The issue for determination is whether Petitioner, OPI, is entitled to CON #5544, for a 60-bed adult short-term psychiatric hospital in Orange County, Florida, HRS District VII.No need for 60 short term psychiatric beds in district 7. Fixed need pool is 0, would impact existing providers and deplete limited manpower- not a novel program

Special unmet need demonstrated; CON approved under exception to the fixed pool formula per rule 10-5.011(j) FAC. CON issued for 5 ECF beds.

CON approval recommended. Petitioner met statutory criteria for expedited review.

The issue for determination is whether either applicant's request for a CON for IRTP beds should be granted. LORTC's allegation that La Amistad plagiarized portions of another PIA facility's CON application was deemed at hearing to be irrelevant. Likewise, it was determined at hearing and in a post- hearing order entered on November 1, 1988, that the sale of La Amistad to UHS of Maitland, Inc. had no material bearing on the La Amistad application under review here. In the parties' prehearing statement filed on September 26, 1988, the following were agreed: Consideration of the applications at issue is governed by the statutory criteria contained in section 381.705, Florida Statutes and Rule 10- 5.011(1)(b)(1)-(4), Florida Administrative Code. These criteria are either satisfied or are inapplicable: Section 381.705(1)(g), (h), (only as to the following clauses: "the effects the project will have on clinical needs of health professional training programs in the service district; the extent to which the services will be accessible to schools for health professions in the service district for training purposes if such services are available in a limited number of facilities"), (j), Florida Statutes (1987) As to LORTC, the parties stipulated that the criteria in Section 381.705(1)(h) as to availability of funds for capital and operating expenditures is satisfied. This is not a stipulation that the application satisfies the financial feasibility criterion contained in Section 381.705(1)(i). Rule 10-5.011(1)(b)(4)(b) , Florida Administrative Code. Each applicant argues that its application, and not that of the other, should be approved. HRS and West Lake both argue that neither application should be approved.Certificate Of Need (CON) for Intensive Rehabilitation Treatment Program beds denied. No need due to availability of alternatives to residential psychiatric services. Sale of facility does not void CON application

Humana Hospital Bennett seeks a certificate of need to establish a cardiac catheterization service at its facility in HRS District X, Broward County, Florida. Humana Bennett filed its certificate of need application in April 1987. The application was deemed complete by the Department of Health and Rehabilitative Services on July 6, 1988. The Department reviewed the application with one filed in the same batching cycle by the North Broward Hospital District, doing business as Imperial Point Medical Center (Imperial Point), which also sought a certificate of need for a cardiac catheterization service. The Department's review resulted in a State Agency Action Report dated September 11, 1987, stating that the Department intended to approve both applications. Hospitals in Broward County which were providers of cardiac catheterization services, North Ridge Medical Center (North Ridge), South Broward Hospital District (South Broward), and Florida Medical Center (FMC) requested formal administrative proceedings to challenge both approvals. The Department forwarded the requests to the Division of Administrative Hearings. Before final hearing, the parties reached an agreement on the application of Imperial Point which resulted in the withdrawal of the petitions challenging the initiation of catheterization services at Imperial Point; this permitted the Department's preliminary approval to become final on March 15, 1988. Plantation General Hospital intervened in the remaining proceeding challenging the application filed by Humana Bennett. The formal administrative hearing was conducted February 12, and 17, 1988, in Tallahassee, Florida. The witnesses for Humana Bennett were its administrator, Rex Etheredge, its chief financial officer James Cruickshank, and a planning consultant, Dennis Moser. The testimony of additional witnesses was offered through depositions.Certificate Of Need application for cardiac catheter denied for absense of a referral agreement for open heart surgery in the application.

Whether or not a certificate of need (CON) application for specialty hospital licensure as an Intensive Residential Treatment Program (IRTP) filed by Residential Treatment Center of the Palm Beaches, Inc. (RTCPB) should be approved by the Department of Health and Rehabilitative Services (HRS).Residential treatment centers were a new type or hybrid type of facility for Certificate of Needs at time this case was decided; application granted upon facts herein

Whether a Certificate of Need (CON) application for specialty hospital licensure as an Intensive Residential Treatment Program (IRTP) filed by Florida Residential Treatment Center (FRTC) should be approved by the Department of Health and Rehabilitative Services (HRS). Residential Treatment Center of the Palm Beaches, Inc. (RTCPB) and Community Hospital of the Palm Beaches, Inc., d/b/a Humana Hospital of the Palm Beaches (Humana) timely filed petitions requesting formal hearing pursuant to Section 120.57(1), F.S., and oppose HRS' intent to issue this CON. Organic Law and Legislative Background Due to recent statutory amendments, a new type of health care entity has emerged in Florida's Certificate of Need experience. This is the "Intensive Residential Treatment Program." (IRTP) An IRTP licensed pursuant to Chapter 395, F.S, is defined at Section 395.002(8), F.S. (1987), as: 'Intensive residential treatment programs for children and adolescents' means a specialty hospital accredited by the Joint Commission on Accreditation of Hospitals which provides 24-hour care and which has the primary functions of diagnosis and treatment of patients under the age of 18 having psychiatric disorders in order to restore such patients to an optimal level of functioning. An IRTP can be licensed under Section 395.003(2)(f), F.S. (1987), which provides: (f) Intensive residential treatment programs for children and adolescents which have received accreditation from the Joint Commission on Accreditation of Hospitals and which meet the minimum standards developed by rule of the department for such programs may be licensed by the department under this part. (Emphasis added). However, before a license can be issued, a CON must be obtained pursuant to Section 381.704(2), F.S. (1987). That statute provides in pertinent part, as follows: ...the department shall not issue a license to any health care facility, health care provider, hospice, or part of a health care facility which fails to receive a Certificate of Need for the licensed facility or service.Respondent's CON application for an IRTP for licensure as a specialty hospi- tal should be approved because it will best meet the needs of the district.

Petitioner's application for Certificate Of Need is denied based on a balanced consideration of all relevant criteria.

Petitioner, Holy Cross Hospital, Inc., contests the decision of the Respondent, Department of Health and Rehabilitative Services, to deny its application for a certificate of need to construct and operate an inpatient cardiac catheterization laboratory at its existing acute care hospital in Broward County, Florida. At hearing Petitioner called as witnesses: Elizabeth Dudek; Gerald Gayla; Joshua Nemzoff, accepted as an expert in financial feasibility analysis of health care projects and comparative review of hospital costs and charges; and, Michael Jernigan, accepted as an expert in health care planning. Petitioner's exhibits 1-31 were received into evidence. Respondent presented the testimony of Elizabeth Dudek which, with the agreement of the parties, was solicited by post hearing deposition. Ms. Dudek's deposition, together with exhibit 1 annexed thereto (the state agency action report), were received into evidence. Intervenor Zachariah P. Zachariah, M.D., an expert in cardiology and cardiac catheterizations, testified on his own behalf and called Howard Fagin, accepted as an expert in health planning, health care economics and operational analysis, as a witness. Zachariah's exhibits 1-4 were received into evidence. Intervenor North Ridge Medical Center called as witnesses: Rick Knapp, accepted as an expert in health care facility and health care system financial analysis, feasibility and reimbursement; and, Deborah J. Krueger; accepted as an expert in health planning. North Ridge's exhibits 2-10 were received into evidence.Notwithstanding numeric need application for cardiac catheter Certificate Of Need denied because not increase access or demonstrate financial feasibility.

Petitioner, St. Mary's, and Intervenor, BRCH contend that Rule 10- 5.011(1)(f), Florida Administrative Code, constitutes an invalid exercise of delegated legislative authority for the reasons more specifically set forth in St. Mary's Amended Petition for Administrative Determination of the Invalidity of a Rule. Respondent, HRS, and Intervenors, JFK, PBGMC, and Florida Hospital, contend that Rule 10-5.011(1)(f), Florida Administrative Code, constitutes a valid exercise of delegated legislative authority.Rule 10-5.011(1)(f) in house open heart surgery certificate of need is valid