93-004880CON Galen Of Florida, Inc., D/B/A Orange Park Medical Center vs. Agency For Health Care Administration Status: Closed Recommended Order on Wednesday, May 11, 1994.

Summary: Where license holder changes during the pendency of a CON, new license holder lacks standing to protest the Agency decision.

3 STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

GALEN OF FLORIDA, INC., d/b/a )

WESTSIDE REGIONAL MEDICAL CENTER, )

)

Petitioner, )

)

vs. ) CASE NO. 93-4880

)

AGENCY FOR HEALTH CARE )

ADMINISTRATION, )

)

Respondent, )

and )

)

NORTH BROWARD HOSPITAL DISTRICT, )

and PLANTATION GENERAL HOSPITAL, )

L.P., )

)

Intervenors. )

___________________________________)

SOUTH BROWARD HOSPITAL DISTRICT, )

d/b/a MEMORIAL HOSPITAL WEST, )

)

Petitioner, )

)

vs. ) CASE NO. 93-4881

)

AGENCY FOR HEALTH CARE )

ADMINISTRATION, )

)

Respondent, )

and )

)

PLANTATION GENERAL HOSPITAL, L.P., )

and HCA HEALTH SERVICES OF )

FLORIDA, INC., d/b/a NORTHWEST )

REGIONAL HOSPITAL, )

)

Intervenors. )

___________________________________)

SUMMARY RECOMMENDED ORDER

Pursuant to notice, the Division of Administrative Hearings, by its

assigned Hearing Officer, James W. York, held an evidentiary hearing on April

12, 1994, in Tallahassee, Florida. This hearing was held pursuant to North

Broward Hospital District's Motion for Summary Recommended Order.

APPEARANCES

For Petitioner John D.C. Newton, II, Esquire

Galen: MESSER, VICKERS, CAPARELLO, MADSEN,

LEWIS, GOLDMAN & METZ

Post Office Box 1876

Tallahassee, Florida 32301-1876

For Petitioner R. Terry Rigsby, Esquire

SBHD: BLANK, RIGSBY & MEENAN, P.A.

204 South Monroe Street

Tallahassee, Florida 32301

For Respondent Dean Bunton, Senior Attorney

AHCA: Agency for Health Care Administration

The Atrium, Suite 301

325 John Knox Road

Tallahassee, Florida 32303-4131

For Intervenor Seann Michael Frazier, Esquire

NBHD: PANZA, MAURER, MAYNARD & NEEL, P.A.

3081 East Commercial Boulevard

Ft. Lauderdale, Florida 33308

For Intervenor Jay Adams, Esquire

Plantation: 418 East Virginia Street

Tallahassee, Florida 32308

STATEMENT OF THE ISSUE

The issue in this proceeding is whether, pursuant to current statutory and

regulatory provisions, the change in licenseholder of Westside Regional Medical

Center from Galen of Florida, Inc., to Columbia Hospital Corporation of South

Broward, requires rejection of Certificate of Need application No. 7248, filed

by Galen and summary dismissal of Galen's petition for formal hearing.

PRELIMINARY STATEMENT

In February 1993, Galen of Florida, Inc., (Galen) filed a letter of intent,

seeking Certificate of Need (CON) approval to convert ten acute care beds at

Westside Regional Medical Center to ten Neonatal Intensive Care Level II beds.

The Agency for Health Care Administration (AHCA), the agency responsible for the

administration of the CON program, designated Galen's CON application as CON

Action No. 7428. AHCA notified Galen of its intent to preliminarily deny

Galen's CON application, and Galen subsequently filed a timely petition to

challenge AHCA's decision (DOAH Case No. 93-4880).

The South Broward Hospital district, d/b/a Memorial Hospital West

(Memorial), a co-batched applicant, filed a competing application to establish

ten Neonatal Intensive Care Level II beds at its campus in Western Broward

County. AHCA designated Memorial West's CON application as CON Action No. 7249.

AHCA notified Memorial West of its intent to preliminarily deny Memorial West's

CON application, and Memorial West subsequently filed a timely petition to

challenge AHCA's decision (DOAH Case No. 93-4881).

The North Broward Hospital District (NBHD) and Plantation General Hospital,

L.P. (Plantation) filed timely petitions to intervene in DOAH Case No. 93-4880,

and both were granted leave to intervene.

Plantation and HCA Health Services of Florida, Inc., d/b/a Northwest

Regional Hospital filed timely petitions to intervene in DOAH Case No. 93-4881,

and both were granted leave to intervene. These two cases were consolidated by

an order entered on September 3, 1993.

On or about November 5, 1993, Galen executed a bill of sale, transferring

ownership of Westside Regional Medical Center to Columbia Hospital Corporation

of South Broward, Inc. (Columbia). Pursuant to a Change of Ownership

application submitted to AHCA, a new license to operate Westside Regional

Medical Center was issued to Columbia on November 5, 1993.

On January 7, 1994, NBHD filed the instant Motion for Summary Recommended

Order, seeking to dismiss Galen's Petition for Formal Administrative Hearing.

NBHD contends that, as a result of the sale and transfer of assets to Columbia

Hospital Corporation of South Broward, Inc., Galen is no longer the applicant

for CON No. 7248.

At the hearing on NBHD's motion, NBHD presented the testimony of Elizabeth

Dudek, Chief of the Certificate of Need and Budget Review Sections for the AHCA,

tendered and accepted as an expert in Health Care Planning specifically related

to CON administration. The parties to this motion introduced SRO Exhibits 1-5,

and SRO Exhibit D, which were admitted and received into evidence.

Galen presented the testimony of Elizabeth Dudek. Prior to its direct

examination of Ms. Dudek, Galen attempted to introduce into evidence Elizabeth

Dudek's deposition taken in connection with a pending rule challenge proceeding

(DOAH Case No. 94-0404RX). Opposing counsel objected to its introduction, which

objection was sustained. Subsequent to the hearing, an Order was entered

reversing the prior ruling, allowing the deposition to be entered into evidence.

On May 2, 1994, a telephonic hearing was held in response to SBHD's request to

reconsider the Order. SBHD's request was denied and the deposition was ordered

admitted into evidence. /1

At the hearing, all participating parties were given the opportunity to

file proposed summary recommended orders. Galen and Memorial each filed timely

proposed summary recommended orders. NBHD and AHCA filed a timely joint

proposed summary recommended order. Specific rulings on the proposed findings

of fact submitted by the parties are included in the Appendix to this Summary

Recommended Order.

FINDINGS OF FACT

The Change of Ownership

1. In March 1993, Galen filed an application for a CON to add a ten-bed

Level II Neonatal Intensive Care Unit (NICU) at its hospital known as Westside

Regional Medical Center, located in Broward County in District X. This

application, CON No. 7248, was initially denied by the Agency. Galen filed a

Petition for Formal Administrative Hearing on August 12, 1993, challenging that

denial and seeking approval of its application.

2. In the same batching cycle, Memorial filed an application for a ten bed

Level II NICU, Con No. 7249, which the Agency also preliminarily denied. On

August 13, 1993, Memorial filed its petition for formal administrative hearing.

The cases were consolidated for hearing by Order entered September 3, 1993.

3. Two existing providers of Level II NICU services in the District sought

and were granted leave to intervene: NBHD and Plantation.

4. On January 7, 1994, NBHD filed a Motion for Summary Recommended Order.

The basis for summary relief was that subsequent to the filing of its

application for the Westside facility, Galen had sold or transferred that

facility to Columbia and that Columbia had become the new license holder for the

facility.

5. Galen responded in opposition that no material facts set forth in the

application for the CON to establish the Level II NICU at Westside had changed

as a result of the transfer to Columbia. Furthermore, Galen contends that its

application must be permitted to undergo the de novo comparative review process.

6. The Galen application was deemed complete, preliminarily reviewed and

initially denied. The basis of the initial denial was unrelated to any change

in ownership. Galen timely sought de novo comparative review by invoking the

administrative hearing process on August 12, 1993. The application has not been

withdrawn.

7. On November 5, 1993, Galen entered into a purchase and sale agreement

with Columbia. Under the terms of that agreement, Columbia undertook legal

responsibility for all liabilities and contractual obligations related to the

Westside facility.

8. As required by law, Columbia filed a change of ownership application

(CHOW) with the Agency which ultimately issued a new license to Columbia for the

operation of the Westside facility.

9. The Agency's CHOW file establishes that the Agency received and

reviewed the following documents, among others, related to Columbia: A list of

the officers and directors of Columbia; Columbia's articles of incorporation;

the certificate of incorporation of Columbia issued by the State of Florida;

Columbia's audited financial statements; affidavits asserting that Columbia

would accept all outstanding liabilities due and payable to the State of

Florida, including but not limited to any outstanding liabilities to the

Medicaid Program; assertions that Columbia would correct deficiencies, if any,

on the facilities most recent license survey; and assertions that Columbia would

comply in all respects with applicable provisions under Chapter 766, Florida

Statutes (regarding the Florida Patient's Compensation Fund).

10. The deposition of Mr. James A. Cruickshank, chief Operating Officer

for Westside Regional Medical Center, was admitted into evidence by NBHD. Mr.

Cruickshank testified that he had been employed at Westside since 1987. He is

directly responsible for the operations of the facility, and held that position

and those duties both before and after the transfer of assets to Columbia. He

participated in the preparation of the CON application and is familiar with its

contents.

11. Mr. Cruickshank testified that, as Chief Operating Officer, he was

familiar with the following matters, none of which had changed, or were expected

to vary from the representations made in the CON application, as a result of the

transfer of assets to Columbia:

A. Administration - no change;

B. Admission and discharge policies - no change;

C. Operational Management - no change;

D. Personnel - no change;

E. Staffing - no change;

F. Medical staff - no change;

G. Medical committees - no change;

H. Financial personnel - no change;

I. Charges of fees - no change;

J. Financial policies or procedures - no change;

K. Budgeting process - no change;

L. Financial commitments - no change;

M. Projected costs - no change;

N. Financial feasibility - no change;

O. Data or underlying assumptions -

no change;

P. Admissions or discharge data - no change;

Q. Average length of stay data - no change;

R. Scope of services - no change;

S. Level of proposed services for NICU unit,

including: Nursing, Specialty Nursing,

Surgical, Emergency, Respiratory therapy,

X-Ray; Obstetrics; Ultrasound; Clinical

laboratory; Nutritional; Anesthesia; or

social services - no change from those

represented in the CON application.

T. Quality of care - no change;

U. Standards and qualifications for medical

staff - no change;

V. Ratios for medical specialists - no change;

W. Nursing staff qualifications, specialists or

ratios - no change;

X. Patient stations, equipment or physical plant

and layout - no change;

Y. Licensed bed capacity - no change;

Z. Accessibility of services - no change;

AA. Extent to which proposed NICU unit will address

patient need in district - no change;

BB. Extent to which the medically under served

individuals in the district use or will use

the Westside facility - no change;

CC. Ability of the facility to meet any federal

regulations requiring uncompensated care,

community service or access by minority and

handicapped service to federally assisted

programs - no change;

DD. Utilization data - no change;

EE. Recruitment - no change;

Mr. Cruickshank's testimony in this regard is accepted.

12. Mr. Cruickshank testified that the financial feasibility and stability

of this proposal is strengthened by the Columbia acquisition: Westside is the

only facility owned by Columbia; the only capital projects or expenditures for

which Columbia would be responsible would thus be significantly less than the

$27,755,000 listed on Schedule 2 of the CON application; and the source of funds

for the proposed NICU is from operating expenses. Mr. Cruickshank's testimony

in this regard is also accepted.

13. Mr. Cruickshank, testified that Galen's board no longer has

operational responsibility for or exercises any control over Westside Regional

Medical Center. /2 Galen is no longer financially committed to the proposed

project.

14. Galen's letter of intent was accompanied by a resolution of its board.

Galen's CON Application No. 7248 included a listing of Galen of Florida, Inc.'s

board. Columbia and Galen do not share any of the same board members.

15. Mr. Cruickshank testified that Galen's CON application only provided

Galen's audited financial statements, and did not contain Columbia's audited

financial statements. No audited financial statements for Columbia have been

provided to AHCA in relation to CON application 7248.

Statutory and Regulatory Criteria

16. Rule 59C-1.008, Florida Administrative Code (the Rule), provides an

outline for what is required of a CON applicant to have an application accepted

and reviewed by AHCA.

17. The Rule implements the statutory criteria in Section 408.037, Florida

Statutes, which specifies the CON "Application Content" requirements.

18. Section 408.037, Florida Statutes, provides, in part, that an

application for a CON shall contain:

(2) A statement of the financial resources

needed by and available to the applicant to

accomplish the proposed project. This

statement shall include:

(a) A complete listing of all capital

projects . . . pending, approved, or underway

in any state at the time of the application

. . .[and] shall include the applicant's

actual or proposed financial commitment to

those projects and an assessment of their

impact on the applicant's ability to provide

the proposed project . . .

(c) A detailed financial projection . . .

[which] shall include a detailed evaluation

of the impact of the proposed project on the

cost of other services provided by the

applicant . . .

(3) An audited financial statement of the

applicant . . . includ[ing] . . . a balance

sheet and a profit-and-loss statement of the

two previous fiscal year's operation . . .

(4) A certified copy of a resolution by the

board of directors of the applicant , or

other governing authority if not a

corporation, authorizing the filing of the

application; authorizing the applicant to

incur the expenditures necessary to

accomplish the proposed project; certifying

that if issued a certificate, the applicant

shall accomplish the proposed project within

the time allowed by law and at or below the

costs contained in the application; and

certifying that the applicant shall license

and operate the facility. [Emphasis added.]

Section 408.037, Florida Statutes.

19. Elizabeth Dudek, Chief of CON and Budget Review for Respondent AHCA,

testified that an applicant's failure to comply with the statutory requirements

concerning submission of the letter of intent and board resolution would result

in the rejection of the application.

20. Pursuant to the above statutory criteria, if an applicant fails to

submit audited financial statements, AHCA would deem the application incomplete,

and the application would be withdrawn from consideration.

21. The Rule also incorporates the letter of intent and board resolution

provisions found in Section 408.039(2), Florida Statutes. This statute

provides:

. . . a letter of intent shall be filed by

the applicant . . . [which] describe[s] the

proposal with specificity, including proposed

capital expenditures, number of beds sought

. . . [and the] identy of the applicant,

including the names of those with controlling

interest in the applicant. The letter of

intent shall contain a certified copy of a

resolution by the board of directors of the

applicant . . . authorizing the filing of the

application described in the letter of intent;

authorizing the applicant to incur the

expenditures necessary to accomplish the

proposed project; certifying that if issued a

certificate, the applicant shall accomplish

the proposed project within the time allowed by

law and at or below the costs contained in the

application; and certifying that the applicant

shall license and operate the facility.

[Emphasis added.]

Section 408.039(2)(a-c), Florida Statutes.

22. Ms. Dudek testified that, pursuant to this statute, the licenseholder

for Westside Regional Medical Center is required to be the applicant for a CON.

23. At the time Galen submitted the letter of intent, Galen was the

licenseholder for Westside Regional Medical Center. Columbia has not filed a

letter of intent or board resolution for CON Application No. 7248.

24. In the case of an existing licensed facility, the "applicant" referred

to in the statute and the Rule must attest that they will license and operate

the facility, and thus is required to be the facility's licenseholder.

25. If AHCA issued a CON to the applicant, Galen, for the proposed

project, Galen would not be able to meet the requirement that it license and

operate the project because Galen no longer holds the license for Westside

Regional Medical Center.

26. Rule 59C-1.008(1)(n), Florida Administrative Code, provides:

The applicant for a project shall not change

from the time a letter of intent is filed, or

from the time an application if filed in the

case of an expedited review project, through

the time of the actual issuance of a

Certificate of Need. Properly executed

corporate mergers or changes in the corporate

name are not a change in the applicant. /3

27. Nothing in the statute specifically mandates that the licenseholder

cannot change or that such change compels involuntary withdrawal of the

application from comparative review.

28. Ms. Dudek testified that when she received notice that AHCA had issued

a new license which changed the ownership of Westside Regional Medical Center of

Columbia, she determined that, pursuant to Rule 59C-1.008, the CON application

filed by Galen was no longer an application that could be reviewed because the

entity submitting the application was no longer the licenseholder.

29. Ms. Dudek explained that in circumstances where the licenseholder

sells the facility to another corporation who then becomes the new

licenseholder, as is the case here, the rule requires that AHCA reject the CON

application because it would not contain a letter of intent, board resolution,

audited financial statements, capital project listing and proforma's for the

acquiring entity.

30. Galen did not offer testimony to show that the change in the applicant

had occurred as a corporate name change or as a corporate merger.

31. Ms. Dudek testified that subsequent to the omissions period,

applicants are not permitted to amend the application, and AHCA is prohibited by

rule from considering subsequent events in the application review process. Rule

59C-1.010(2)(b), Florida Administrative Code, provides in pertinent part:

Subsequent to an application being deemed

complete by the agency, no further

application information or amendment will be

accepted by the agency.

32. Ms. Dudek testified that the purpose for this prohibition is to set

forth parameters in terms of what information will be reviewed for a particular

period of time, so that each applicant knows what the agency considers, and that

it is considering the same information for all applicants as of the date each is

deemed complete.

33. Without amending or supplementing the application, there is no outlet

for Columbia to produce, or for the agency to consider, information concerning

the new licenseholder. Amending and supplementing the application is prohibited

by Rule 59C-1.010, Florida Administrative Code, as discussed in finding of fact

#31.

34. Ms. Dudek testified that when an existing facility submits a CON

application, the "applicant" is required by Agency rule to be the current

licenseholder. Rule 59C-1.008(1)(m), Florida Administrative Code, provides in

pertinent part:

An applicant for a project subject to

Certificate of Need review which affects an

existing licensed health care facility . . .

must be the license holder. . . . If agency

records indicate information different from

that presented in the letter of intent with

respect to the identification of the holder

of the license and the licensure status, then

the agency records create a rebuttable

presumption as to the correctness of those

records and therefore the application will be

rejected.

35. Ms. Dudek testified that agency records show that Columbia currently

holds the license for Westside Regional Medical Center. Mr. Cruickshank

confirmed that Columbia, and not Galen, is the current licenseholder for

Westside Regional Medical Center.

CONCLUSIONS OF LAW

36. The Division of Administrative Hearings has jurisdiction over the

subject matter of and the parties in this proceeding. Section 120.57, Florida

Statutes, and Section 408.039, Florida Statutes.

37. A summary recommended order is comparable to summary judgment in a

civil proceeding. The movant has the burden to demonstrate that it is entitled

to judgment as a matter of law and any doubts are to be resolved against summary

disposition. Martin v. Golden Corral Corp., 601 So.2d 1316 (Fla. 2d DCA 1992).

38. In this case competent, substantial evidence clearly shows that the

original license holder and applicant in these proceedings was Galen. The

application was filed with the AHCA in March 1993. The evidence in this case

also clearly establishes that Galen entered into a purchase and sale agreement

with Columbia in the fall of 1993. The change in ownership of Westside Regional

Medical Center obviously occurred prior to the issuance of a CON. In addition,

Columbia applied for and received a change of ownership application and a new

license for the facility in question. Therefore, both the original applicant

and the original license holder have changed since the application was filed in

March 1993.

39. Galen has not presented evidence that the transactions with Columbia

which are at issue fall within the corporate name change or merger exception to

Rule 59-1.008(1)(n) and acknowledges, in its proposed recommended order that it

has not pursued this defense to the application of the rule. Therefore there is

no genuine issue of fact present here with respect to the application of the

rule. There has been a clear departure from Rule 59-1.008., Florida

Administrative Code in this case.

40. In addition, it was clearly established at hearing that the identity

of the original applicant and license holder in this case occurred after the

agency made a determination that the application was complete, therefore, the

agency is now prohibited from allowing any amendment to the original

applications by Rule 59C-1.010(2)(6), Florida Administrative Code, which

provides in pertinent part:

Subsequent to an application being deemed

complete by the agency, no further

application or amendment will be accepted

by the agency.

41. Galen's argues that the rules should not apply here because the

management, direction, staffing and funding of the facility at issue will not be

any different as a result of the change in the original applicant. Galen's

argument is not persuasive. The agency has established that its rules for

review of CON applications are intended to establish parameters in terms of

specific information that will be considered at relevant time points within the

process. The agency rules appear to be an attempt of AHCA to promote

predictable, equal and fair treatment to all applicants.

42. Galen argues that the application of these agency rules to dismiss its

petition under these facts amounts to applying "form over substance." This is

not the case. Instead, the agency, by dismissing Galen's petition in this

proceeding, would simply be adhering to its rules which are designed to promote

consistency and predictability in the CON process. Where, as here, a change in

CON applicant has occurred after the application has been deemed by the agency

to be complete, the application should be denied. See North Shore Medical

Center, Inc. v. Agency for Health Care Administration, 15 F.A.L.R. 4661 (AHCA

1993).

43. The facts developed at the evidentiary hearing conducted in this case

also establish that the applicant no longer holds the license to operate the

facility in question. Reasonable interpretation of and adherence to the

statutory and rule provisions applicable in this case require that only the

license holder of the existing facility be permitted to apply for and receive

the CON at issue. See, Brookwood-Jackson Convalescent Center v. Dept. of Health

and Rehabilitative Services, 591 So.2d 1083 (Fla. 1st DCA 1992).

44. Further the application at issue contains only Galen's letter of

intent, board resolution approving the proposed project and certifying that the

project would be completed, and audited financial statements. Therefore, the

agency properly takes the position that the Galen application is incomplete and

fails to meet unconditional statutory requirements. See, Sections

408.039(2)(c), and 408.037(3), Florida Statutes. See also Humhosco, Inc. v.

Dept. of Health and Rehabilitative Services, 561 So.2d 388 (Fla. 1st DCA 1990).

45. Based upon the forgoing findings and conclusions Galen's application

should be deemed incomplete, and its petition in this cause should be dismissed.

RECOMMENDATION

Based upon the foregoing Findings of Fact and Conclusions of Law, it is

RECOMMENDED that a summary final order be entered dismissing the Petition

for Formal Administrative Hearing filed by Galen of Florida, Inc., d/b/a

Westside Regional Medical Centers in this case.

DONE and ORDERED this 11th day of May 1994, in Tallahassee, Florida.

___________________________________

JAMES W. YORK, Hearing Officer

Division of Administrative Hearings

The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-1550

904/488-9675

FILED with the Clerk of the

Division of Administrative Hearings

this 11th day of May 1994.

ENDNOTES

1/ SBHD preserves its objection to the introduction of the subject transcript

during the final hearing on this matter in that, pursuant to Rule 1.330, Florida

Rules of Civil Procedure, Ms. Dudek's deposition, taken in connection with the

rule challenge proceeding (DOAH Case No. 94-0404RX), may not be admitted into

evidence in this proceeding against parties who were not represented or present

at the taking of the deposition, or who did not receive reasonable notice of the

taking of the deposition.

2/ Galen provided a board resolution with its letter of intent, approving the

proposed project and certifying that the project would be completed, that it

would be accomplished within the time allowed by law, and that Galen would

license and operate the facility.

3/ Rule 59C-1.008(1)(n), Florida Administrative Code, is the subject of a rule

challenge, filed by Galen, in DOAH Case No. 94-0404RX, a separate proceeding.

APPENDIX

Rulings on proposed findings of fact submitted by Galen of Florida, Inc.

1-5. Adopted, in substance, in paragraphs 1-5 of the order.

6. Proposed finding of fact is hereby accepted.

7-9. Adopted, in substance, in paragraphs 6-8 of the order.

10. Adopted in part in paragraph 9 of the order. Portions of this

proposed finding are conclusory and argumentative and therefore rejected.

11. Proposed finding of fact is hereby accepted

12-14. Adopted, in substance, in paragraphs 10-12 of the order.

15. Adopted in paragraph 26 of the order.

16. Rejected in part as conclusory and argument. The final sentence in

proposed finding of fact 16 is adopted in paragraph 27 of the order.

17-18. Proposed finding of fact 18 is hereby accepted.

19. Rejected as conclusory and argument. Ms. Dudek's testimony in this

regard is on the record and speaks for itself.

20. Rejected as argument.

Rulings on proposed findings of fact submitted by South Broward Hospital

District d/b/a Memorial Hospital West.

1-4. Adopted in paragraphs 16-19 of the order.

5. Adopted in paragraph 14 of the order.

6. Adopted in paragraph 13 of the order.

7. Adopted in paragraph 20 of the order.

8. Adopted in paragraph 15 of the order.

9-14. Adopted in paragraphs 21-26 of the order.

15-16. Adopted in paragraphs 28-29 of the order.

17. Proposed finding of fact 17 is hereby adopted.

18-23. Adopted in paragraphs 30-35 of the order.

Rulings on proposed findings of fact submitted by North Broward Hospital

District and the Agency for Health Care Administration

1-3. Proposed findings of fact 1-3 are hereby adopted.

4. Adopted in paragraph 1 of the order.

5-6. Proposed findings of fact 5 & 6 are hereby adopted.

7-8. Adopted, in substance, in paragraph 1 of the order.

9-10. Adopted, in substance, in paragraph 8 of the order.

11. Adopted, in substance, in paragraph 7 of the order.

12. Adopted, in substance, in paragraph 8 of the order.

13. Adopted, in substance, in paragraph 14 of the order and otherwise

hereby adopted.

14. Adopted in paragraph 26 of the order.

15. Proposed finding of fact 15 is hereby adopted.

16-18. Proposed finding of fact 15 is hereby adopted.

19. Proposed finding of fact 15 is hereby adopted.

20. Adopted, in substance, in paragraph 28 of the order.

21. Proposed finding of fact 21 is hereby adopted.

22. Rejected, not supported by the record.

23. Proposed finding of fact 23 is hereby adopted.

24. Is cumulative and not necessary to the conclusion reached.

25-27. Proposed findings of fact are hereby adopted.

COPIES FURNISHED:

Dean Bunton, Esquire

Senior Attorney

Agency for Health Care Administration

The Atrium, Suite 301

325 John Knox Road

Tallahassee, Florida 32303-4131

R. Terry Rigsby, Esquire

F. Philip Blank, Esquire

BLANK, RIGSBY & MEENAN

204 South Monroe Street

Tallahassee, Florida 32301

Clarke Walden, Esquire

Memorial Hospital

3501 Johnson Street

Hollywood, Florida 33021

Seann Frazier, Esquire

PANZA, MAURER, MAYNARD & NEEL, P.A.

3081 East Commercial Boulevard

Ft. Lauderdale, Florida 33308

Jay Adams, Esquire

418 East Virginia Street

Tallahassee, Florida 32301

Barbara Del Castillo, Esquire

CONRAD, SCHERER, JAMES & JENNE

Post Office Box 14723

Ft. Lauderdale, Florida 33302

James C. Hauser, Esquire

Lauchlin T. Waldoch, Esquire

MESSER, VICKERS, CAPARELLO, MADSEN,

LEWIS, GOLDMAN & METZ

Post Office Box 1876

Tallahassee, Florida 32301-1876

Sam Power, Agency Clerk

Agency for Health Care

Administration

The Atrium, Suite 301

325 John Knox Road

Tallahassee, Florida 32303

Harold D. Lewis, Esquire

Agency for Health Care

Administration

The Atrium, Suite 301

325 John Knox Road

Tallahassee, Florida 32303

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written exceptions to this Recommended

Order. All agencies allow each party at least 10 days in which to submit

written exceptions. Some agencies allow a larger period within which to submit

written exceptions. You should contact the agency that will issue the final

order in this case concerning agency rules on the deadline for filing exceptions

to this Recommended Order. Any exceptions to this Recommended Order should be

filed with the agency that will issue the final order in this case.