STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
PALM BEACH HEALTHCARE, LTD., ) d/b/a CONVALESCENT NURSING ) CENTER OF PALM BEACH COUNTY, )
)
Petitioner, )
)
vs. ) CASE NO. 87-0704
)
DEPARTMENT OF HEALTH AND )
REHABILITATIVE SERVICES, )
)
Respondent. )
)
RECOMMENDED ORDER
Pursuant to notice, the Division of Administrative Hearings, by its duly designated Hearing Officer, W. Matthew Stevenson, held a formal hearing in this cause on December 17, 1987, in Tallahassee, Florida. The following appearances were entered:
APPEARANCES
For Petitioner: R. Terry Rigsby
325 John Knox Road Building C, Suite 135 Tallahassee, Florida 32303
For Respondent: Richard A. Patterson, Esquire
Fort Knox Executive Center 2727 Mahan Drive, Suite 309
Tallahassee, Florida 32308 PROCEDURAL BACKGROUND
These proceedings result from the Department of Health and Rehabilitative Services' ("DHRS") denial of the Applications for Certificates of Need ("CON") to construct community nursing
home beds submitted by Forum Group, Inc., sponsor of Retirement Living of Palm Beach County ("Forum"); Palm Beach Healthcare, Ltd., d/b/a Convalescent Nursing Center of Palm Beach County; and Radice Care, Inc. Prior to the formal hearing, Palm Beach Healthcare and Radice Care each voluntarily dismissed from this case.
At the final hearing, Forum presented the testimony of the following witnesses: David L. Warner, accepted as an expert in health care planning, need analysis and health care finance; Gene Nelson, accepted as an expert in health care planning and need analysis; and Donald Craig, accepted as an expert in health care planning and nursing home development. Petitioner's Exhibits 1 through 8 were duly offered and received into evidence. DHRS presented the
testimony of Elizabeth Dudek, who was accepted as an expert in health care and planning and Florida CON review. Respondent's Exhibit 2 was duly offered and received into evidence.
The parties have submitted post-hearing Proposed Findings of Fact. A ruling on each proposed finding of fact has been made in the Appendix in this Recommended Order.
FINDINGS OF FACT
Based upon my observation of the witnesses and their demeanor while testifying, the documentary evidence received, the stipulations of the parties and the entire record complied herein, I hereby make the following findings of fact:
THE STIPULATIONS OF THE PARTIES
The parties stipulated to the following facts: Forum timely filed its letter of intent and application with DHRS and the District IX Local Health Council for the July 1986 batching cycle. DHRS ultimately deemed the application complete and, following review, published its notice of intent to deny the application. Forum timely filed a petition requesting a formal administrative hearing pursuant to Section 120.57(1), Florida Statutes. The sole issue is whether there is a need for Forum's proposed services; additionally, it is DHRS's position that a lack of need for the project results in the project not being financially feasible in the short or long term. All other statutory and rule criteria were satisfied, at least minimally, except proof of need pursuant to Rule 10-5.011(1)(k) [formerly 10-5.11(21)(b)], Florida Administrative Code, and financial feasibility as it relates to need.
FORUM'S PROPOSAL
Forum is a publicly held health services company which owns, develops and operates retirement living centers and nursing homes on a national basis.
Forum proposes to develop a retirement living center in Palm Beach County that would consist of 120 to 150 apartment units for independent living, a separate personal care unit (known in Florida as an adult congregate living facility), and a 60-bed nursing home component certified for skilled and intermediate care. Palm Beach County is in HRS Service District IX, Subdistrict 4.
All three components of Forum's retirement living center would be physically connected and share some operational functions, such as dietary facilities and the heating plant. Such a design provides for an efficient operation as well as an economic distribution of costs facility wide.
No specific site has been selected , although Forum has narrowed its focus to the eastern half of Palm Beach County. It is not economically feasible to acquire property or pay for an option on property until after receiving CON approval.
The projected total cost of Forum's proposed 60-bed nursing home is
$2,329,800. Forum has the necessary resources for project accomplishment and operation.
Forum proposes to seek Medicare certification and will provide up to 25 of its beds for Medicaid patients.
FINANCIAL FEASIBILITY
Forum is a national company, with substantial experience in developing and operating nursing homes and retirement living centers. If need for the facility is shown, Forum would be able to capture a sufficient share of the nursing home market to render its proposed nursing home financially feasible while at the same time having no material negative impact on existing providers in the district.
NUMERIC NEED
Need for new or additional community nursing home beds in Florida is determined, preliminarily, by use of the methodology found in Rule 10- 5.011(1)(k), Florida Administrative Code. Additional beds normally are not approved if there is no need for beds as calculated under the rule. Pursuant to the rule, need for a defined nursing home subdivision is projected to a three- year planning horizon, in this case July 1989.
The need methodology prescribed in the rule is as follows:
A (POPA x BA) + (POPB x BB) or:
The District's age-adjusted number of community nursing home beds for the review cycle for which a projection is being made [A] (The population age 65-74 years in the relevant departmental districts projected three years into the future [POPA] x the estimated current bed rate for the population age 65-74 years in the relevant district [BA]) + (The population age 75 years and older in the relevant departmental district projected three years into the future [POPB] x the estimated current bed rate for the population age 75 years and over in the relevant district [BB].)
BA LB/(POPC) + (6 x POPD) or:
The estimated current bed rate for the population age 65-74 years in the relevant district [BA] (The number of licensed community nursing home beds in the relevant district [LB]/the current population age 65-74 years [POPC] + (6 x the current population age 75 years and over [POPD])
BB 6 x BA or:
The estimated current bed rate for the population age 75 years and over in the relevant district [BB] 6 x the estimated current bed rate for the population age 65-74 years in the relevant district [BA].
SA A x (LBD/LB) x (OR/.90) or:
The preliminary subdivision allocation of community nursing home beds [SA] The district's age-adjusted number of community nursing home bids for the review cycle for which a projection is being made [A] x (The number of licensed community nursing home beds in the relevant subdistrict [LBD]/the number of licensed community nursing home beds in the relevant district [LB]) x (The average occupancy rate for all licensed community nursing homes within the subdistrict of the relevant district [OR]/.90)
Rule 10-5.011(1)(k)(2)(i), Florida Administrative Code, provides that:
The new bed allocation for a subdistrict, which is the number of beds available for CON approval, is determined by subtracting the total number of licensed and 90 percent of the approved beds within the relevant
departmental subdistrict from the bed allocation determined under subparagraphs a. through i., unless the subdistrict's average estimated occupancy rate for the most recent six months is less than 80 percent, in which case the net bed allocation is zero.
The appropriate planning horizon for the instant case is July 1989, corresponding to the review cycle which began July 15, 1986, and the subdistrict is Palm Beach County.
THE NUMBER OF LICENSED COMMUNITY NURSING HOME BEDS IN THE RELEVANT DISTRICT (LB)/THE NUMBER OF LICENSED COMMUNITY NURSING HOME BEDS IN THE RELEVANT SUBDISTRICT (LBD)
Rule 10-5.011(1)(k) requires that "review of applications submitted for the July batching cycle shall be based upon the number of licensed beds (LB and LBD) as of June 1 preceding this cycle..."
On June 1, 1986, there were 5,459 licensed community nursing home beds in District XI (LB) and 4,084 licensed community nursing home beds in subdistrict 4 (Palm Beach County LBD). These figures include 220 licensed beds that were previously categorized as sheltered.
In the instant case, the appropriate figure for LB is 5,459, and the appropriate figure for LBD is 4,084.
APPROVED BEDS WITHIN THE RELEVANT DEPARTMENTAL SUBDISTRICT
DHRS's interpretation of the rule is to include in the count of approved beds, those approved up to the date of the supervisor's signature on the State Agency Action Report (SAAR). In this case, there were 640 approved beds in Palm Beach County at that time.
As of June 1, 1986, the same date as the licensed bed cutoff, there were 640 approved beds in the subdistrict. In Dr. Warner's opinion, approved beds should be determined as of the same time period as licensed beds in order to have consistency and avoid anomalies in the formula. This opinion is reasonable and appropriate.
In the instant case, the figure to be applied in the formula for approved beds in the subdistrict is 640 approved beds.
THE POPULATION AGE 65-79 YEARS IN THE RELEVANT DEPARTMENTAL DISTRICT PROJECTED THREE YEARS INTO THE FUTURE (POPA). THE POPULATION AGE 75 YEARS AND OVER IN THE RELEVANT DEPARTMENTAL
DISTRICT PROJECTED THREE YEARS INTO THE FUTURE (POPB).
The rule provides that the three year projections of population shall be based upon the official estimates and projections adopted by the Office of
the Governor. For the purposes of calculating need, DHRS utilizes at the final hearing the figures for estimated population obtained from data available at the time of initial application and review. The set of population projections which were available when Petitioner's application was filed and reviewed were those published on July 1, 1986. Based on this data, which is reasonable to use, POPA 170,639; and, POPB 122,577.
THE CURRENT POPULATION AGE 65-74 YEARS (POPC)/THE CURRENT POPULATION AGE 75 YEARS AND OVER (POPD).
In calculating POPC and POPD, DHRS also utilizes at final hearing the most current data available at the time of initial application and review, in this case the July 1, 1986, release. Based on that data, POPC 153,005 and POPD 112,894.
In the opinion of Dr. Warner, Forum's expert, the base for POPC and POPD should correspond to the period for which the average occupancy rate (OR) is calculated. For the July batching cycle, OR is based upon the occupancy rates of licensed facilities for the months of October through March preceding that cycle. According to Warner, January 1, 1986, as the midpoint of this time period, is the appropriate date to derive POPC and POPD in this case.
The formula mandated by the rule methodology for calculating the estimated current bed rate requires that the "current population" for the two age groups be utilized. It is reasonable and appropriate for the base for POPC and POPD to correspond to the period for which the average occupancy rate is calculated.
Supportive of Dr. Warner's opinion are the past practices of DHRS. Between December 1984 and December 1986, DHRS routinely used a three and one half year spread between the base population period and the horizon date in determining "current population" in its semiannual nursing home census report and bed need allocation. In the January 1987 batching cycle, which cycle immediately followed the cycle at issue in this case, DHRS utilized a three and one half year spread between the base population period and the horizon data for "current population" when it awarded beds. DHRS offered In this case, it proposed to use a three year spread between the base population period and the horizon dated for "current population" in calculating POPC and POPD. Using the July 1986 population release, POPC for January 1986 is 149,821 and POPD for January 1986 is 98,933.
THE AVERAGE OCCUPANCY RATE FOR ALL LICENSED COMMUNITY NURSING HOMES WITHIN THE SUBDIVISION OF THE RELEVANT DISTRICT (OR).
The rule requires the use of occupancy data from the HRS Office of Health Planning and Development for the months of the previous October through March when calculating a July batch of nursing home applicants. However, the rule is not instructive as to how one calculates this number. In this case, DHRS computed average occupancy rates based on the existing occupancy rates at applicable facilities on the first day of each month. Based on this occupancy data, which includes the data for the 220 previously sheltered beds in the subdistrict, occupancy rates for the July 1986 batch of Palm Beach County nursing home applicants is 83.75 percent.
Forum's witness, Dr. Warner, determined that the correct occupancy rate was 85.46 percent for Palm Beach County for the period October 1985 to March 1986. Dr. Warner arrived at this figure by including paid reservation
days. A paid reservation day is a day which is paid for by the patient or the patient's intermediary during which the patient is not physically in the bed. Typically, the patient will either be in the hospital, visiting relatives or otherwise away from the facility and will continue to pay for the nursing home bed, so that they will be able to return and not have someone occupy the bed.
One of the goals and objectives of the District IX Local Health Plan is that paid reservation days be considered when bed need calculations are made. Calculating prepaid reservation days is consistent with the Rule because such beds are no longer available to the public and are therefore in use. Dr. Warner determined that during the applicable period, 1.25 percent of the licensed beds in the subdistrict were paid reservation days.
Although taking paid reservation days into account would not be inconsistent with the rule, Forum failed to demonstrate that the 1.25 percent figure arrived at is valid for the applicable period, i.e., October 1985 to March 1986. Dr. Warner merely calculated a two-year average number of paid reservation days, broke this figure down to a six-month average and applied this average to the six-month period specified in the Rule.
Gene Nelson, an expert called on behalf of Forum, calculated the occupancy rate as 88.72 percent in Palm Beach County for the appropriate period called for in the Rule. Nelson used the average monthly occupancy data obtained from medicaid cost reports for some facilities rather than first-day of the month data as used by DHRS. In addition, Nelson did not factor in the occupancy date of licensed beds in the extreme western portion of the County based on his belief that the District IX Local Health Plan mandates that the western area not be considered in any way with the eastern coast section of Palm Beach County for purposes of determining competitiveness.
While the use of average full-month occupancy data is generally more reliable than using first-day of the month data, it is best, from a health planning prospective, to be able to use either all full-month data or all first- day of the month data. In making his calculations, Mr. Nelson mixed the two types of data, using full-month data when available and in other cases using first-day of the month data when full-month data was not available.
It is inappropriate to fail to consider licensed beds in the extreme western portion of the County based solely on the local health plan. Among other reasons, the rule does not provide for exclusions for any of the subdistricts licensed facilities from the methodology.
The appropriate and most reasonable occupancy rate (OR) in the instant case for the applicable time period is 83.75 percent.
NET NEED
Applying the above-referenced variables to the Rule formula produces the following results.
July, 1986. District Allocation
BA LB (POPC + (6 x POPD)
- 5459 [149,821 + (6 x 98,833)]
- .007349
BB - 6 x BA .044094
(.007349)
July, 1989 Allocation
(POPA x BA) + (POPB x BB)
- (170,639 x .007349) + (122,577 x .044094)
- 6659
Subdivision Allocation and Need SA A x (LBD / LB) x (OR 1.9)
- 6659 x (4084 / 5459) x (.8375/.9)
- 6659 x .74812236673 x .93055555555
4636
Subdistrict Allocation for Palm Beach County
4084 (Licensed Beds)
576 (90 percent of 640 Approved Beds)
-24 (Bed Surplus)
CONCLUSIONS OF LAW
The Division of Administrative Hearings has jurisdiction over the parties to, and the subject matter of, these proceedings. Section 120.57(1), Florida Statutes.
The Petitioner bears the burden of establishing entitlement to the CON it seeks. Boca Raton Artificial Kidney Center, Inc. vs. Department of Health and Rehabilitative Services, 475 So.2d 260 (Fla. 1st DCA 1985), and Florida Department of Transportation vs. J.W.C. Company, 396 So.2d 788 (Fla. 1st DCA 1981).
Section 381.705, Florida Statutes (1987), and Rule 10-5.011(k), Florida Administrative Code, establish the criteria which must be considered in evaluating applications for a certificate of need. Balsam vs. Department of Health and Rehabilitative Services, 486 So.2d 1341 (Fla. 1st DCA 1986), and Department of Health and Rehabilitative Services vs. Johnson and Johnson Home Health Care, Inc. 447 So.2d 361 (Fla. 1st DCA 1984). The appropriate weight to be given the individual criteria, and the consequent balancing of the criteria will vary, however, depending on the facts and circumstances of the case Collier Medical Center Inc. vs. Department of Health and Rehabilitative Services, 462 So.2d 83 (Fla. 1st DCA 1985).
Proceedings pursuant to Section 120.57(1), Florida Statutes, are de novo in nature and are intended to formulate final agency Section, "not to review action taken earlier and preliminarily." McDonald vs. Department of Banking and Finance, 346 So.2d 569 (Fla. 1st DCA 1977). Non-rule policy must be clearly explicated by the agency seeking to rely on it. Non-rule policy does not enjoy the presumption of validity which is afforded formally promulgated Rules. Barker vs. Board of Medical Examiners, 346 So.2d 569 (Fla. 1st DCA 1977).
Based upon the totality of the record, as heretofore set forth, the Petitioner has failed to demonstrate that there is need for an additional 60
nursing home beds in Palm Beach County. Since there is no need for Petitioner's proposed project, financial feasibility has not been shown.
Based on the foregoing Findings of Fact, and Conclusions of Law, it is, RECOMMENDED that the application for certificate of need filed by Forum be
Denied.
DONE AND ORDERED, this 4th day of April, 1988, in Tallahassee, Florida.
W. MATTHEW STEVENSON Hearing Officer
Division of Administrative Hearings The Oakland Building
2009 Apalachee Parkway
Tallahassee, Florida 32399-1550
(904) 488-9675
Filed with the Clerk of the Division of Administrative Hearings this 4th day of April, 1988.
APPENDIX TO RECOMMENDED ORDER, CASE NO. 87-0704
The following constitutes my specific rulings pursuant to Section 120.59(2), Florida Statutes, on all of the Proposed Findings of Fact submitted by the parties to this case.
Rulings on Proposed Findings of Fact Submitted by the Petitioner
Adopted in substance in Finding of Fact 2.
Adopted in substance in Finding of Fact 3.
Adopted in substance in Finding of Fact 4.
Adopted in substance in Finding of Fact 5.
Adopted in substance in Finding of Fact 5.
Adopted in substance in Finding of Fact 6.
Adopted in substance in Finding of Fact 6.
Adopted in substance in Finding of Fact 7.
Adopted in substance in Finding of Fact 9. Sentence 1 is rejected as contrary to the weight of the evidence.
Rejected as subordinate and/or unnecessary.
11. Adopted | in | substance | in | Finding | of | Fact | 9. |
12. Adopted | in | substance | in | Finding | of | Fact | 9. |
13. Adopted | in | substance | in | Finding | of | Fact | 10. |
14. Adopted | in | substance | in | Finding | of | Fact | 12. |
15. Adopted | in | substance | in | Finding | of | Fact | 1. |
16. Adopted | in | substance | in | Finding | of | Fact | 14. |
17. Adopted | in | substance | in | Finding | of | Fact | 21. |
18. Adopted | in | substance | in | Finding | of | Fact | 20. |
19. Adopted | in | substance | in | Finding | of | Fact | 22. |
20. Adopted | in | substance | in | Finding | of | Fact | 22. |
21. Adopted | in | substance | in | Finding | of | Fact | 18. |
Adopted in substance in Finding of Fact 15.
Adopted in substance in Finding of Fact 17.
Adopted in substance in Finding of Fact 17.
Adopted in substance in Finding of Fact 23.
Rejected as a recitation of testimony and/or unnecessary.
Rejected as subordinate and/or unnecessary.
Adopted in substance in Finding of Fact 24.
Rejected as a recitation of testimony and/or unnecessary.
Adopted in substance in Finding of Fact 25.
Rejected as a recitation of testimony and/or subordinate.
Adopted in substance in Finding of Fact 25.
Adopted in substance in Finding of Fact 21.
Rejected as contrary to the weight of the evidence.
Rejected as not supported by the weight of the evidence and/or unnecessary.
Rejected as subordinate and/or unnecessary.
Rejected as subordinate and/or unnecessary.
Adopted in substance in Finding of Fact 27.
Adopted in substance in Finding of Fact 28.
Adopted in substance in Finding of Fact 27.
Adopted in substance in Finding of Fact 28.
Rejected as a recitation of testimony and/or subordinate.
Rejected as misleading and/or subordinate.
Rejected as subordinate and/or unnecessary.
Rejected as contrary to the weight of the evidence.
Rejected as contrary to the weight of the evidence.
Rulings on Proposed Findings of Fact Submitted by the Respondent
Adopted in substance in Finding of Fact 1.
Adopted in substance in Finding of Fact 1.
Adopted in substance in Finding of Fact 9.
Adopted in substance in Finding of Fact 3.
Rejected as contrary to the weight of evidence.
Adopted in substance in Finding of Fact 13.
Adopted in substance in Finding of Fact 18 and 19.
Adopted in substance in Finding of Fact 16.
Adopted in substance in Finding of Fact 23.
Addressed in Conclusions of Law.
Addressed in Conclusions of Law.
Rejected as subordinate and/or unnecessary.
COPIES FURNISHED:
Thomas W. Stahl, Esquire
102 South Monroe Street Tallahassee, Florida 32301
R. Terry Rigsby, Esquire
325 John Knox Road Building C, Suite 135 Tallahassee, Florida 32303
Richard Patterson, Esquire Department of Health
and Rehabilitative Services 2727 Mahan Drive
Tallahassee, Florida 32308
Gregory L. Coler Secretary
Department of Health
and Rehabilitative Services 1323 Winewood Blvd.
Tallahassee, Florida 32399-0700
John Miller, Esquire Department of Health
and Rehabilitative Services 1323 Winewood Blvd.
Tallahassee, Florida 32399-0700
Sam Power HRS Clerk
Department of Health and Rehabilitative Services
1323 Winewood Blvd.
Tallahassee, Florida 32399-0700
=================================================================
AGENCY FINAL ORDER
=================================================================
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
FORUM-GROUP, INC.,
(Palm Beach County),
Petitioner, CASE NO.: 87-0704 CON NO.: 4764
vs.
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES,
Respondent.
/
FINAL ORDER
This cause came on before me for the purpose issuing a final agency order. The Hearing Officer assigned by the Division of Administrative Hearings (DOAH)
in the above-styled case submitted a Recommended Order to the Department of Health and Rehabilitative Services (HRS). A copy of that Recommended Order is attached hereto
RULING ON EXCEPTIONS FILED BY HRS
HRS takes exception to that portion of paragraph 7 of the findings of fact wherein the Hearing Officer found as fact that Florida Administrative Code Rule 10-5.011(1)(k) requires determination of approved beds as of the same date as licensed beds, on the grounds that it is an incorrect conclusion of law. Exception number one (1) is granted. The department's interpretation of the rule is contained in numerous Final Order of the department and has been affirmed by the First District 5 Court of Appeal. See Broward Healthcare, Ltd. vs. HRS, 9 FALR 1973 (March 31, 1987), affirmed, So2d (Fla. 1st DCA Case No. BT-258, opinion filed January 21, 1988). Section 120.57(1)(b)10, Florida Statutes (1987) provides that an agency ay reject a Hearing Officer's interpretation of a rule.
HRS takes exception to that portion of paragraph 1 of the findings of fact wherein the Hearing Officer concludes that Florida Administrative Code Rule 10-5.011(1)(k) requires use population variables for a date six months prior to the application date for "current population." Current means the rate of the batching cycle, here July 1986. The Hearing officer's conclusion is rejected as there is no language in the Rule which supports use of a date earlier than the application catching cycle date. Exception number two (2) is granted.
HRS takes exception to paragraph 22 of the bindings of fact wherein the Hearing Officer found that HRS used three and one half year spread between the base population period and the horizon date in determining "current population," HRS interprets "current population" as set forth in the ruling on exception number two (2); therefore, exception number three (3) is granted. Although the HRS semiannual nursing home census reports utilized such a "spread," the department has not utilized 7 such a spread in any case prior to the January 1987 batch during either initial review or at hearing. Those reports do not conform to the requirements of the ethodo1ogy and are not intended to be published fixed need pools of beds as is now provided for in current rules. The cover letter to each report confirms those facts. HRS uses the three year planning horizon required pursuant to Florida Administrative Code Rule 10- 5.011(1)(k)2.
HRS takes exception to that portion of paragraph 25 of the findings of fact wherein the Hearing Officer found as a fact that "Calculating prepaid reservation days is consistent with the Rule because such beds are no longer available to the public and are therefore in use, "This is rejected as an incorrect conclusion of law. Such a calculation is inconsistent with the rule because the rule does not allow for any deletion of licensed nursing home beds, or the occupancy thereof, in the determination of need. Therefore, exception number four (4) is granted.
HRS takes exception to those portions of paragraph 30 of the findings of fact which were calculated by interpreting the methodology inconsistent with the HRS interpretation as set forth in the ruling on exception number two (2). Exception number five (5) is granted.
RULING ON EXCEPTION FILED BY FORUM
Forum excepts to the finding of fact in paragraph 23 relating to the correct occupancy figure. The finding is supported by competent, substantial evidence; therefore, exception number one (1) is denied. Heifetz vs. Department of Business Regulation, 475 So2d 1277 at 1281 (Fla. 1st DCA 1985).
Forum takes exception to finding of fact number 26. The finding is supported by competent, substantial evidence; therefore, exception number one
(1) is denied.
Forum takes exception to finding of fact number 28. The finding is supported by competent, substantial evidence; therefore, exception number one
(1) is denied.
Forum takes exception to finding of fact in paragraph 29. The finding is supported by competent, substantial evidence; therefore, exception number one
(1) is denied.
FINDINGS OF FACT
The Department hereby adopts and incorporates by deference the findings of fact set forth in the Recommended Order except where conclusions of law are stated which are inconsistent with the ruling on exceptions.
CONCLUSIONS OF LAW
The Department hereby adopts and incorporates by reference the conclusions of law set forth in the Recommended Drder except where inconsistent with the rulings on the exceptions. When the numeric need rule is correctly interpreted, there is no numeric need for Forum's proposed nursing home facility. Based on a balanced weighing of all applicable rule and statutory criteria, I conclude that the application should be denied.
Based upon the foregoing, it is
ORDERED, that application for certificate of need number 4764 by Forum be denied.
DONE and ORDERED this 2nd day of May, 1988, in Tallahassee, Florida.
Gregory L. Cole Secretary
Department of Health and Rehabilitative Services
by Assistant Secretary for Programs
Copies furnished to:
Larry Rigsby, Esquire RIGSBY & HOLDER
325 John Knob Road Suite C135
Tallahassee, Florida 32303
Richard Patterson, Esquire Assistant General Counsel Department of Health and
Rehabilitative Services 2727 Mahan Drive
Fort Knox Executive Center Tallahassee, Florida 32308
Matthew Stevenson Hearing Officer
Division of Administrative Hearings The Oakland Building
2009 Apalachee Parkway
Tallahassee, Florida 32301
Theodore Mack, Esquire Assistant General Counsel Department of Health and Rehabilitative Services 2727 Mahan Drive
Fort Knox Executive Center Tallahassee, Florida 32308
FALR
Post Office Box 385 Gainesville, Florida 32602
Nell Mitchem (PDDR)
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a copy of the foregoing was sent to the above-named people by U.S. Mail this 6th day of May, 1988.
R. S. Power, Agency Clerk Assistant General Counsel Department of Health and Rehabilitative Services 1323 Winewood Boulevard Building One, Room 407
Tallahassee, Florida 32399-0700 904/488-2381
NOTICE OF RIGHT TO JUDICIAL REVIEW
A party who is adversely affected by this final order is entitled to judicial review which shall be instituted by filing one copy of a Notice of Appeal with the agency clerk of HRS, and a second copy, along with filing fee as prescribed by law, with the District Court of Appeal in the Appellate District where the agency maintains its headquarters or where a party resides. Review proceedings shall be conducted in accordance with the Florida Appellate Rules.
The Notice of Appeal must be filed within 30 days of rendition of the order to be reviewed.
| Issue Date | Proceedings |
|---|---|
| Apr. 01, 1988 | Recommended Order (hearing held , 2013). CASE CLOSED. |
| Issue Date | Document | Summary |
|---|---|---|
| May 02, 1988 | Agency Final Order | |
| Apr. 01, 1988 | Recommended Order | Petitioner 's Certificate Of Need application is denied because it failed to demonstrate that there is a need for an additional 60 nursing home beds in Palm Beach County. |
