 166 of the

3410Recommended Order, arguing the proceedings on which the findings of fact in these paragraphs

3424are based did not comply with the essential requirements of law because the ALJ impermissibly

3439considered the costs and methods of construction of both proposals. The Agency denies

3452Exception 8 as it pertains to Paragraph 133 of the Recommended Order based on the reasoning

3468set forth in the Agency's ruling on Exception 1 supra, which is hereby incorporated by reference.

3484The Agency denies Exception 8 as it pertains to Paragraphs 64, 68, 101 and 166 of the

3501Recommended Order based on the reasoning set forth in the Agency's ruling on JW's Exception

35163 supra, which is hereby incorporated by reference. In regard to Paragraph 99 of the

3531Recommended Order, JW's argument fails because the findings of fact in this paragraph have

3545absolutely nothing to do with either applicant's costs and methods of construction. Instead, they

3559concern hospital use rates. Furthennore, the findings of fact in Paragraph 99 of the

3573Recommended Order are based on competent, substantial record evidence. See Transcript,

3584Volume 3, Page 513; Transcript, Volume 8, Page 1303; Transcript, Volume 23, Page 3730;

3598DMC Exhibit 1; and JW Exhibit 2. Thus, the Agency is not permitted to reject or modify them.

3616See§ 120.57(1){!), Fla. Stat.; Heifetz, 475 So. 2d at 1281. For these reasons, the Agency denies

3632Exception 8 as it pertains to Paragraph 99 of the Recommended Order.

3644In Exception 9, JW takes exception to Paragraphs 12, 22, 46, I 02 and 163 of the

3661Recommended Order, arguing the proceedings on which the findings of fact in these paragraphs

3675are based did not comply with the essential requirements of law because the ALJ impermissibly

3690considered the needs of research and educational facilities, which are not part of the statutory

3705review criteria for general hospital CON applications. The Agency denies Exception 9 as it

3719pertains to Paragraphs 46 and 163 of the Recommended Order based on the reasoning set forth in

3736the Agency's ruling on JW's Exception I supra, which is hereby incorporated by reference. The

3751Agency denies Exception 9 as it pertains to Paragraph 102 of the Recommended Order based on

3767the reasoning set forth in the ruling on JW' s Exception 3 supra, which is hereby incorporated by

3785reference. In regard to Paragraphs 12 and 22 of the Recommended Order, JW's argument is

3800erroneous because the findings of fact in these paragraphs do nothing more than provide

3814background information on existing providers in District 11. Furthermore, the findings of fact in

3828these paragraphs are based on competent, substantial record evidence. See Transcript, Volume

384014, Pages 2298-2299 and 2306-2307; and Transcript, Volume 21, Pages 3382-3383. Thus, the

3853Agency is not at liberty to reject or modify them. See§ 120.57(1)(/), Fla. Stat.; Heifetz, 475 So.

38702d at 1281. For these reasons, the Agency denies Exception 9 as it pertains to Paragraphs 12 and

388822 of the Recommended Order.

3893In Exception I 0, JW takes exception to Paragraphs 75, 76, 77, 213, 214 and 215 of the

3911Recommended Order, arguing the findings of fact and conclusions of law in these paragraphs are

3926a mischaracterization of the Agency's rationale for preliminarily approving JW's CON

3937application. The Agency denies Exception 10 as it pertains to Paragraphs 213, 214 and 215 of

3953the Recommended Order based on the reasoning set forth in the ruling on JW's Exception 1,

3969which is hereby incorporated by reference. In regard to Paragraphs 75, 76 and 77 of the

3985Recommended Order, JW does not allege a valid basis for the Agency to reject or modify the

4002findings of fact contained within those paragraphs. Furthennore, the findings of fact in

4015Paragraphs 75, 76 and 77 of the Recommended Order are based on competent, substantial

4029evidence. See Transcript, Volume 15, Pages 2493-2495; Transcript, Volume 34, Pages 5117,

40415122-5123, 5126-5127, 5130-5131, 5134-5135, 5142-5143 and 5146-5147; and AHCA Exhibit

4051I. Thus, the Agency is prohibited from rejecting or modifying them. See § 120.57(1 )(!), Fla.

4067Stat.; Heifetz, 475 So. 2d at 1281. For these reasons, the Agency denies Exception 10 as it

4084pertains to Paragraphs 75, 76 and 77 ofthe Recommended Order.

4094In Exception 11, JW takes exception to Paragraphs 62, 63, 84, 102, 114, 115, 137, 146,

4110147, 148, 149, 152, 153, 154, 155, 156, 157, 158, 159, 160, 163, 165, 166, 168, 169, 170, 172

4129and 210 of the Recommended Order, arguing the ALJ conducted an improper analysis of JW's

4144service area definition, utilization projection and adverse impact projections. The Agency denies

4156Exception 11 as it pertains to Paragraphs 102, 163, 166, 170 and 210 of the Recommended Order

4173based on the reasoning set forth in the Agency's ruling on JW's Exception I supra, which is

4190hereby incorporated by reference. The Agency denies Exception 11 as it pertains to Paragraphs

4204152, 153, 154, 155, 156, 157, 158 and 159 based on the reasoning set forth in the Agency's

4222ruling on JW' s Exception 2 supra, which is hereby incorporated by reference. In regard to

4238Paragraphs 62, 63, 114, 115, 137, 146, 147, 148, 149, 160, 165, 168, 169 and 172 of the

4256Recommended Order, the findings of fact in these paragraphs are based on competent,

4269substantial evidence. See Transcript, Volume 2, Pages 162-164; Transcript, Volume 7, Pages

42811194-1195; Transcript, Volume 10, Pages 1595, 1597-1599 and 1629; Transcript, Volume 15,

4293Pages 2450-2451, 2452-2457, 2465-2466. 2486-2488, 2499-2500, 2503-2504 and 2505-2506;

4302Transcript, Volume 19, Pages 3076-3077, 3080-3083 and 3100; Transcript, Volume 23, Page

43143657; DMC Exhibits 1, 22 and 24; and JW Exhibit 2. Thus, the Agency cannot reject or modify

4332them. See§ 120.57(1)(1), Fla. Stat.; Heifetz, 475 So. 2d at 1281. Therefore, the Agency denies

4347Exception 11 as it pertains to Paragraphs 62, 63, 114, 115, 137, 146, 147, 148, 149, 159, 160,

4365165, 168, 169 and 172 of the Recommended Order. Paragraphs 84 and 165 of the

4380Recommended Order, while labeled as findings of fact, are actually conclusions of law within

4394the Agency's substantive jurisdiction because they pertain to whether the facts demonstrate the

4407need for a new hospital in District 11 pursuant to the statutory and rule criteria the Agency is

4425charged with implementing. The Agency does not agree with the ALI's conclusions of law in

4440these paragraphs, but not for the reasons JW put forth in Exception 11. 1 Therefore, the Agency

4457denies Exception 11 as it pertains to Paragraphs 84 and 165 of the Recommended Order.

4472In Exception 12, JW takes exception to Paragraphs 24, 41, 100, 128, 161, 173, 174, 175,

4488176, 177, 178, 179, 180 and 181 of the Recommended Order, arguing the findings of fact in

4505these paragraphs are not based on competent, substantial evidence and are contrary to the plain

4520language of section 408.035(1 )(g), Florida Statutes, as well as the Agency's policy and prior

4535DOAH decisions. The Agency denies Exception 12 as it pertains to Paragraphs 100 and 181 of

4551the Recommended Order based on the reasoning set forth in the Agency's ruling on JW's

4566Exception 1 supra, which is hereby incorporated by reference. The Agency denies Exception 12

4580as it pertains to Paragraphs 24, 41, 174, 175, 176, 177, 178, 179 and 180 based on the reasoning

4599set forth in the Agency's ruling on JW's Exception 5 supra, which is hereby incorporated by

4615reference. In regard to Paragraphs 128, 161 and 173 of the Recommended Order, none of these

46311 The Agency addresses these paragraphs in its rulings on Tenet's Exception Number Two and Exception Number

4648Three infra.

4650paragraphs runs contrary to section 408.035(1 )(g), Florida Statutes, and all are supported by

4664competent, substantial record evidence. See Transcript, Volume 15, Pages 2450-2452 and 2488;

4676Transcript, Volume 19, Pages 3035-3038; and DMC Exhibits 1 and 22. Thus, the Agency is

4691prohibited from rejecting or modifying them. See§ 120.57(1)(!), Fla. Stat.; Heifetz, 475 So. 2d

4705at 1281. Therefore, the Agency denies Exception 12 as it pertains to Paragraphs 128, 161 and

4721173 of the Recommended Order.

4726In Exception 13, JW takes exception to Paragraphs 100, 190 and 191 of the

4740Recommended Order, arguing the ALJ's conclusions of law in these paragraphs result from an

4754improper analysis of JW's and DMC's CON application conditions regarding the provision of

4767care for Medicaid and indigent patients. The Agency denies Exception 13 as it pertains to

4782Paragraph 100 based on the reasoning set forth in the ruling on JW' s Exception 1 supra, which is

4801hereby incorporated by reference. The Agency denies Exception 13 as it pertains to Paragraph

4815190 of the Recommended Order based on the reasoning set forth in the Agency's ruling on JW's

4832Exception 2 supra, which is hereby incorporated by reference. In regard to Paragraph 191 of the

4848Recommended Order, that paragraph contains findings of fact, not conclusions of law as JW

4862alleges, and the findings of fact are based on competent, substantial record evidence. See

4876Transcript, Volume 12, Pages 1942-1945. Thus, the Agency cannot reject or modify them. See

4890§ 120.57(1)(1), Fla. Stat.; Heifetz, 475 So. 2d at 1281. Therefore, the Agency denies Exception

490513 as it pertains to Paragraph 191 of the Recommended Order.

4916In Exception 14, JW takes exception to Paragraphs 205 and 213 of the Recommended

4930Order, arguing the conclusions of law in these paragraphs are unreasonable and ignore the

4944Agency's discretion to weigh and balance the statutory review criteria. The Agency denies

4957Exception 14 as it pertains to Paragraph 213 of the Recommended Order based on the reasoning

4973set forth in the Agency's ruling on JW's Exception 1 supra, which is hereby incorporated by

4989reference. In regard to Paragraph 205 ofthe Recommended Order, the ALl's conclusions oflaw

5002in that paragraph are based on the ALJ's weighing of the competent, substantial record evidence.

5017See Transcript, Volume 23, Pages 3682 and 3701. JW is, in essence, improperly asking the

5032Agency to re-weigh the record evidence to reach conclusions of law more favorable to it, which

5048the Agency cannot do. See Heifetz, 475 So. 2d at 1281. For this reason, the Agency denies

5065Exception 14 as it pertains to Paragraph 205 ofthe Recommended Order.

5076In Exception 15, JW takes exception to Paragraphs 65, 66, 67, 68, 69, 71, 78, 84 and 203

5094of the Recommended Order, arguing the ALJ impermissibly allowed DMC to amend its CON

5108application. The Agency denies Exception 15 as it pertains to Paragraphs 66 and 68 of the

5124Recommended Order based on the reasoning set forth in the Agency's ruling on JW' s Exception

51401 supra, which is hereby incorporated by reference. The denies Exception 15 as it pertains to

5156Paragraph 71 based on the reasoning set forth in the Agency's ruling on JW's Exception 7,

5172which is hereby incorporated by reference. The Agency denies Exception 15 as it pertains to

5187Paragraph 84 of the Recommended Order based on the reasoning set forth in the ruling on JW' s

5205Exception 11 supra, which is hereby incorporated by reference. In regard to Paragraphs 65, 67

5220and 69 of the Recommended Order, the Agency finds no evidentiary support for JW's allegation

5235that KRMC impermissibly amended its CON application. Instead, JW is attempting to twist the

5249competent, substantial record evidence to support its allegation by making unreasonable

5260inferences from it. These paragraphs make no indication that DMC amended its CON

5273application. Instead, they reflect one of the assertions of need that DMC made in its CON

5289application. See DMC Exhibit 1. Therefore, the Agency denies Exception 15 as it pertains to

5304Paragraphs 65, 67 and 69 of the Recommended Order. In regard to Paragraphs 78 (which

5319contains conclusions of law and not findings of fact, as labeled by the ALJ) and 203 of the

5337Recommended Order, the Agency does not agree with the ALl's conclusions of law in these

5352paragraphs, but not for the reasons JW put forth in Exception 15. In regard to Paragraph 78 of

5370the Recommended Order, the Agency hereby incorporates the reasoning set forth in the ruling on

5385Tenet's Exception Number Two infra. In regard to Paragraph 203 of the Recommended Order,

5399the Agency finds that the conclusions of law in that paragraph are within its substantive

5414jurisdiction because they involve the detennination of need for a new facility pursuant to section

5429408.035, Florida Statutes; and the Agency can substitute conclusions of law that are as or more

5445reasonable than those of the ALJ, based on the reasoning set forth in the rulings on Tenet's

5462Exception Number One and Exception Number Two infra, which are hereby incorporated by

5475reference. Therefore, the Agency grants Exception 15 as it pertains to Paragraphs 78 and 203 of

5491the Recommended Order, adopts and incorporates the modifications to Paragraph 78 of the

5504Recommended Order that it made in ruling on Tenet's Exception Number Two infra, and rejects

5519Paragraph 203 of the Recommended Order in toto.

5527In Exception 16, JW takes exception to Paragraphs 73, 85, 93, 112, 113, 118, 119, 120,

5543121, 122, 123, 126, 127, 128, 132, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145,

5562147, 159, 162, 164, 165, 166, 167, 168, 170, 189, 190,201,202,203,211,212 and 217 ofthe

5581Recommended Order, arguing DMC's utilization projections and adverse impact analysis did not

5593comply with the requirements of section 408.037(2), Florida Statutes. First, the Agency denies

5606Exception 16 as it pertains to Paragraphs 137, 145, 147, 159, 165, 166, 168, 170, 189, 190 and

5624211 of the Recommended Order based on the reasoning set forth in its rulings on JW' s

5641Exceptions 1, 2, 3, 4 and 11 supra, which are hereby incorporated by reference. Second, the

5657findings offact in Paragraphs 85, 93, 112, 113, 118, 119, 120, 121, 122, 123, 126, 127, 128, 132,

5675134,135,136,138,139,140,141,142,143,144,162, 164and 167oftheRecommendedOrder

5688are all based on competent, substantial record evidence. See Transcript, Volume 4, Pages 674

5702and 686; Transcript, Volume 7, Pages 1103 and 1153-1154; Transcript, Volume 11, Pages 1863-

57161865; Transcript, Volume 13, Pages 2079 and 2106-21 07; Transcript, Volume 14, Pages 2256-

57302257; Transcript, Volume 15, Pages 2459, 2473-2475 and 2496-2504; Transcript, Volume 19,

5742Pages 3035-3038, 3043-3050, 3064-3067, 3068-3075 and 3098-3099; Transcript, Volume 21,

5752Pages 3342-3344; AHCA Exhibit I; and DMC Exhibits 1, 22, 24, 161, 162, 163 and 164. Thus,

5769the Agency is not at liberty to reject or modify them. See § 120.57(1 )(I), Fla. Stat.; Heifetz, 475

5788So. 2d at 1281. Third, in regard to Paragraphs 73 (which contains conclusions oflaw and not

5804findings of fact, as labeled by the ALJ), 20 I, 202 and 212 of the Recommended Order, the

5822Agency does not agree with the ALJ' s conclusions of law in these paragraphs, but not for the

5840reasons JW put forth in Exception 16. Instead, the Agency will address Paragraph 73 of the

5856Recommended Order its ruling on Tenet's Exception 1 infra. The Agency has already addressed

5870Paragraph 203 of the Recommended Order in its ruling on JW's Exception 15 supra, which is

5886hereby incorporated by reference, and Paragraph 217 of the Recommended Order in its ruling on

5901JW's Exception 1 supra, which is hereby incorporated by reference. For all these reasons, the

5916Agency denies Exception 16.

5920In Exception 17, JW takes exception to Paragraphs 102 and 163 of the Recommended

5934Order, arguing the findings of fact in these paragraphs are not based on competent, substantial

5949evidence. Based on the reasoning set forth in the Agency's ruling on JW's Exception I supra,

5965which is hereby incorporated by reference, along with the fact that JW's argument is not a valid

5982reason for the Agency to reject findings of fact under section 120.57(1)(1), Florida Statutes, the

5997Agency hereby denies Exception 17.

6002In Exception 18, JW takes exception to Paragraphs 62, 99, 101 and 168 of the

6017Recommended Order, arguing the findings of fact in these paragraphs conflict with each other

6031and therefore must be rejected by the Agency. For the reasons set forth in the Agency's rulings

6048on JW' s Exceptions 1, 8 and 11 supra, which are hereby incorporated by reference, and also

6065because JW's argument is not a valid reason for the Agency to reject findings of fact under

6082section 120.57(1)(1), the Agency hereby denies Exception 18.

6090In Exception 19, JW takes exception to Paragraphs 50, 62 and 168 of the Recommended

6105Order, arguing the findings of fact in these paragraphs conflict with each other, are not based on

6122competent, substantial evidence, and deal with criteria that is not part of the statutory review

6137criteria for general hospital CON applications. For the reasons set forth in the Agency's rulings

6152on JW' s Exceptions I, 3 and 11 supra, which are hereby incorporated by reference, along with

6169the fact that an alleged "conflict" between findings of fact is not a valid reason for the Agency to

6188reject findings of fact under section 120.57(1 )(!),the Agency hereby denies Exception 19.

6202In Exception 20, JW takes exception to Paragraphs 50, 62, 64, 65, 99, 101, 166 and 168

6219of the Recommended Order, arguing the findings of fact in these paragraphs are contradictory

6233and thus do not comply with the essential requirements of law. Based on the reasoning set forth

6250in the Agency's rulings on JW's Exceptions 1, 3, 8, 11 and 15 supra, hereby incorporated by

6267reference, and because an alleged "contradiction" between findings of fact is not a valid reason

6282for the Agency to reject findings of fact under section 120.57(1 ){!), Florida Statutes, the Agency

6298hereby denies Exception 20.

6302In Exception 21, JW takes exception to Paragraphs 58, 78, 79, 80, 81, 112, 114, 115, 116,

6319148, 164, 170 and 212 of the Recommended Order, arguing: 1) the findings of fact contradict

6335each other and are not supported by competent, substantial evidence; and 2) the conclusions of

6350law ignore the Agency's discretion to weigh and balance the statutory review criteria for CON

6365applications. InregardtothefindingsoffactinParagraphs78, 112,114,115,148, 164and I70

6373of the Recommended Order, the Agency denies Exception 21 based upon the reasoning set forth

6388in the Agency's rulings on JW's Exceptions I I, 15 and 16 supra, which are hereby incorporated

6405by reference. In regard to Paragraphs 58, 79, 80, 81 and I I 6 of the Recommended Order, the

6424findings of fact in these paragraphs are all based on competent, substantial record evidence. See

6439Transcript, Volume 2, Pages 159- I 60; Transcript, Volume 15, Pages 2435, 2440-2444 and 2457;

6454DMC Exhibits 1 and 24; and JW Exhibit 2. Thus, the Agency is prohibited from rejecting or

6471modifying them. See § I20.57(1)(l), Fla. Stat.; Heifetz, 475 So. 2d at 1281. Therefore, the

6486Agency denies Exception 2 I as it pertains to Paragraphs 58, 79, 80, 81 and 116 of the

6504Recommended Order. In regard to Paragraph 212 of the Recommended Order, the Agency does

6518not agree with the ALJ' s conclusions of law in this paragraph, but not for the reasons JW put

6537forth in Exception 21. 2 Therefore, the Agency denies Exception 21 as it pertains to Paragraph

65532 I 2 of the Recommended Order.

6560In Exception 22, JW takes exception to Paragraphs 84, 1 00, 116, 150 and I 5 I of the

6579Recommended Order, arguing they are really conclusions of law in which the ALJ improperly

6593substituted his interpretation of law in place of the Agency's interpretation. In regard to

6607Paragraphs 84, I 00 and I I 6 of the Recommended Order the Agency denies Exception 22 based

6625on the reasoning set forth in the Agency's rulings on JW's Exceptions 1, 11 and 21 supra, which

6643are hereby incorporated by reference. In regard to Paragraphs I 50 and 151 of the Recommended

6659Order, the Agency disagrees with JW's assertion that these paragraphs contain conclusions of

6672law. Instead, Paragraphs 150 and 151 of the Recommended Order contain findings of fact that

6687are supported by competent, substantial evidence. See Transcript, Volume 17, Pages 2828-2833;

66992 The Agency addresses this paragraph in its ruling on Tenefs Exception Number Four infra.

6714and DMC Exhibit 24. Thus, the Agency is not at liberty to reject or modify them. See §

6732120.57(1)(1), Fla. Stat.; Heifetz, 475 So. 2d at 1281. Therefore, the Agency denies Exception 22

6747as it pertains to Paragraphs 150 and 151 of the Recommended Order.

6759In Exception 23, JW takes exception to Paragraphs 215 and 216 of the Recommended

6773Order, arguing the ALJ's conclusion that the fact that DMC's parent company abandoned a prior

6788CON is not relevant to the consideration of its current CON application is erroneous and should

6804be rejected by the Agency. The Agency finds that, while it does have jurisdiction over the

6820conclusions of law in Paragraphs 215 and 216 of the Recommended Order, it cannot substitute

6835conclusions of law that are as or more reasonable than those of the ALI. Therefore, the Agency

6852denies Exception 23. However, the Agency notes that the ALJ's conclusions of law in

6866Paragraphs 215 and 216 of the Recommended Order are limited to the specific facts of this case,

6883and should not be construed to mean that abandonment of a prior CON could never be relevant

6900to the consideration of a subsequent CON application.

6908In Exception 24, JW takes exception to Paragraphs 84, 201, 202, 204, 212 and 217 of the

6925Recommended Order, arguing the Agency should disregard the conclusions of law in these

6938paragraphs as unreasonable. In regard to Paragraph 84 of the Recommended Order, the Agency

6952denies Exception 24 as it pertains to this paragraph based on the reasoning set forth in the

6969Agency's ruling on Exception 11 supra, which is hereby incorporated by reference. In regard to

6984Paragraph 204 of the Recommended Order, the Agency finds that, while it does have substantive

6999jurisdiction over the conclusions of law in Paragraph 204 of the Recommended Order since it is

7015the state agency in charge of administering Florida's CON program, it cannot substitute

7028conclusions oflaw that are as or more reasonable than those of the ALJ. Therefore, the Agency

7044denies Exception 24 as it pertains to Paragraph 204 of the Recommended Order. In regard to

7060Paragraphs 201, 202 and 212 of the Recommended Order, the Agency disagrees with the

7074conclusions of law in these paragraphs, but not for the reasons JW asserts in Exception 24. 3

7091Therefore, the Agency denies Exception 24 as it pertains to Paragraphs 201, 202 and 212 of the

7108Recommended Order. Paragraph 217 of the Recommended Order has already been addressed by

7121the Agency in the ruling on JW's Exception 1 supra, which is hereby incorporated by reference.

7137Tenet's Exceptions

7139In Exception Number One, Tenet takes exception to the portion of Paragraph 73 of the

7154Recommended Order, wherein the ALJ found that "both applications met the statutory criteria

7167for approval." Tenet argues the finding of fact is not supported by any competent, substantial

7182evidence. First, the portion of Paragraph 73 of the Recommended Order that Tenet took

7196exception to is actually a conclusion of law within the Agency's substantive jurisdiction, not a

7211finding of fact. Second, based on a survey of cases 4 involving hospital CON applications that

7227were submitted to the Agency after the 2008 changes to the review criteria in section 408.035,

7243Florida Statutes, the ALJ erred in concluding that both applications met the statutory criteria for

7258approval because neither application demonstrated the need for a new hospital in District 11.

7272In Memorial Healthcare Group, Inc. d/b/a Memorial Hospital Jacksonville v. Agency for

7284Health Care Admin. and Shands Jacksonville Medical Center, Inc., Case No. 12-0429CON

7296(DOAH Dec. 7, 20 12; AHCA Apr. 10, 2013 ), Memorial Hospital Jacksonville submitted a CON

7312application for a new 1 00-bed acute care hospital in Duval County, Florida, Subdistrict 4-1. The

7328evidence in the Memorial Hospital Jacksonville case demonstrated that a new hospital was not

73423 The Agency addresses these paragraphs in its rulings on Tenet's Exception Number Three and Exception Number

7359Four, and NCH's Exception 3 infra.

73654 The Agency did not discuss the case of South Broward Hospital District d/b/a Memorial Healthcare System v.

7383Agency for Health Care Admin., Case Nos. 15-0129CON and 15-0130CON (DOAH Apr. I, 2016; AHCA May 17,

74002016), which was also decided subsequent to the 2008 amendments to section 408.035, Florida Statutes, in its ruling

7418warranted because the service area had several existing providers within a reasonable distance of

7432the applicant's proposed location (Recommended Order at Pages 6-7 and 9), the proposed

7445service area was relatively small in population size (Recommended Order at Page 24), there was

7460underutilization of the existing beds in the service area (Recommended Order at Page 21 ), there

7476were no major geographic barriers that prevented residents of the proposed service area from

7490accessing existing services (Recommended Order at Pages 29-32), there were no barriers to

7503emergency services (Recommended Order at Pages 32-35), and no evidence that Medicaid and

7516indigent patients from the proposed service area were unable to access existing services

7529(Recommended Order at Pages 36-39). Thus, the Agency entered a final order denying

7542Memorial Hospital Jacksonville's CON application.

7547In Columbia Hospital (Palm Beaches) Limited Partnership d/b/a West Palm Hospital and

7559Jupiter Medical Center, Inc. d/b/a Jupiter Medical Center v. Florida Regional Medical Center and

7573Agency for Health Care Admin., Case Nos. 12-0428CON and 12-0496CON (DOAH Apr. 30,

75862013; AHCA Jun. 6, 2013), Florida Regional Medical Center submitted a CON application for a

7601new 80-bed acute care hospital in Palm Beach County, Florida, Subdistrict 9-4. The evidence in

7616the Columbia Hospital case demonstrated that a new hospital was not warranted because there

7630was low population growth in the proposed service area (Recommended Order at Page 20), there

7645was underutilization of the existing acute-care beds in the subdistrict (Recommended Order at

7658Page 21 ), there would be no increase in geographic or programmatic access to health care

7674services because the proposed location of the new facility was only a few miles from existing

7690facilities (Recommended Order at Page 28), and there would be a substantial adverse impact to

7705existing providers because the applicant's proposed service area completely overlapped that of

7717on Tenet's Exception Number One because it is not relevant to the case at hand since it involved a CON application

7738for a replacement hospital, which would not result in any new providers being added to a district.

7755the existing providers (Recommended Order at Pages 35-39). Thus, the Agency entered a final

7769order denying Florida Regional Medical Center's CON application.

7777In Lee Memorial Health System v. Agency for Health Care Admin., Case Nos. 13-

77912508CON and 13-2558CON (DOAH Mar. 28, 2014; AHCA Apr. 24, 2014), Lee Memorial

7804Health System submitted a CON application for a new 80-bed acute care hospital in Lee County,

7820Florida, AHCA District 8. The evidence in the Lee Memorial case demonstrated that a new

7835hospital was not warranted because the proposed service area was relatively small in population

7849size (Recommended Order at Page 19), there was underutilization of the existing acute care beds

7864in the district (Recommended Order at Page 26), there would be no increase in geographic or

7880programmatic access to health care services because the proposed location of the new facility

7894was only a few miles from existing facilities (Recommended Order at Pages 30-42), and no

7909enhanced access for Medicaid and indigent patients of the proposed service area (Recommended

7922Order at Pages 42-44). Thus, the Agency entered a final order denying Lee Memorial Health

7937System's CON application.

7940The case at hand is very similar to those of Memorial Hospital Jacksonville, Columbia

7954Hospital and Lee Memorial. The city of Doral has a relatively small population (Recommended

7968Order at Paragraph 96). The existing beds in District II are underutilized with an overall

7983occupancy rate of roughly 53% (See Transcript, Volume 23, Page 3660; Tenet Exhibit 5). And,

7998there was no competent, substantial record evidence that the "geographic barriers to access"

8011alleged by both JW and DMC prevented residents of the proposed service area from accessing

8026existing providers Transcript, Volume 17, Pages 2753-2759). In sum, if the Agency

8038were to grant either applicant a CON, it would be departing from prior Agency precedent without

8054any rational explanation. Thus, the Agency finds that it has substantive jurisdiction over the

8068conclusion of law in Paragraph 73 of the Recommended Order because it is the state agency in

8085charge of administering Florida's CON program, and that it can substitute conclusions of law

8099that are as or more reasonable than those of the ALI. Therefore, the Agency grants Exception

8115Number One and modifies Paragraph 73 of the Recommended Order as follows:

812773. Although 00-thneither of the applications met the statutory

8136criteria for approval, the Agency preliminarily approved JW's

8144CON application and denied DMC's Application.

8150In Exception Number Two, Tenet takes exception to Paragraphs 78 and 84 of the

8164Recommended Order, as well as the last sentence of Paragraph 97 of the Recommended Order,

8179arguing the findings of fact in these paragraphs are not based on competent, substantial evidence

8194and that the conclusion of there being need for a new hospital "is unfounded and cannot stand."

8211Paragraphs 78, 84 and 97 of the Recommended Order are a mixture of findings of fact and

8228conclusions of law regarding the need for a new facility in District 11. As it stated in the

8246reasoning set forth on Tenet's Exception Number One supra, the Agency finds that the facts of

8262this case do not demonstrate a need for a new hospital in District 11 in light of the cases of

8282Memorial Hospital Jacksonville, Columbia Hospital and Lee Memorial, which are prior Agency

8294precedent and pertinent to this matter. There is no competent, substantial record evidence that

8308the alleged "geographic barriers to access" prevented residents ofthe proposed service area from

8321accessing existing providers. Transcript, Volume 17, Pages 2753-2759. Additionally,

8330the population size and growth of Doral is not significant enough to justify the need for a new

8348hospital. See, Transcript, Volume 17, Page 2759. Furthermore, granting DMC's

8358application in order to decompress KRMC is not warranted because KRMC currently has excess

8372capacity and is in the process of expanding its facility. Transcript, Volume 17, Pages

83862771-2774. In sum, there is no competent, substantial record evidence to support the ALI's

8400findings that DMC's application should be granted due to geographic barriers to access, Doral's

8414dense and growing population, and the need to decompress KRMC. Thus, to the extent these

8429paragraphs contain findings of fact, the Agency finds that the findings of fact are not supported

8445by competent, substantial record evidence. To the extent these paragraphs contain conclusions

8457of law concerning the need for a new facility in District 11, the Agency finds that it has

8475substantive jurisdiction over the conclusions of law in these paragraphs because it is the state

8490agency in charge of administering Florida's CON program, and that it can substitute conclusions

8504of law that are as or more reasonable than those of the ALJ. Therefore, the Agency grants

8521Exception Number Two, rejects Paragraph 84 of the Recommended Order in toto, and modifies

8535Paragraphs 78, and 97 of the Recommended Order as follows:

854578. Generally, applicants are responsible for demonstrating need

8553for new acute care hospitals. DMC did not established that

8563geographic features surrounding Doral create access barriers for

8571the residents of the area. Doral is a densely populated community

8582that is grmving quickly and lacks a readily accessible hospital.

8592KRMC is a grmving tertiary facility that cannot expand to meet its

8604future demands, and DMC will help decompress KRMC's acute

8613care load so it can focus on its tertiary service lines.

862497. Although there is not a hospital in Doral itself, there are a

8637number of hospitals nearby. PGH and Palm Springs Hospital are

8647just north of Doral. KRMC is just south of Doral. Hialeah is

8659northeast of Doral. CGH, Westchester General Hospital and NCH

8668are southeast of Doral. JHS and all of the facilities in and around

8681JHS's main campus are east of Doral. Ho'Never, as described in

8692paragraphs 82 84 above, there are perceived, and based upon

8702patient flmv and utilization, actual geographic barriers to many of

8712these facilities.

8714In Exception Number Three, Tenet takes exception to the ALJ's statement in Paragraph

8727165 of the Recommended Order that "need has been demonstrated," and the conclusions of law

8742in Paragraph 201 ofthe Recommended Order. Tenet argues that the record of this case does not

8758support the ALJ' s ultimate finding or conclusion that need exists. The portion of Paragraph 165

8774of the Recommended Order to which Tenet takes exception is a conclusion of law. The Agency

8790finds that it is a conclusion of law within the Agency's substantive jurisdiction because it

8805involves an interpretation of section 408.035, which the Agency is charged with implementing.

8818Paragraph 201 of the Recommended Order is also a conclusion of law within the Agency's

8833substantive jurisdiction because it too involves an interpretation of section 408.035, which the

8846Agency is charged with implementing. Based on the reasoning set forth in the ruling on Tenet's

8862Exception Number One supra, the Agency finds that it can substitute conclusions of law that are

8878as or more reasonable than those of the ALJ. Therefore, the Agency grants Exception Number

8893Three and modifies Paragraphs 165 and 201 ofthe Recommended Order as follows:

8905165. Tenet's and NHC's objections to the proposals are twofold:

8915there is no need for a hospital, and if DMC or JW is built, it will

8931adversely impact their respective facilities. However, because need

8939has not been demonstrated, it makes no difference that Tenet and

8950NCH have a relatively low market share in the service area, and

8962DMC will not materially impact those market shares, especially

8971when compared with the adverse impact that approval of JW

8981would have.

8983201. When reviewing the evidence presented, in totality, by the

8993parties at the final hearing, it is evident that there is a cleamo need

9007in acute care District 11 for an acute care hospital to serve the City

9021of Doral and the surrounding area. § 408.035(1 )(a), Fla. Stat.

9032Further, DMC demonstrated that, on balance, it best satisfies the

9042statutory criteria and v1arrants approval of its application over that

9052ofJ\\V.

9053In Exception Number Four, Tenet takes exception to Paragraph 212 of the Recommended

9066Order, arguing the AL.T' s conclusion that '"nearly every one of the statutory criteria weighs in

9083favor of the DMC application" is not supported by the record of this case and should be rejected.

9101The Agency agrees and finds that it has substantive jurisdiction over the conclusion of law in

9117Paragraph 212 of the Recommended Order because it is the state agency in charge of

9132administering Florida's CON program, and that it can substitute a conclusion of law that is as or

9149more reasonable than that of the ALJ. Therefore, the Agency grants Exception Number Four and

9164modifies Paragraph 212 of the Recommended Order as follows:

9173212. Overall, nearly every onenone of the statutory criteria weighs

9183in favor of the DMC application.

9189In Exception Number Five, Tenet takes exception to the last sentence of Paragraph 190

9203and also Paragraph 191 of the Recommended Order, arguing the ALJ failed to recognize "that

9218there is legal significance to CON conditions." The Agency disagrees with Tenet's argument.

9231Furthermore, the findings of fact in Paragraphs 190 and 191 of the Recommended Order are

9246based on competent, substantial evidence. See Transcript, Volume 12, Pages 1942-1945;

9257Transcript, Volume 15, Pages 2495-2496; and DMC Exhibits 1 and 24. Thus, the Agency is not

9273allowed to reject or modify them. See § 120.57(1)(1), Fla. Stat.; Heifetz, 475 So. 2d at 1281.

9290Therefore, the Agency denies Exception Number Five.

9297NCH's Exceptions

9299In Exception 1, NCH takes exception to Paragraphs 78, 79, 80, 81, 82, 83 and 97 of the

9317Recommended Order, arguing the findings of fact in these paragraphs are not based on

9331competent, substantial evidence. In regard to Paragraphs 78 and 97 of the Recommended Order,

9345which contain a mixture of findings of fact and conclusions oflaw, the Agency grants Exception

93601 based on the reasoning set forth in the ruling on Tenet's Exception Number Two supra, which

9377is hereby incorporated by reference, and adopts the resulting modifications it made to these

9391paragraphs in that ruling. In regard to Paragraphs 79, 80, 81, 82 and 83 ofthe Recommended

9407Order, the Agency denies Exception 1 because these paragraphs contain findings of fact that are

9422based on competent, substantial record evidence. See Transcript, Volume 15, Pages 2435, 2440-

94352444 and 2457; and DMC Exhibits 1 and 24.

9444In Exception 2, NCH takes exception to Paragraph 84 of the Recommended Order,

9457arguing the findings of fact in this paragraph are not based on competent, substantial evidence.

9472Paragraph 84 of the Recommended Order is actually a conclusion of law within the Agency's

9487substantive jurisdiction because it concerns whether an applicant has demonstrated the need for a

9501new facility pursuant to section 408.035. The Agency finds that it has substantive jurisdiction

9515over the conclusion of law in Paragraph 84 of the Recommended Order because it is the state

9532agency in charge of implementing Florida's CON program, and that it can substitute a

9546conclusion of law that is as or more reasonable than that of the ALJ. Therefore, the Agency

9563f,Tfants Exception 2 and rejects Paragraph 84 of the Recommended Order in toto.

9577In Exception 3, NCH takes exception to Paragraphs 201 and 202 of the Recommended

9591Order, arguing that, contrary to the ALJ' s conclusions of law in these paragraphs, neither JW nor

9608DMC demonstrated that there was a need for a new hospital in the service area. Based on the

9626reasoning set forth in the ruling on Tenet's Exception Number One and Exception Number Three

9641supra, which are hereby incorporated by reference, the Agency agrees with NCH's argument.

9654Paragraphs 201 and 202 of the Recommended Order are conclusions of law within the Agency's

9669substantive jurisdiction because it is the state agency in charge of administering Florida's CON

9683program, and the Agency finds that it can substitute conclusions of law that are as or more

9700reasonable than those of the ALJ. Therefore, the Agency grants Exception 3, rejects Paragraph

9714202 in toto, and adopts and incorporates the modifications it made to Paragraph 201 of the

9730Recommended Order in the ruling on Tenet's Exception Number Three supra.

9741FINDINGS OF FACT

9744The Agency hereby adopts the findings of fact set forth in the Recommended Order,

9758except where noted supra.

9762CONCLUSIONS OF LAW

9765The Agency hereby adopts the conclusions of law set forth in the Recommended Order,

9779except where noted supra.

9783ORDER

9784Based upon the foregoing, both JW's CON application no. 10395 and DMC's CON

9797application no. 10394 are hereby denied. The parties shall govern themselves accordingly.

9809DONE and ORDERED this 2b 1 J.day of____.A'-.Ljor-'--'rl-=-·/ ___ , 2018, in Tallahassee, Florida.

9822I

9823CRETARY

9824TH CARE ADMINISTRATION

9827NOTICE OF RIGHT TO JUDICIAL REVIEW

9833A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO

9846A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A

9859NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A SECOND COPY

9872ALONG WITH THE FILING FEE AS PRESCRIBED BY LAW, WITH THE DISTRICT

9884COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE AGENCY

9894MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW

9903PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE FLORIDA

9912APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN 30 DAYS OF

9925RENDITION OF THE ORDER TO BE REVIEWED.

9932CERTIFICATE OF SERVICE

9935I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has

9950been furnished by the method indicated to the persons named below on this

9963----'-ztg-+ ...... __ ,, 2o18.

9967RICHARD J. SHOOP, Agency Clerk

9972Agency for Health Care Administration

99772727 Mahan Drive, MS #3

9982Tallahassee, Florida 32308-5403

9985(850) 412-3630

9987COPIES FURNISHED TO:

9990Honorable Robert S. Cohen

9994Chief Administrative Law Judge

9998Division of Administrative Hearings

10002(via electronic filing)

10005Geoffrey D. Smith, Esquire

10009Susan C. Smith, Esquire

10013Corinne T. Porcher, Esquire

10017Smith & Associates

100203301 Thomasville Road, Suite 201

10025Tallahassee, Florida 32303

10028(via electronic mail to geoff@smithlawtlh.com,

10033susan@smithlawtlh.com and corinne@smithlawtlh.com)

10036Christopher C. Kokoruda, Esquire

10040Laura E. Wade, Esquire

10044Eugene Shy, Jr., Esquire

10048Assistant County Attorneys

10051Miami-Dade County Attorney

100541611 Northwest 12 111 Avenue

10059West Wing, Suite 109

10063Miami, Florida 33136

10066(via electronic mail to kokorud@miamidade.gov,

10071wade@miamidade.gov, and eshy@miamidade.gov)

10074Stephen A. Ecenia, Esquire

10078R. David Prescott, Esquire

10082Craig D. Miller, Esquire

10086Rutledge Ecenia, P .A.

10090119 South Monroe Street, Suite 202

10096Tallahassee, Florida 32301

10099(via electronic mail to Steve@rutledge-ecenia.com,

10104David@rutledge-ecenia.com, and CMiller@rutledge-ecenia.com)

10107Thomas F. Panza, Esquire

10111Paul C. Buckley, Esquire

10115Elizabeth L. Pedersen, Esquire

10119Angelina Gonzalez, Esquire

10122Panza, Maurer & Maynard, P .A.

10128Coastal Tower

101302400 East Commercial Boulevard, Suite 905

10136Fort Lauderdale, Florida 33308

10140(via electronic mail to tpanza@panzamaurer.com,

10145pbuckley@panzamaurer.com, epederson@panzamaurer.com,

10147and agonzalez@panzamaurer.com)

10149Michael J. Glazer, Esquire

10153Steven M. Hogan, Esquire

10157E. Dylan Rivers, Esquire

10161Ausley McMullen

10163Post Office Box 391

10167123 South Calhoun Street

10171Tallahassee, Florida 32302

10174(via electronic mail to mglazer@ausley.com,

10179drivers@ausley.com, shogan@ausley.com, and jmcvaney@ausley.com)

10183Richard J. Saliba, Esquire

10187Kevin M. Marker, Esquire

10191Assistant General Counsels

10194(via electronic mail to Richard.Saliba@ahca.myflorida.com and

10200Kevin.Marker@ahca.myflorida.com)

10201Marisol Fitch

10203Certificate of Need Unit

10207(via electronic mail to Marisol.Fitch@ahca.myflorida.com)

10212Jan Mills

10214Facilities Intake Unit

10217(via electronic mail to Janice.Mills@ahca.myflorida.com)

Select the PDF icon to view the document.
PDF
Date
Proceedings
PDF:
Date: 04/26/2018
Proceedings: Agency Final Order
PDF:
Date: 04/26/2018
Proceedings: Jackson West's Exceptions to Recommended Order filed.
PDF:
Date: 04/26/2018
Proceedings: Tenet's Exceptions to Recommended Order filed.
PDF:
Date: 04/26/2018
Proceedings: NCH's Exceptions to the Recommended Order filed.
PDF:
Date: 04/26/2018
Proceedings: Agency Final Order filed.
PDF:
Date: 03/16/2017
Proceedings: Recommended Order
PDF:
Date: 03/16/2017
Proceedings: Recommended Order cover letter identifying the hearing record referred to the Agency.
PDF:
Date: 03/16/2017
Proceedings: Recommended Order (hearing held July 14, 15, 18-22, 25-29, and September 6-8, 21, 22, and 26-30, 2016). CASE CLOSED.
PDF:
Date: 12/19/2016
Proceedings: Notice of Filing Joint Proposed Recommended Order filed.
PDF:
Date: 12/19/2016
Proceedings: NCH's Proposed Recommended Order filed.
PDF:
Date: 12/19/2016
Proceedings: Tenet's Proposed Recommended Order filed.
PDF:
Date: 12/19/2016
Proceedings: Joint Proposed Recommended Order of Jackson Hospital West and the Agency for Health Care Administration filed.
PDF:
Date: 12/01/2016
Proceedings: Order Granting Extension of Time.
PDF:
Date: 11/30/2016
Proceedings: Unopposed Motion for Additional Pages and Extension of Time to File the Proposed Recommended Orders filed.
PDF:
Date: 11/14/2016
Proceedings: Order Granting Extension of Time.
PDF:
Date: 11/14/2016
Proceedings: Unopposed Motion for Extension of Time to File the Proposed Recommended Order (filed in Case No. 16-000113CON).
Date: 10/24/2016
Proceedings: Transcript (Volumes 1-34) (not available for viewing) filed.
PDF:
Date: 10/03/2016
Proceedings: Nicklaus Children's Hospital's Notice of Filing (enclosed thumb drive of testimony of Dr. Kinni; not available for viewing) filed.
PDF:
Date: 09/30/2016
Proceedings: Notice of Hearing Exhibits Admitted into Evidence.
PDF:
Date: 09/07/2016
Proceedings: Nicklaus Children's Hospital's Motion to Permit Jacqueline Lytle Gonzalez to Appear via Video filed.
Date: 09/06/2016
Proceedings: CASE STATUS: Hearing Held.
PDF:
Date: 08/24/2016
Proceedings: Nicklaus Children's Hospital's Amended Response to Jackson West's Second Request for Production of Documents filed.
PDF:
Date: 08/17/2016
Proceedings: Response to Nicklaus Children's Hospital's Request to Take Judicial Notice (filed in Case No. 16-000115CON).
PDF:
Date: 08/11/2016
Proceedings: Nicklaus Children's Hospital's Request to Take Judicial Notice filed.
PDF:
Date: 08/02/2016
Proceedings: Nicklaus Children's Hospital's Corrected Notice of Video Presentation filed.
PDF:
Date: 08/01/2016
Proceedings: Response to Nicklaus Children's Hospital's Notice of Video Presentation filed.
PDF:
Date: 07/26/2016
Proceedings: Nicklaus Children's Hospital's Notice of Video Presentation filed.
PDF:
Date: 07/18/2016
Proceedings: Agreed Confidentiality Order.
PDF:
Date: 07/15/2016
Proceedings: Agreed Confidentiality Order filed.
Date: 07/14/2016
Proceedings: CASE STATUS: Hearing Partially Held; continued to September 6, 2016.
PDF:
Date: 07/13/2016
Proceedings: Nicklaus Children's Hospital's Notice of Filing Amended Exhibit List filed.
PDF:
Date: 07/13/2016
Proceedings: Joint Pre-hearing Stipulation filed.
PDF:
Date: 07/13/2016
Proceedings: Joint Pre-hearing Stipulation filed.
PDF:
Date: 07/12/2016
Proceedings: Nicklaus Children's Hospital's Response to Motion to Compel and Response to Order to Show Cause filed.
PDF:
Date: 07/12/2016
Proceedings: Nicklaus Children's Hospital's Cross-notice of Taking Depositions Duces Tecum (of Armand Balsano and David Levitt) filed.
PDF:
Date: 07/12/2016
Proceedings: Cross-notice of Taking Depositions (of Armand Balsano and David Levitt) filed.
PDF:
Date: 07/12/2016
Proceedings: Respondent's The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Supplemental Responses and Objections to Variety Children's Hospital d/b/a Nicklaus Children's Hospital's Requests No. 2, 3, 5, and 6 of the Third Request for Production Served May 6, 2016, (filed in Case No. 16-000115CON).
PDF:
Date: 07/12/2016
Proceedings: Respondent, The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West's Supplemental Response and Objections to Variety Children's Hospital d/b/a Nicklaus Children's Hospital's Request No. 2 of the Fourth Request for Production Served May 13, 2016 (filed in Case No. 16-000115CON).
PDF:
Date: 07/11/2016
Proceedings: Order to Show Cause.
PDF:
Date: 07/08/2016
Proceedings: Motion to Compel Nicklaus Children's Hospital's Production of Discovery (filed in Case No. 16-000115CON).
PDF:
Date: 07/08/2016
Proceedings: Order Granting Extension of Time.
PDF:
Date: 07/07/2016
Proceedings: Cross-Notice of Taking Depositions (Dr. Jeffry Biehler and Patti Greenberg (continuation) filed.
PDF:
Date: 07/07/2016
Proceedings: Joint Motion for Extension of Time to File Pre-Hearing Stipulation (filed in Case No. 16-000115CON).
PDF:
Date: 07/05/2016
Proceedings: Nicklaus Children's Hospital's Response to Jackson West's Second Request for Production of Documents filed.
PDF:
Date: 07/05/2016
Proceedings: Cross Notice of Taking Depositions Duces Tecum filed.
PDF:
Date: 07/05/2016
Proceedings: Order on Motion for Clarification of Order Granting, in Part, and Denying, in Part, Respondent's, The Public Health Trust's Motion in Limine to Exclude Evidence of Quality of Care, Availablity of Resources to Accomplish and Operate JAckson-West Proposal, Financial Feasibility, and Costs and Methods of Proposed Construction and Operation of Jackson-West
PDF:
Date: 07/01/2016
Proceedings: Nicklaus Children's Hospital's Amended Response to Jackson's Supplemental Motion for Protective Order filed.
PDF:
Date: 07/01/2016
Proceedings: Nicklaus Children's Hospital's Response to Jackson's Supplemental Motion for Protective Order filed.
PDF:
Date: 06/30/2016
Proceedings: Jackson's Supplemental Motion for Protective Order as to Discovery (filed in Case No. 16-000115CON).
PDF:
Date: 06/30/2016
Proceedings: Nicklaus Children's Hospital's Notice of Taking Continued Telephonic Deposition filed.
PDF:
Date: 06/30/2016
Proceedings: Nicklaus Children's Hospital's Notice of Taking Telephonic Depositions Duces Tecum filed.
PDF:
Date: 06/30/2016
Proceedings: Notice of Taking Depositions Duces Tecum (Biehler, Platt, Weiner, Sullivan, Greenberg) filed.
PDF:
Date: 06/29/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Supplemental Response and Objections to Requests No. 6-10 of Variety Children's Hospital d/b/a Nicklaus Children's Hospital's Second Request for Production (filed in Case No. 16-000115CON).
PDF:
Date: 06/29/2016
Proceedings: Respondent's, The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Supplemental Response and Objections to Requests No. 6-10 of Petitioners, CGH Hospital, Ltd. d/b/a Coral Gables Hospital, Tenet Hialeah Healthsystem, Inc., d/b/a Hialeah Hospital, and Lifemark Hospitals, Inc., d/b/a Palmetto General Hospital's Amended Third Request for Production (filed in Case No. 16-000115CON).
PDF:
Date: 06/29/2016
Proceedings: Motion for Clarification of Order Granting, in Part, and Denying, in Part, Respondent, the Public Health Trust's Motion in Limine to Exclude Evidence of Quality of Care, Availability of Resources to Accomplish and Operate Jackson-West Proposal, Financial Feasibility, and Costs and Methods of Proposed Construction and Operation of Jackson-West (filed in Case No. 16-000115CON).
PDF:
Date: 06/28/2016
Proceedings: Nicklaus Children's Hospital's Amended Notice of Taking Telephonic Deposition (of Jefry Biehler) filed.
PDF:
Date: 06/27/2016
Proceedings: East Florida-DMC, Inc.'s Responses to Jackson Hospital West's Second Request for Production of Documents filed.
PDF:
Date: 06/27/2016
Proceedings: Kendall Healthcare Group, Ltd.'s Responses to Jackson Hospital West's Second Request for Production of Documents filed.
PDF:
Date: 06/24/2016
Proceedings: Palmetto General Hospital's Response to Second Request for Production from Jackson Memorial West filed.
PDF:
Date: 06/24/2016
Proceedings: Hialeah Hospital's Response to Second Request for Production from Jackson Memorial West filed.
PDF:
Date: 06/24/2016
Proceedings: Coral Gables Hospital's Response to Second Request for Production from Jackson Memorial West filed.
PDF:
Date: 06/23/2016
Proceedings: Order Granting, in Part, and Denying, in Part, Respondent's, The Public Health Trust's Motion in Limine to Exclude Evidence of Quality of Care, Availability of Resources to Accomplish and Operate Jackson-West Proposal, Financial Feasibility, and Cost.
PDF:
Date: 06/23/2016
Proceedings: Nicklaus Children's Hospital's Notice of Withdrawal of NCH's Motion to Compel Discovery from Jackson filed.
PDF:
Date: 06/22/2016
Proceedings: Jackson Hospital West?s Response in Opposition to Nicklaus Children?s Hospital?s Amended Motion to Compel Discovery from Jackson filed.
PDF:
Date: 06/22/2016
Proceedings: Amended Cross-Notice of Taking Telephonic Deposition Duces Tecum (Dr. Deise Granado-Villar) (filed in Case No. 16-000115CON).
PDF:
Date: 06/21/2016
Proceedings: Nicklaus Children's Hospital's Amended Notice of Taking Telephonic Deposition (of Deise Granado-Villar) filed.
PDF:
Date: 06/20/2016
Proceedings: Amended Cross-notice of Taking Deposition Duces Tecum (of Michael Davis) filed.
PDF:
Date: 06/20/2016
Proceedings: East Florida-DMC, Inc.'s Response in Opposition to the Public Health Trust's Motion in Limine filed.
PDF:
Date: 06/20/2016
Proceedings: Tenet's Notice of Filing Amended Exhibit B to Response in Opposition to Jackson's Motion in Limine filed.
PDF:
Date: 06/20/2016
Proceedings: Amended Notice of Hearing (hearing set for July 14, 15, 18 through 22, 25 through 29, September 6 through 8, 19 through 23 and 26 through 30, 2016; 9:00 a.m.; Tallahassee, FL; amended as to Dates of Hearing).
Date: 06/20/2016
Proceedings: CASE STATUS: Motion Hearing Held.
PDF:
Date: 06/20/2016
Proceedings: Nicklaus Children's Hospital's Amended Response to Jackson's Motion in Limine filed.
PDF:
Date: 06/20/2016
Proceedings: Order on NCH's Ore Tenus Motion for in Camera Inspection.
PDF:
Date: 06/20/2016
Proceedings: The Public Health Trust's Request for Leave of Court to File Reply to East Florida-DMC, Inc.s Amended Response in Opposition to The Public Health Trust's Motion for Protective Order Regarding Discovery filed.
PDF:
Date: 06/20/2016
Proceedings: Amended Cross-notice of Taking Depositions Duces Tecum (of Patti Greenberg and John McWilliams) filed.
PDF:
Date: 06/17/2016
Proceedings: Response in Opposition to Jackson's Motion in Limine and Motion for Protective Order filed.
PDF:
Date: 06/17/2016
Proceedings: Amended Cross-notice of Taking Depositions filed.
PDF:
Date: 06/17/2016
Proceedings: Cross-notice of Taking Depositions filed.
PDF:
Date: 06/17/2016
Proceedings: Order on NCH's Motion for In Camera Inspection.
PDF:
Date: 06/17/2016
Proceedings: Respondent, the Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Supplemental Response and Objections to Petitioners, CGH Hospital, Ltd., d/b/a Coral Gables Hospital, Tenet Hialeah Healthsystem, Inc., d/b/a Hialeah Hospital and Lifemark Hospitals, Inc., d/b/a Palmetto General Hospital's Request No. 15 to the Amended Third Request for Production Served May 6, 2016, (filed in Case No. 16-000115CON).
PDF:
Date: 06/17/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Supplemental Response and Objections to Request No. 13 of Variety Children's Hospital d/b/a NIcklaus Children's Hospital's Second Request for Production Served May 3, 2016, (filed in Case No. 16-000115CON).
PDF:
Date: 06/17/2016
Proceedings: Notice of Fling June 17, 2016, Correspondence to Judge Cohen Regarding In Camera Inspection of Additional Jackson Documents filed.
PDF:
Date: 06/17/2016
Proceedings: Respondent's The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Responses and Objections to Requests No. Two, Three, Four and Six of East Florida-DMC, Inc.'s Third Request for Production Served May 16, 2016 (filed in Case No. 16-000115CON).
Date: 06/16/2016
Proceedings: CASE STATUS: Motion Hearing Held.
PDF:
Date: 06/16/2016
Proceedings: Nicklaus Children's Hospital's Notice of Clarification filed.
PDF:
Date: 06/16/2016
Proceedings: Notice of Filing June 16, 2016 Correspondence to Judge Cohen Regarding in Camera Inspection of Jackson Documents filed.
PDF:
Date: 06/16/2016
Proceedings: Nicklaus Children's Hospital's Response to Jackson's Motion in Limine filed.
PDF:
Date: 06/16/2016
Proceedings: Cross Notice of Taking Depositions Duces Tecum (of John McWilliams) filed.
PDF:
Date: 06/15/2016
Proceedings: East Florida-DMC, Inc.'s Responses to Nicklaus Children's Hospital's Second Request for Production of Documents filed.
PDF:
Date: 06/15/2016
Proceedings: Cross-notice of Taking Deposition Duces Tecum (of Michael Davis and John McWilliams) filed.
PDF:
Date: 06/15/2016
Proceedings: Nicklaus Children's Hospital's Response to Jackson's Motion for Protective Order as to Discovery filed.
PDF:
Date: 06/15/2016
Proceedings: Nicklaus Children's Hospital's Amended Motion to Compel Discovery from Jackson filed.
Date: 06/15/2016
Proceedings: CASE STATUS: Motion Hearing Held.
PDF:
Date: 06/15/2016
Proceedings: Nicklaus Children's Hospital's Amended Notice of Taking Depositions filed.
PDF:
Date: 06/15/2016
Proceedings: East Florida- DMC, Inc.'s Amended Response in Opposition to the Public Health Trust's Motion for Protective Order Regarding Discovery filed.
PDF:
Date: 06/15/2016
Proceedings: East Florida-DMC, Inc.'s Amended Response in Opposition to the Public Health Trust's Motion for Protective Order Regarding Discovery filed.
PDF:
Date: 06/15/2016
Proceedings: East Florida-DMC, Inc.'s Response in Opposition to the Public Health Trust's Motion for Protective Order Regarding Discovery filed.
PDF:
Date: 06/15/2016
Proceedings: Nicklaus Children's Hospital's Notice of Telephonic Hearing on Jackson's Motion for Protective Order from NCH's Amended Cross-Notice of Taking Deposition Duces Tecum Issued to Carlos Migoya for Deposition Scheduled for June 17, 2016 filed.
PDF:
Date: 06/14/2016
Proceedings: Nicklaus Childrens Hospital's Motion to Compel Discovery from Jackson filed.
PDF:
Date: 06/14/2016
Proceedings: Nicklaus Children's Hospital's Notice of Taking Telephonic Deposition (of Michael Davis) filed.
PDF:
Date: 06/14/2016
Proceedings: Nicklaus Children's Hospital's Notice of Taking Deposition Duces Tecum (of John McWilliams) filed.
PDF:
Date: 06/14/2016
Proceedings: Nicklaus Children's Hospital's Motion to Compel Discovery from KRMC filed.
PDF:
Date: 06/14/2016
Proceedings: Nicklaus Children's Hospital's Response to Jackson's Motion for Protective Order from NCH's Amended Cross-notice of Taking Deposition Duces Tecum Issued to Carlos Migoya for Deposition Scheduled for June 17, 2016 filed.
PDF:
Date: 06/14/2016
Proceedings: Respondent, Jackson Hospital West's Response to NCH's Motion for in Camera Inspection (filed in Case No. 16-000115CON).
PDF:
Date: 06/14/2016
Proceedings: The Public Health Trust's Motion in Limine to Exclude Evidence of Quality of Care, Availability of Resources to Accomplish and Operate Jackson West Proposal, Financial Feasibility, and Costs and Methods of Proposed Construction and Operation of Jackson West (filed in Case No. 16-000115CON).
PDF:
Date: 06/14/2016
Proceedings: Respondent's, the Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Response and Objections to Petitioners, CGH Hospital, LTD., d/b/a Coral Gables Hospital, Tenet Hialeah Healthsystem, Inc., d/b/a Hialeah Hospital and Lifemark Hospitals, Inc., d/b/a Palmetto General Hospital's Fourth Request for Production Served May 11, 2016, (filed in Case No. 16-000115CON).
PDF:
Date: 06/14/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Notice of Serving Answers to Petitioner, Lifemark Hospitals, Inc., d.b.a Palmetto General Hospital's Second Set of Interrogatories Served May 11, 2016 (filed in Case No. 16-000115CON).
PDF:
Date: 06/14/2016
Proceedings: Respondent, the Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Response and Objections to Variety Children's Hospital d/b/a Nicklaus Children's Hospital's Fourth Request for Production Served May 13, 2016 (filed in Case No. 16-000115CON).
PDF:
Date: 06/13/2016
Proceedings: Nicklaus Children's Hospital's Second Amended Cross-notice of Taking Depositions Duces Tecum (of Patti Greenberg) filed.
PDF:
Date: 06/13/2016
Proceedings: Nicklaus Children's Hospital's Amended Notice of Taking Deposition (of Patti Greenberg) filed.
PDF:
Date: 06/13/2016
Proceedings: Respondent's, The Public Health Trust of Miami-Dade County, Florida's, Motion for Protective Order from Nicklaus Children's Hospital's Amended Cross-notice of Taking Deposition Duces Tecum Issued to Carlos Migoya for Deposition Scheduled for June 17, 2016 (filed in Case No. 16-000115CON).
PDF:
Date: 06/13/2016
Proceedings: Respondent's, The Public Health Trust of Miami-Dade County, Florida's, Motion for Protective Order as to Discovery (filed in Case No. 16-000115CON).
PDF:
Date: 06/13/2016
Proceedings: Cross Notice of Taking Depositions Duces Tecum (of Cathy Sweetapple) filed.
PDF:
Date: 06/13/2016
Proceedings: NCH's Amended Motion for in Camera Inspection filed.
PDF:
Date: 06/13/2016
Proceedings: Nicklaus Children's Hospital's Notice of Taking Depositions Duces Tecum (of Cathy Sweetapple) filed.
PDF:
Date: 06/13/2016
Proceedings: Motion for Protective Order Regarding Nicklaus Children's Hospital's First Request for Production of Documents to Kendall Regional Medical Center filed.
PDF:
Date: 06/10/2016
Proceedings: NCH's Motion for in Camera Inspection filed.
PDF:
Date: 06/10/2016
Proceedings: Respondent's, The Public Health Trust of Miami-Dade County, Florida, d/b/a Jackson Hospital West, Response and Objections to Request No. 5 of East Florida-DMC, Inc.'s Third Request for Production Served May 16, 2016 (filed in Case No. 16-000115CON).
PDF:
Date: 06/10/2016
Proceedings: Jacksons Cross-notice of Taking Depositions Duces Tecum filed.
PDF:
Date: 06/09/2016
Proceedings: Cross Notice of Taking Depositions Duces Tecum (June 16, 2016) filed.
PDF:
Date: 06/09/2016
Proceedings: Cross-notice of Taking Depositions (June 14, 2016) filed.
PDF:
Date: 06/09/2016
Proceedings: Cross Notice of Taking Deposition Duces Tecum (June 14, 2016) filed.
PDF:
Date: 06/09/2016
Proceedings: Amended Cross Notice of Taking Depositions Duces Tecum (June 13 and June 17, 2016) filed.
PDF:
Date: 06/09/2016
Proceedings: Nicklaus Children's Hospital's Notice of Taking Depositions (Deise Granado-Villar and Jefry Biehler) filed.
PDF:
Date: 06/09/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida's Amended Final Witness List filed.
PDF:
Date: 06/08/2016
Proceedings: Nicklaus Children's Hospital's Amended Cross-notice of Taking Depositions Duces Tecum (of Carlos Migoya) filed.
PDF:
Date: 06/08/2016
Proceedings: Nicklaus Children's Hospital's Amended Cross-notice of Taking Depositions Duces Tecum (of Carlos Migoya) filed.
PDF:
Date: 06/08/2016
Proceedings: Nicklaus Children's Hospital's Notice of Taking Deposition (of Patti Greenberg) filed.
PDF:
Date: 06/08/2016
Proceedings: Nicklaus Children's Hospital's Notice of Taking Depositions (of Michael Kushner, Michael Durr, and Narendra Kini) filed.
PDF:
Date: 06/08/2016
Proceedings: Petitioner's, The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Response and Objections to East Florida-DMC, Inc.'s Request No. 1 of the Third Request for Production Served May 16, 2016 (filed in Case No. 16-000115CON).
PDF:
Date: 06/08/2016
Proceedings: Nicklaus Children's Hospital's Cross-notice of Taking Depositions Duces Tecum filed.
PDF:
Date: 06/08/2016
Proceedings: The Public Health Trust of Miami-Dade County, Floridas Response and Objections to Variety Childrens Hospitals Third Request for Production (filed in Case No. 16-000115CON).
PDF:
Date: 06/08/2016
Proceedings: Notice of Appearance (Steven Hogan) filed.
PDF:
Date: 06/07/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Amended Response and Objections to Petitioners, CGH Hospital, Ltd. d/b/a Coral Gables, Tenet Hialeah Healthsystem, Inc. d/b/a Hialeah Hospital and Lifemark Hospitals, Inc. d/b/a Palmetto General Hospital's Second Request for Production Served May 3, 2016 (filed in Case No. 16-000115CON).
PDF:
Date: 06/07/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Amended Response and Objections to Variety Children's Hospital d/b/a Nicklaus Children's Hospital's Second Request for Production Served May 3, 2016 (filed in Case No. 16-000115CON).
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Date: 06/07/2016
Proceedings: Notice of Telephonic Status Conference (status conference set for June 20, 2016; 10:00 a.m.).
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Date: 06/07/2016
Proceedings: Petitioner's the Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Response and Objections to Petitioners, CGH Hospital, Ltd/. d/b/a Coral Gables Hospital, Tenet Hialeah Healthsystem, Inc., d/b/a Hialeah Hospital, and Lifemark Hospitals, Inc., d/b/a Palmetto General Hospital's Amended Third Request for Production Served May 6, 2014, (filed in Case No. 16-000115CON).
Date: 06/06/2016
Proceedings: CASE STATUS: Motion Hearing Held.
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Date: 06/06/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida e/b/a Jackson Hospital West, Response and Objections to Variety Children's Hospital d/b/a Nicklaus Children's Hospital's Second Request for Production Served on May 3, 2016, filed.
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Date: 06/06/2016
Proceedings: Notice of Appearance (Angelina Gonzalez) filed.
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Date: 06/06/2016
Proceedings: Notice of Appearance (Angelina Gonzalez) (filed in Case No. 16-000113CON).
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Date: 06/06/2016
Proceedings: Notice of Appearance (Angelina Gonzalez) (filed in Case No. 16-000114CON).
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Date: 06/06/2016
Proceedings: Respondent, Jackson Hospital West's Response in Opposition to Petitioner's Amended Motion for Continuance filed.
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Date: 06/06/2016
Proceedings: Notice of Appearance (Angelina Gonzalez) (filed in Case No. 16-000115CON).
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Date: 06/03/2016
Proceedings: Jackson Hospital West's Second Request for Production to Variety Children's Hospital, d/b/a Nicklaus Children's Hospital (filed in Case No. 16-000115CON).
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Date: 06/03/2016
Proceedings: Second Amended Cross-Notice of Taking Depositions Duces Tecum (as to Platts start time) filed.
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Date: 06/03/2016
Proceedings: Nicklaus Children's Hospital's Amended Cross-notice of Taking Depositions Duces Tecum filed.
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Date: 06/02/2016
Proceedings: Amended Notice of Taking Depositions Duces Tecum (of Dan Sullivan, Kathy Platt, and David Levitt) filed.
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Date: 06/02/2016
Proceedings: Amended Motion for a Continuance of Final Hearing filed.
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Date: 06/02/2016
Proceedings: Joinder in Motion for Continuance filed.
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Date: 06/02/2016
Proceedings: Amended Cross-notice of Depositions Duces Tecum (of Dan Sullivan and Kathy Platt) filed.
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Date: 06/01/2016
Proceedings: Motion for a Continuance of Final Hearing filed.
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Date: 06/01/2016
Proceedings: Nicklaus Children's Hospital's Cross-notice of Taking Depositions Duces Tecum filed.
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Date: 05/31/2016
Proceedings: NCH's Amended Final Witness List filed.
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Date: 05/31/2016
Proceedings: Petitioner's Amended Final Witness List filed.
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Date: 05/31/2016
Proceedings: Cross-notice of Taking Depositions filed.
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Date: 05/27/2016
Proceedings: Cross-notice of Taking Depositions Duces Tecum (of Dr. Robert Hernandez, Dr. Carlos Medina, and Dr. Ulises Militano) filed.
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Date: 05/26/2016
Proceedings: Jackson Hospital West's Second Request for Production to Kendall Healthcare Group, Ltd., d/b/a Kendall Regional Medical Center filed.
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Date: 05/26/2016
Proceedings: Respondent, Jackson Hospital West's Second Request for Production to East Florida-DMC, Inc filed.
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Date: 05/25/2016
Proceedings: Jackson Hospital West's Second Request for Production to Lifemark Hospital, Inc., d/b/a Palmetto General Hospital filed.
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Date: 05/25/2016
Proceedings: Respondent, Jackson Hospital West's Second Request for Production to CGH Hospital, Ltd., d/b/a Coral Gables Hospital filed.
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Date: 05/25/2016
Proceedings: Jackson Hospital West's Second Request for Production to Tenet Hialeah HEalthsystem, Inc., d/b/a Hialeah Hospital filed.
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Date: 05/25/2016
Proceedings: Nicklaus Children's Hospital's Cross-notice of Taking Depositions Duces Tecum filed.
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Date: 05/24/2016
Proceedings: Cross Notice of Taking Depositions Duces Tecum (June 15, 2016) filed.
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Date: 05/24/2016
Proceedings: Cross Notice of Taking Depositions Duces Tecum (June 9-13, 2016) filed.
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Date: 05/24/2016
Proceedings: Notice of Taking Depositions Duces Tecum filed.
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Date: 05/24/2016
Proceedings: Jackson Hospital Wests Request for Copies to Kendall Regional Medical Center filed.
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Date: 05/24/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West's Request for Copies to Kendall Healthcare Group, Ltd. d/b/a Kendall Regional Medical Center filed.
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Date: 05/24/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West's Request for Copies to Variety Children's Hospital d/b/a Nicklaus Children's Hospital filed.
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Date: 05/24/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West's Request for Copies to Lifemark Hospitals, Inc. d/b/a Palmetto General Hospital filed.
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Date: 05/24/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West's Request for Copies to Lifemark Hospitals, Inc. d/b/a Palmetto General Hospital filed.
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Date: 05/24/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West's Request for Copies to Tenet Hialeah Healthsystem, Inc. d/b/a Hialeah Hospital filed.
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Date: 05/24/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West's Request for Copies to CGH Hospital, Ltd. d/b/a Coral Gables Hospital filed.
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Date: 05/24/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West's Request for Copies to East Florida-DMC filed.
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Date: 05/23/2016
Proceedings: East Florida-DMC, Inc.'s Responses to Tenet's Second Request for Production of Documents filed.
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Date: 05/20/2016
Proceedings: Cross-Notice of Taking Deposition Duces Tecum (Kethy Platt and Dan Sullivan) filed.
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Date: 05/20/2016
Proceedings: Second Amended Notice of Taking Deposition Duces Tecum filed.
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Date: 05/20/2016
Proceedings: Petitioner's The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Response and Objections to Petitioners, CGH Hospital, LTD d/b/a Coral Gables Hospital, Tenet Hialeah Healthsystem, Inc., d/b/a Hialeah Hospital and Lifemark Hospital's, Inc., d/b/a Palmetto General Hospital's, Second Request for Production Served April 20, 2016 filed.
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Date: 05/20/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Response and Objections to East Florida-DMC's Second Request for Production Served April 20, 2016, filed.
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Date: 05/20/2016
Proceedings: Nicklaus Children's Hospital's Cross-Notice of Taking Depositions Duces Tecum filed.
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Date: 05/20/2016
Proceedings: Notice of Taking Depositions Duces Tecum filed.
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Date: 05/18/2016
Proceedings: Cross-notice of Taking Depositions filed.
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Date: 05/18/2016
Proceedings: Amended Notice of Taking Depositions Duces Tecum filed.
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Date: 05/17/2016
Proceedings: Nicklaus Children's Hospital's Cross-notice of Taking Depositions filed.
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Date: 05/17/2016
Proceedings: Cross Notice of Taking Depositions Duces Tecum filed.
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Date: 05/17/2016
Proceedings: Joinder and Request for Copies filed.
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Date: 05/17/2016
Proceedings: Notice of Taking Depositions Duces Tecum filed.
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Date: 05/17/2016
Proceedings: Joinder and Request for Copies filed.
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Date: 05/16/2016
Proceedings: Joinder and Request for Copies filed.
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Date: 05/16/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida's Final Witness List filed.
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Date: 05/16/2016
Proceedings: Joinder and Request for Copies filed.
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Date: 05/16/2016
Proceedings: Kendall Regional Medical Center's Final Witness List filed.
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Date: 05/16/2016
Proceedings: Nicklaus Childrens Hospitals Response to East Florida-DMCs Second Request for Production of Documents filed.
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Date: 05/16/2016
Proceedings: East Florida-DMC, Inc.'s Final Witness List filed.
PDF:
Date: 05/16/2016
Proceedings: East Florida-DMC, Inc.'s Third Request for Production of Documents to Jackson Hospital West filed.
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Date: 05/16/2016
Proceedings: Petitioner's Final Witness List filed.
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Date: 05/16/2016
Proceedings: NCH's Final Witness List filed.
PDF:
Date: 05/16/2016
Proceedings: Nicklaus Children's Hospital's Cross-notice of Taking Telephonic Deposition Duces Tecum (of Marisol Fitch) filed.
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Date: 05/16/2016
Proceedings: Cross Notice of Taking Deposition Duces Tecum (of Mark McKenney, M.D.) filed.
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Date: 05/16/2016
Proceedings: Nicklaus Children's Hospital's First Request for Production of Documents to Kendall Healthcare Group, Ltd filed.
PDF:
Date: 05/16/2016
Proceedings: Nicklaus Children's Hospital's Second Request for Production of Documents to East Florida DMC, Inc. filed.
PDF:
Date: 05/16/2016
Proceedings: Cross-Notice of Taking Deposition Duces Tecum (Mark McKenney, M.D.) (filed in Case No. 16-000115CON).
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Date: 05/13/2016
Proceedings: Nicklaus Children's Hospital's Fourth Request for Production of Documents to Public Trust filed.
PDF:
Date: 05/12/2016
Proceedings: NCH's Amended Notice of Taking Depositions Duces Tecum filed.
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Date: 05/11/2016
Proceedings: NCH's Third Amended Preliminary Witness List filed.
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Date: 05/11/2016
Proceedings: Petitioner's Fourth Request for Production to Jackson Hospital West filed.
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Date: 05/11/2016
Proceedings: Petitioner's Notice of Service of Second Interrogatories to Jackson Hospital West filed.
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Date: 05/11/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida's Second Amended Preliminary Witness List filed.
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Date: 05/10/2016
Proceedings: Amended Cross-notice of Taking Depositions Duces Tecum filed.
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Date: 05/09/2016
Proceedings: NCH's Second Amended Preliminary Witness List filed.
PDF:
Date: 05/09/2016
Proceedings: Nicklaus Children's Hospital's Notice of Taking Depositions Duces Tecum (of Ana Mederos, Patrick Downes, and Lourdes Camps) filed.
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Date: 05/06/2016
Proceedings: Cross-notice of Taking Depositions filed.
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Date: 05/06/2016
Proceedings: Notice of Taking Deposition Duces Tecum (of Marisol Fitch) filed.
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Date: 05/06/2016
Proceedings: Cross Notice of Taking Depositions Duces Tecum filed.
PDF:
Date: 05/06/2016
Proceedings: Cross-notice of Taking Depositions Duces Tecum filed.
PDF:
Date: 05/06/2016
Proceedings: Nicklaus Children's Hospital's Third Request for Production of Documents to Public Trust filed.
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Date: 05/06/2016
Proceedings: Petitioner's Amended Third Request for Production to Jackson Hospital West filed.
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Date: 05/06/2016
Proceedings: Agreed Confidentiality Order.
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Date: 05/05/2016
Proceedings: NCH's Notice of Taking Depositions Duces Tecum filed.
PDF:
Date: 05/05/2016
Proceedings: Petitioners' Third Request for Production of Documents to Jackson Hospital West filed.
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Date: 05/05/2016
Proceedings: Agreed Confidentiality Order filed.
PDF:
Date: 05/05/2016
Proceedings: Cross-notice of Taking Depositions Duces Tecum filed.
PDF:
Date: 05/04/2016
Proceedings: Nicklaus Children's Hospital's Cross-notice of Taking Depositions Duces Tecum filed.
PDF:
Date: 05/04/2016
Proceedings: Order of Pre-hearing Instructions.
PDF:
Date: 05/03/2016
Proceedings: Notice of Taking Depositions Duces Tecum (of Scott Cihak and Michael Joseph) filed.
PDF:
Date: 05/03/2016
Proceedings: Nicklaus Children's Hospital's Second Request for Production of Documents to Public Trust filed.
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Date: 05/02/2016
Proceedings: Kendall Regional Medical Center's Preliminary Witness List filed.
PDF:
Date: 05/02/2016
Proceedings: East Florida-DMC, Inc.'s First Amended Preliminary Witness List filed.
PDF:
Date: 04/20/2016
Proceedings: East Florida-DMC, Inc.'s Second Request for Production of Documents to Jackson Hospital West filed.
PDF:
Date: 04/20/2016
Proceedings: Petitioner's Second Request for Production of Documents to Jackson Hospital West filed.
PDF:
Date: 04/20/2016
Proceedings: Petitioner's Second Request for Production of Documents to East Florida-DMC, filed.
PDF:
Date: 04/20/2016
Proceedings: Amended Cross Notice of Taking Depositions Duces Tecum filed.
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Date: 04/20/2016
Proceedings: Amended Cross Notice of Taking Depositions Duces Tecum filed.
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Date: 04/19/2016
Proceedings: NCH's Second Amended Notice of Taking Depositions Duces Tecum filed.
PDF:
Date: 04/15/2016
Proceedings: East Florida-DMC, Inc.'s Second Request for Production of Documents to Nicklaus Children's Hospital filed.
PDF:
Date: 04/14/2016
Proceedings: NCH's Amended Notice of Taking Depositions Duces Tecum filed.
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Date: 04/14/2016
Proceedings: Cross Notice of Taking Depositions Duces Tecum filed.
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Date: 04/14/2016
Proceedings: NCH's Amended Preliminary Witness List filed.
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Date: 04/13/2016
Proceedings: Cross-Notice of Taking Depositions filed.
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Date: 04/13/2016
Proceedings: NCH's Notice of Taking Deposition Duces Tecum filed.
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Date: 04/12/2016
Proceedings: Notice of Transfer.
PDF:
Date: 04/06/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida's Amended Preliminary Witness List (filed in Case No. 16-000114CON).
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Date: 03/30/2016
Proceedings: Petitioner's The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Response and Objections to Petitioners, CGH Hospital, Ltd., d/b/a Coral Gables Hospital, Tenet Hialeah Healthsystem, Inc., d/b/a Hialeah Hospital and Lifemark Hospitals, Inc., d/b/a Palmetto General Hospital's First Request for Production Served February 18, 2016, filed.
PDF:
Date: 03/30/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Notice of Serving Verified Answers to Petitioner, Lifemark Hospitals, Inc., d/b/a Palmetto General Hospital's First Interrogatories Served February 18, 2016, filed.
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Date: 03/29/2016
Proceedings: Notice of Service of East Florida-DMC, Inc.'s Responses to Petitioner's First Request for Production of Documents filed.
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Date: 03/29/2016
Proceedings: Notice of Service of East Florida-DMC, Inc.'s Answers and Objections to Palmetto General Hospital's First Set of Interrogatories filed.
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Date: 03/25/2016
Proceedings: Coral Gabels' Notice of Service of Answers to First Interrogatories from East Florida DMC, Inc. filed.
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Date: 03/25/2016
Proceedings: Coral Gables' Hospital Response to First Request for Production from East Florida DMC, Inc. filed.
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Date: 03/25/2016
Proceedings: Palmetto General Hospital's Response to First Request for Production from East Florida DMC, Inc.filed.
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Date: 03/24/2016
Proceedings: Hialeah Hospital's Response to First Request for Production from East Florida DMC, Inc. filed.
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Date: 03/24/2016
Proceedings: Coral Gables' Notice of Service of Answers to First Interrogatories from Jackson Memorial West filed.
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Date: 03/24/2016
Proceedings: Coral Gables' Notice of Service of Answers to First Interrogatories from Jackson Memorial West filed.
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Date: 03/24/2016
Proceedings: Hialeah Hospital's Notice of Service of Answers to First Interrogatories from Jackson Memorial West filed.
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Date: 03/24/2016
Proceedings: Palmetto General's Notice of Service of Answers to First Interrogatories from East Florida-DMC, Inc. filed.
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Date: 03/24/2016
Proceedings: Palmetto General's Notice of Service of Answers to First Interrogatories from East Florida-DMC, Inc. filed.
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Date: 03/24/2016
Proceedings: Hialeah Hospital's Notice of Service of Answers to First Interrogatories from East Florida-DMC, Inc. filed.
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Date: 03/24/2016
Proceedings: Palmetto General's Notice of Service of Answers to First Interrogatories from Jackson Memorial West filed.
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Date: 03/24/2016
Proceedings: Palmetto General Hospital's Response to First Request for Production from Jackson Memorial West filed.
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Date: 03/24/2016
Proceedings: Hialeah Hospital's Response to First Request for Production from Jackson Memorial West filed.
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Date: 03/24/2016
Proceedings: Coral Gables Hospital's Response to First Request for Production from Jackson Memorial West filed.
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Date: 03/21/2016
Proceedings: Petitioner's, The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Response and Objections to East Florida-DMC's First Request for Production Served February 15, 2016, filed.
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Date: 03/21/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West Notice of Serving Verified Answers to East Florida-DMC's First Set of Interrogatories Served February 15, 2016, filed.
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Date: 03/21/2016
Proceedings: Petitioner's The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Response and Objections to to Nicklaus Children's Hospital's First Request for Production Served February 12, 2016, filed.
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Date: 03/21/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida d/b/a Jackson Hospital West, Notice of Serving Verified Answers to Variety Children's Hospital d/b/a Nicklaus Children's Hospital's First Interrogatories Served February 12, 2016, filed.
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Date: 03/18/2016
Proceedings: Nicklaus Children's Hospital's Response to East Florida-DMC's First Request for Production of Documents filed.
PDF:
Date: 03/18/2016
Proceedings: Nicklaus Children's Hospital's Notice of Serving Answers to East Florida DMC, Inc.'s First Set of Interrogatories filed.
PDF:
Date: 03/18/2016
Proceedings: Nicklaus Children's Hospital's Response to Jackson West's First Request for Production of Documents filed.
PDF:
Date: 03/18/2016
Proceedings: Nicklaus Children's Hospital's Notice of Serving Answers to Jackson Hospital West's First Set of Interrogatories filed.
PDF:
Date: 03/18/2016
Proceedings: East Florida-DMC, Inc.'s Responses to Nicklaus Children's Hospital's First Request for Production of Documents filed.
PDF:
Date: 03/18/2016
Proceedings: Kendall Healthcare Group, Ltd.'s Responses to Jackson Memorial West's First Request for Production of Documents filed.
PDF:
Date: 03/18/2016
Proceedings: East Florida-DMC, Inc.'s Responses to Jackson Memorial West's First Request for Production of Documents filed.
PDF:
Date: 03/18/2016
Proceedings: Notice of Service of East Florida-DMC, Inc.'s Answers and Objections to Jackson Hospital West's First Set of Interrogatories filed.
PDF:
Date: 03/18/2016
Proceedings: Notice of Service of Kendall Regional Medical Center's Answers and Objections to Jackson Hospital West's First Set of Interrogatories filed.
PDF:
Date: 03/18/2016
Proceedings: Notice of Service of East Florida-DMC, Inc.'s Answers and Objections to Nicklaus Children's Hospital's First Set of Interrogatories filed.
PDF:
Date: 03/17/2016
Proceedings: Preliminary Witness List filed.
PDF:
Date: 03/17/2016
Proceedings: The Public Health Trust of Miami-Dade County, Florida's Preliminary Witness List (filed in Case No. 16-000115CON).
PDF:
Date: 03/17/2016
Proceedings: Petitioner's Preliminary Witness List filed.
PDF:
Date: 03/15/2016
Proceedings: East Florida-DMC, Inc.'s Preliminary Witness List filed.
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Date: 03/15/2016
Proceedings: Kendall Regional Medical Center's Preliminary Witness List filed.
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Date: 03/15/2016
Proceedings: The Agency for Health Care Administration's Preliminary and Final Witness List filed.
PDF:
Date: 02/19/2016
Proceedings: Petitioner's First Request for Production of Documents to East Florida-DMC., Inc., filed.
PDF:
Date: 02/19/2016
Proceedings: Petitioner's First Request for Production of Documents to Jackson Hospital West filed.
PDF:
Date: 02/19/2016
Proceedings: Petitioner's Notice of Service of First Interrogatories to East Florida-DMC., Inc., filed.
PDF:
Date: 02/19/2016
Proceedings: Petitioner's Notice of Service of First Interrogatories to Jakson Hospital West filed.
PDF:
Date: 02/16/2016
Proceedings: Joint Proposed Order of Pre-hearing Instructions filed.
PDF:
Date: 02/16/2016
Proceedings: East Florida-DMC,Inc.'s First Request for Production of Documents to Jackson Hospital West (filed in Case No. 16-000115CON).
PDF:
Date: 02/16/2016
Proceedings: East Florida DMC, Inc.'s Notice of First Set of Interrogatories to Nicklaus Children's Hospital (filed in Case No. 16-000115CON).
PDF:
Date: 02/16/2016
Proceedings: East Florida DMC, Inc.'s Notice of First Set of Interrogatories to Hialeah Hospital (filed in Case No. 16-000115CON).
PDF:
Date: 02/16/2016
Proceedings: East Florida DMC, Inc.'s Notice of Service of First Set of Interrogatories to Coral Gables Hospital (filed in Case No. 16-000115CON).
PDF:
Date: 02/16/2016
Proceedings: East Florida DMC, Inc.'s Notice of Service of First Set of Interrogatories to Jackson Hospital West (filed in Case No. 16-000115CON).
PDF:
Date: 02/16/2016
Proceedings: Notice of Appearance (Craig Miller) filed.
PDF:
Date: 02/15/2016
Proceedings: East Florida-DMC, Inc.'s First Request for Production of Documents to Nicklaus Children's Hospital filed.
PDF:
Date: 02/15/2016
Proceedings: East Florida-DMC, Inc.'s First Request for Production of Documents to Coral Gables filed.
PDF:
Date: 02/15/2016
Proceedings: East Florida-DMC, Inc.'s First Request for Production of Documents to Palmetto General Hospital filed.
PDF:
Date: 02/15/2016
Proceedings: East Florida-DMC, Inc.'s First Request for Production of Documents to Hialeah Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Nicklaus Children's Hospital's First Request for Production of Documents to Public Trust filed.
PDF:
Date: 02/12/2016
Proceedings: Variety Children's Hospital d/b/a Nicklaus Children's Hospital's First Request for Production of Documents to East Florida DMC, Inc. filed.
PDF:
Date: 02/12/2016
Proceedings: Variety Children's Hospital d/b/a Nicklaus Children's Hospital's Notice of Serving First Interrogatories to East Florida DMC, Inc. filed.
PDF:
Date: 02/12/2016
Proceedings: Variety Children's Hospital d/b/a Nicklaus Children's Hospital's Notice of Serving First Interrogatories to Jackson Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Jackson Memorial West's First Request for Production to Lifemark Hospital, Inc., d/b/a Palmetto General Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Jackson Memorial West's First Request for Production to Variety Children's Hospital, d/b/a Nicklaus Children's Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Jackson Memorial West's First Request for Production to Kendall Healthcare Group, Ltd., d/b/a Kendall Regional Medical Center filed.
PDF:
Date: 02/12/2016
Proceedings: Jackson Memorial West's First Request for Production to Tenet Hialeah Healthsystems, Inc., d/b/a Hialeah Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Respondent, Jackson Memorial West's, First Request for Production to East Florida-DMC, Inc filed.
PDF:
Date: 02/12/2016
Proceedings: Respondent, Jackson Memorial West's First Request for Production to CGH Hospital, Ltd., d/b/a Coral Gables Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Jackson Memorial West's First Request for Production to Tenet Hialeah Healthsystem, Inc., d/b/a Hialeah Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Respondent, Jackson Memorial West's, First Request for Production to East Florida-DMC, Inc filed.
PDF:
Date: 02/12/2016
Proceedings: Respondent, Jackson Memorial West's First Set of Interrogatories to Coral Gables Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Respondent, Jackson Memorial West's, Notice of Serving First Set of Interrogatories to East Florida-DMC, Inc filed.
PDF:
Date: 02/12/2016
Proceedings: Respondent, Jackson Memorial West's, Notice of Serving First Set of Interrogatories to Lifemark Hospital, Inc., d/b/a Palmetto General Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Respondent, Jackson Memorial West's, Notice of Serving First Set of Interrogatories to Variety Children's Hospital, d/b/a Nicklaus Children' Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Respondent, Jackson Memorial West's, Notice of Serving First Set of Interrogatories to Kendall Healthgroup, Ltd. d/b/a Kendall Regional Medical Center filed.
PDF:
Date: 02/12/2016
Proceedings: Respondent, Jackson Memorial West's, Notice of Serving First Set of Interrogatories to Tenent Hialeah Healthsystem, Inc., d/b/a Hialeah Hospital filed.
PDF:
Date: 02/12/2016
Proceedings: Respondent, Jackson Memorial West's, Notice of Serving First Set of Interrogatories on CGH Hospital, Ltd., d/b/a Coral Gables Hospital filed.
PDF:
Date: 02/02/2016
Proceedings: Notice of Retaining Court Reporter filed.
PDF:
Date: 01/27/2016
Proceedings: Order Requesting Proposed Order of Pre-hearing Instructions.
PDF:
Date: 01/27/2016
Proceedings: Notice of Hearing (hearing set for July 11 through 15, 18 through 22 and 25 through 29, 2016; 9:30 a.m.; Tallahassee, FL).
PDF:
Date: 01/22/2016
Proceedings: Joint Response to Initial Order filed.
PDF:
Date: 01/19/2016
Proceedings: Order Granting Motion to Intervene.
PDF:
Date: 01/15/2016
Proceedings: Order Granting Motion to Intervene.
PDF:
Date: 01/15/2016
Proceedings: Order Granting Motion to Intervene.
PDF:
Date: 01/14/2016
Proceedings: Notice of Appearance (Paul Buckley) (filed in Case No. 16-000115CON).
PDF:
Date: 01/14/2016
Proceedings: Notice of Appearance (Paul Buckley) (filed in Case No. 16-000114CON).
PDF:
Date: 01/14/2016
Proceedings: Notice of Appearance (Paul Buckley) (filed in Case No. 16-000113CON).
PDF:
Date: 01/14/2016
Proceedings: Notice of Appearance (Paul Buckley) filed.
PDF:
Date: 01/14/2016
Proceedings: Notice of Appearance (Laura Wade) filed.
PDF:
Date: 01/14/2016
Proceedings: Notice of Appearance (Laura Wade) (filed in Case No. 16-000115CON).
PDF:
Date: 01/14/2016
Proceedings: Notice of Appearance (Laura Wade) (filed in Case No. 16-000114CON).
PDF:
Date: 01/14/2016
Proceedings: Notice of Appearance (Laura Wade) (filed in Case No. 16-000113CON).
PDF:
Date: 01/14/2016
Proceedings: Order of Consolidation (DOAH Case Nos. 16-0112CON, 16-0113CON, 16-0114CON, and 16-0115CON).
PDF:
Date: 01/14/2016
Proceedings: Nicklaus Children's Hospital's Petition for Leave to Intervene filed.
PDF:
Date: 01/13/2016
Proceedings: Notice of Appearance (Christopher Kokoruda) filed.
PDF:
Date: 01/13/2016
Proceedings: Motion to Intervene (filed by CGH Hospital, Ltd. d/b/a Coral Gables Hospital, Tenet Hialeah Healthsystem, Inc. d/b/a Hialeah Hospital and Lifemark Hospitals, Inc. d/b/a Palmetto General Hospital) filed.
PDF:
Date: 01/12/2016
Proceedings: Notice of Appearance (Thomas Panza) filed.
PDF:
Date: 01/12/2016
Proceedings: Notice of Appearance (Elizabeth Pedersen) filed.
PDF:
Date: 01/12/2016
Proceedings: Initial Order.
PDF:
Date: 01/12/2016
Proceedings: Petition to Intervene (The Public Health Trust of Miami-Dade County, Florida, d/b/a Jackson Hospital West) filed.
PDF:
Date: 01/12/2016
Proceedings: Petition for Formal Administrative Proceeding filed.
PDF:
Date: 01/12/2016
Proceedings: Notice (of Agency referral) filed.

Case Information

Judge:
ROBERT S. COHEN
Date Filed:
01/12/2016
Date Assignment:
04/12/2016
Last Docket Entry:
04/26/2018
Location:
Tallahassee, Florida
District:
Northern
Agency:
Other
Suffix:
CON
 

Counsels

Related DOAH Cases(s) (3):

Related Florida Statute(s) (7):