Rule need for new home health agency only in one county. Application would serve under served Medicaid patients irrelevant to Medicare certified home need.

Agency reliance on unproven policy rather than rule method criteria, was not valid basis for denial of Certificate of Need to operate home health agency.

Whether Petitioner, Palm Beach-Martin County Medical Center, Inc.'s ("PBMC"), application for a certificate of need ("CON") to build a 60-bed inpatient rehabilitation hospital in Palm Beach County, Florida, should be approved, or denied (as proposed by Respondent, Department of Health and Rehabilitative Services ("HRS") in preliminary action.). By petition filed with HRS on August 1, 1984, PBMC invoked Section 120.57(1) remedies to contest DHRS' preliminary denial of its application for a CON authorizing establishment of an inpatient rehabilitation hospital at its medical campus in Jupiter, Florida, by converting 60 existing skilled nursing beds to comprehensive medical rehabilitation inpatient beds. On August 14, 1984, HRS forwarded this case to the Division of Administrative Hearings for assignment of a hearing officer to conduct the requested proceedings. Petitions to intervene for the purpose of contesting issuance of a CON to PBMC were subsequently filed by NME Hospitals, Inc. d/b/a Delray Rehabilitative Institute, Rehab Hospital Services Corporation, and University Rehabilitation Services, Inc. (collectively referred to a "NME"). Intervention was granted and final hearing was set for May 1-3, 1985. On PBMC's subsequent unopposed motion for continuance, hearing was reset for July 8-10, 1985; then, on Intervenor's unopposed motion, continued and reset for October 21-23, 1985. At final hearing on October 21-23, 1985, PBMC presented (in support of its application) the testimony of Dino Cagni, Frank Griffith, Richard Chidsey, M. D., Thomas Schultz, and Woodrin Grossman. Elizabeth Dudek testified on behalf of HRS. NME presented (in opposition to PBMC's application) the testimony of Mark Rottenberg, M. D., Jerry Ingran, Tom R. Futch, and Dan Sullivan. PBMC exhibit Nos. 1 thorugh 20, HRS exhibit nos. 1, 2A, and 2B, and NME exhibit nos. 1 thorugh 9 were received in evidence. The parties stipulated that the CON application at issue is governed by statutory criteria contained in Section 381.494(6)(c) and (d), Florida Statutes, except for Section 381.494(6)(c) and (13), which they agreed were either inapplicable or were satisfied by the PBMC application. They agreed that rule criteria in DHRS Rule 10-5.11(1)-(9), (11), (12), and (24), Florida Administrative Code, also applied. The transcript of hearing was filed on December 2, 1985. PBMC and NME filed post-hearing memoranda and proposed findings of fact and conclusions of law (including responses) by January 20, 1985--within the time agreed on at hearing. (Explicit rulings on their proposed findings are contained in the attached Appendix.) HRS filed no proposed findings or memorandum of law. Based on the evidence adduced at hearing, the following facts are determined.CON denied. Failed to show entitlement under statute & rule. DHRS showed no need for proposed rehab center & exceeding standard in state health plan.

Existing home health agency is meeting need for Medicare-certified home health. Need for Medicaid indigent patients was irrelevant. Final Order was reversed.

Certain adjustments to Petitioner's Medicaid cost report was allowed.

Certificate of Need (CON) issued. Need demonstrated for number of beds requested. District need exceeded number of beds requested.

American Medical International, Inc. (hereinafter referred to as "AMI"), filed an application for a certificate of need to construct a 175-bed acute care hospital to be located in Orange County, Florida. The application was denied by the Respondent, the Department of Health and Rehabilitative Services (hereinafter referred to as the "Department"). AMI timely requested a formal administrative hearing to review the Department's denial of its application. Winter Park Memorial Hospital (hereinafter referred to as "Winter Park") filed an application for a certificate of need to construct of a 100-bed acute care hospital in Orange County, Florida, which was also denied by the Department. Winter Park also timely requested a formal administrative hearing to review the Department's denial of its application. AMI's case, number 84-1819, and Winter Park's case, number 84-1872, were consolidated for comparative review by Order dated August 15, 1984. A third case, case number 84-1777, was also consolidated with these cases. On January 28, 1985, however, the Petitioner in case number 84-1777 voluntarily dismissed its case. Florida Hospital and Orlando General Hospital (hereinafter referred to as "OGH"), existing acute care hospitals in Orange County, Florida, and South Seminole Community Hospital, an existing acute care hospital in Seminole County, Florida, intervened in both cases. South Seminole Community Hospital took no part in the hearing of these cases. Subsequent to the filing of its Petition for Formal Administrative Hearing, AMI amended its application from a request for a 175-bed hospital to a request for a 100-bed hospital. Attached to this Recommended Order and incorporated herein is a list of the witnesses who testified on behalf of the parties at the final hearing of these cases and the areas of expertise, if any, they were accepted in. In addition to the witnesses who testified on behalf of the parties, six individuals testified as "public witnesses" during the proceedings. The names of those witnesses are also included on the list of witnesses as "public witnesses." The following exhibits were accepted into evidence: AMI Exhibits 1-28 and 30-34; Winter Park Exhibits 1-14; Florida Hospital Exhibits 1-2, 4-12 and 14; and OGH Exhibits 1-5. Written evidence presented at the hearing by public witnesses are identified as "Public Exhibits". Following the completion of the hearing of these cases, Florida Hospital filed a Notice of Supplementing the Record in which it requested that certain documents be accepted into evidence or, in the alternative, that official recognition be taken of one of those documents. The Department and OGH both filed a Notice of Joinder in Motion and Notice of No Objection. Winter Park and AMI objected to the request. After due consideration of the request, Florida Hospital's request is denied. The documents "in question will not be received into evidence. Nor will any of the documents be officially recognized. Official recognition of the following laws was taken during the hearing: Portions of the Internal Revenue Code of 1954, as amended, and the Treasury Regulations, pertaining to tax-exempt organizations; and, statutes, rules and regulations pertaining to developments of regional impact. All of the parties participating in the hearing submitted proposed findings of fact pursuant to Section 120.57(1)(b)4, Florida Statutes (1984 Suppl.). OGH has also filed a Memorandum in Support of Proposed Findings of Fact, Conclusions of Law and Proposed Final Order of Intervenor, Orlando General Hospital. A ruling on each proposed finding of fact has been made either directly or indirectly in this Recommended Order, except where such proposed findings of fact have been rejected as subordinate, cumulative, immaterial or unnecessary.Comparative review of acute care hospital Certificate of Need (CON) applications for Orange County. No numeric need proven. Subdistricting not authorized.

State worker was credited with too much leave time. Neither limitation, laches nor estoppel bar corrected account despite time. No credits used.

The issues concern the issue in challenge to Proposed Rule 10C-3.60, based upon the theory that this proposed rule is an invalid exercise of delegated legislative authority. It is further alleged that Respondent, State of Florida, Department of Health and Rehabilitative Services, has acted in an arbitrary, capricious and unreasonable manner in the promulgation of the subject rule. It is alleged that the proposed rule illegally conflicts with the Federal Law, 7 CFR, Section 273.22(f)(3). It is alleged that the proposed rule in one of its sections is in violation of Section 120.54, Florida Statutes, and is unconstitutional in that it allows the automatic amendment of the rule without the benefit of rule-making by the agency, based upon future changes that may occur in the federal law. Finally, it is alleged that the proposed rule violates Rule 1S-1.005, Florida Administrative Code, by purporting to incorporate, by reference, materials not filed with the Secretary of State.Petitioners failed to show standing to challenge proposed rule--no specific, real and immediate harm to them was demonstrated.

Deny application because city zoning ordinance won't allow a night club on the proposed site and zoning ordinance upheld in circuit court.