STATE OF FLORIDA

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AGENCY FOR HEALTH CARE ADMINISTRATION

HOLMES REGIONAL MEDICAL CENTER,

_!J, j hU!J I 6 A 9: tib

vs.

Petitioner,

PROVIDER NO.: 100081

AHCA NO.: 15-016MPF

RENDITION NO.: AHCA- 1."i • ,..:,o 'b \ -S-MOA

AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

                                                                   I

FINAL ORDER

4,) , ,

THE PARTIES resolved all disputed issues and executed a Settlement Agreement. The parties are directed to comply with the terms of the attached settlement agreement. Based on the foregoing, this file is CLOSED.

DONE and ORDERED on this the day of 2019, in Tallahassee,

Leon County, Florida.

Holmes Regional Medical Center vs. Agency for Health Care Administration (AHCANo.: 15-016MPF)

FINAL ORDER

Page 1 of3

Filed August 21, 2019 4:47 PM Division of Administrative Hearings

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 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.

Copies furnished to:

Holmes Regional Medical Center Attn: Hospital Administrator 3300 Fiske Blvd.

Rockledge, Florida 32955 (U.S. MAIL)

Joseph M. Goldstein, Esquire Shutts & Bowen LLP

200 East Broward Blvd., Suite 2100 Fort Lauderdale, FL 33301 jgoldstein@shutts.com

(E-Mail)

Shena L. Grantham, Esquire MAL & MPI Chief Counsel

Shena.Grantham@ahca.myflorida.com (E-Mail)

Stefan Grow, General Counsel

Agency for Health Care Administration (E-Mail)

Lisa Smith, Bureau Chief MPF

Agency for Health Care Administration (E-Mail)

Steven A. Grigas Akerman LLP

Steven.grigas@akerman.com (E-Mail)

Bureau of Health Quality Assurance Agency for Health Care Administration (E-Mail)

Division of Health Quality Assurance Bureau of Central Services

CSMU-86@ahca.myflorida.com (E-Mail)

Division of Administrative Hearings The Desoto Building

1230 Apalachee Parkway

Tallahassee, FL 32399-3060

Deborah Kenon

Medicaid Program Finance (E-Mail)

Holmes Regional Medical Center vs. Agency for Health Care Administration (AHCA No.: 15-016MPF)

FINAL ORDER

Page 2 of3

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing has been fu d-te

the above named addressees by U.S. Mail or other designated method on this the /pi day of

,2019.

, c_ .

Richard J. Shoop, Esquire

Agency Clerk State of Florida

Agency for Health Care Administration 2727 Mahan Drive, MS #3

Tallahassee, Florida 32308-5403

(850) 412-3689/FAX (850) 921-0158

Holmes Regional Medical Center vs. Agency for Health Care Administration (AHCA No.: 15-016MPF)

FINAL ORDER

Page 3 of3

Docket for Case No: 15-001520

Orders for Case No: 15-001520