IZ30-49 STATE OF FLORIDA Hoty AGENCY FOR HEALTH CARE ADMINISTRATION * * ~~ i 1 Pog 69 SUNRISE COMMUNITY, INC., ‘ CASE NO.: 96-4608 ae Petitioner, 98-4349 Bar 2 RK 98-4942 vs. RENDITION NO.: AHCA-00-€55 -FOF-MDR —— j STATE OF FLORIDA, AGENCY FOR JD P-clos ec] HEALTH CARE ADMINISTRATION, % A , BE, Respondent. AT @ AAS. / : FINAL ORDER This cause was referred to the Division of Administrative Hearings for a formal administrative hearing. The assigned Administrative Law Judge (“ALJ”) has submitted a Recommended Order to the Agency for Health Care Administration (“AGENCY). The Recommended Order of December 30, 1999, entered herein is incorporated by reference. RULING ON EXCEPTIONS Sunrise is a Medicaid provider of residential services to persons with severe developmental disabilities. Sunrise was the prevailing party at the First District Court of Appeal in a rate dispute case dating back to August 1995. The Court found that the agency incorrectly denied Sunrise’s request for interim increases to its Medicaid per diem rate. Sunrise Community, Inc. vs. Agency for Health Care Administration, 704 So.2d 1135 (First DCA 1998). This proceeding was initiated by Sunrise based on the inability of Sunrise and the Agency to agree on whether certain costs claimed in the interim rate requests were allowable. After a two day hearing, the ALJ resolved the remaining disputed fact issues in a Recommended Order in which the ALJ concluded that certain costs claimed by Sunrise were allowable and others were not allowable. By exceptions filed January 14, 2000 counsel for Sunrise excepts to those findings and conclusions of the ALJ that were not favorable to Sunrise. Counsel alleges in paragraph 6 of the exceptions that the ALJ ignored, overlooked, or wholly misconstrued the evidence regarding findings adverse to Sunrise. In the exceptions Sunrise reiterates its factual and legal position already rejected in part by the ALJ. At this level of review the agency has no authority to reweigh the evidence. dHeifetz_ vs. Department _of Business Requlation, 475 So.2d 1277, 1281 (Fla. 1st DCA 1985). The agency does have the authority to reject or modify the conclusions of law over which it has substantive jurisdiction. Section 120.57(1)(1), Florida Statutes (1999). ' . Sunrise did not prevail in the Recommended Order on two issues: one, costs claimed for attorney’s fees for representing Sunrise in the litigation resulting in the First District Court of Appeal’s decision in Sunrise, supra.; and two, costs claimed for interest on the amount owed to Sunrise for Medicaid reimbursement after it prevailed in the District Court of Appeal. Specifically as to the first issue, Sunrise excepts to findings of fact in paragraphs 32, 33 and 45 regarding whether the costs claimed for attorney’s fees were allowable as claimed by Sunrise. Counsel represented Sunrise under a contingency fee contract. In the words of the ALJ “(petitioner represented no credible evidence of the reasonable fee for representation in this type of proceeding”. See paragraph 32 of the Recommended Order. Additionally, no fee could be said to have been incurred until Sunrise prevailed in the District -2- t Court of Appeal opinion of January 27, 1998; long after the time periods in ‘which Sunrise claimed the costs. Under the Medicaid plan costs are allowable only in the period when they are incurred. See paragraph 45 of the Recommended Order. The challenged findings of fact are supported by competent, substantial evidence; therefore, the exceptions are denied. The exceptions to the related conclusions of law are denied. As to the second issue, Sunrise excepts to findings of fact in paragraph 22, 23, 24, and 43 on the issue of whether interest on the amounts due Sunrise as a result of its successful appeal is an allowable cost. As to the weight of the evidence, the ALJ found that Sunrise failed to establish by credible evidence that factually it was entitled to the claimed cost. Sunrise’s evidence was characterized by the ALJ as speculative and not persuasive. See paragraphs 24 and 43 of the Recommended Order. The challenged findings of fact are supported by competent, substantial evidence; therefore, the exceptions are denied. The exceptions to the related conclusions of law are denied. Sunrise excepts to the ALJ’s “failure to address” alleged violations of federal law. This exception lacks merit and is accordingly denied. See generally Florida Pharmacy Association vs. Cook, 17 F.Supp2d 1293, 1303 (N.D. Fla. 1998). Sunrise maintains that the ALJ violated Florida’s Administrative Procedure Act by not addressing its proposed findings of fact and conclusions of law. This exception lacks merit and is denied. Life Care Centers vs. Agency for Health Care Administration and Sawgrass Care Center, 683 So.2d 609, 612 - 614 (Fla. 1st DCA 1996). FINDINGS OF FACT The agency hereby adopts the findings of fact set forth in the Recommended Order. CONCLUSIONS OF LAW The agency hereby adopts the conclusions of law set forth in the Recommended Order. Based on the foregoing, the bond interest claimed by Sunrise is an allowable cost, interest on the dollar amount of Medicaid reimbursement due based on Sunrise supra. is not allowable, the costs claimed for Pablo and Country Meadows are allowable, and finally the attorney’s fees claimed are not allowable. The dollar amount due Sunrise shall be paid based on the foregoing conclusions. See Hollywood Hills Nursing Home vs. Department of Health and Rehabilitative Services, 468 So.2d 1049, 1050 (Fla. 4t? DCA 1985). DONE and ORDERED this FZ _ day of rad. 2000, in Tallahassee, Florida. STATE O Ip&, AGENCY FOR: HEA INISTRATION. RUBEN J. KING-SHAW, JR., DIRECTOR A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A SECOND COPY ALONG WITH THE 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 -4- t FLORIDA APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN 30 DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. COPIES FURNISHED TO: J.D. Parrish Administrative Law Judge DOAH, The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Steven M. Weinger, Esquire Kurzban, Kurzban, Weinger & Tetzeli, P. A. 2650 Southwest 27% Avenue Second Floor Miami, Florida 33133 Steven Grigas, Esquire Senior Attorney, Agency for Health Care Administration 2727 Mahan Drive, Suite 3431 Fort Knox Building II Tallahassee, Florida 32308 Carol B. Shotwell, Administrator of. Audit Services Medicaid Program Analysis 2727 Mahan Drive Fort Knox Building 3, Room 2130 Tallahassee, Florida 32308-5403 - CERTIFICATE OF SERVICE ‘ I HEREBY CERTIFY that a copy of the foregoing was served on the t above-named people by U. S. Mail this _, / ) day of fi / L BAL. = 2000. _ S. Power, gency Clerk State of Florida, Agency for Health Care Administration 2727 Mahan Drive, Suite 3431 Fort Knox Building III, MSC 3 Tallahassee, Florida 32308 850/922-5865 power/3-Feb-00

Docket for Case No: 98-004942

Orders for Case No: 98-004942