STATE OF FLORIDA es i ae AGENCY FOR HEALTH CARE ADMINISTRATION [= 3 2G LS th A155 208 JUN ET AT Ol DIVISION Gr Petitioner, DOAH CASEINONOT123001¥ E AHCA NO. 200866508925 v. DISMISSAL NO. 20060831-002 WINN-DIXIE STORES, INC., STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent, FINAL ORDER THIS CAUSE concerns a Petition for Administrative Hearing (“Petition”) that the Petitioner filed on May 3, 2007. On May 22, 2007, the Petition was forwarded to the Division of Administrative Hearings by the Agency and assigned to an Administrative Law Judge (“ALJ”). On July 19, 2007, the Petitioner filed a Notice of Voluntary Dismissal of Petition for Administrative Hearing, stating that the Petitioner requested DOAH close its file. On July 24, 2007, the ALJ assigned to the case entered an Order Closing File, relinquishing jurisdiction back to the Agency. Based upon the foregoing, IT IS THEREFORE ORDERED AND ADJUDGED THAT: The Petitioner’s Petition is dismissed with prejudice and the Agency’s February 2, 2007, Dismissal is hereby upheld. Petitioner shall govern itself accordingly. DONE and ORDERED this 43 day of Ctra ; 2008, in Tallahassee, Florida. HOLLY BENSON, Secretary AGENCY FOR/HEALTH CARE ADMINISTRATION 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 THE ORIGINAL NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A COPY ALONG WITH THE FILING FEE 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 THE RENDITION OF THE ORDER TO BE REVIEWED. CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furnished by U.S. or interoffice mail to the persons named below on this VS day of Vac’ _, 2008. RICHARD J. SHOOP, Agency Clerk ~ Agency for Health Care Administration 2727 Mahan Drive, MS #3 Tallahassee, Florida 32308 (850) 922-5873 COPIES FURNISHED TO: Ella Jane P. Davis Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Mari H. McCully, Esquire Department of Financial Services Division of Worker’s Compensation 200 East Gaines Street Tallahassee, Florida 32399-4229 Timothy L. Newhall, Esquire Stiles, Taylor & Grace, P.A. Post Office Box 1140 Tallahassee, Florida 32302-1140 Jan Mills Facilities Intake Joseph W. May, Esquire Bacen and Jordan, P.A. 2901 Stirling Road Suite 206 Fort Lauderdale, Florida 3312 Elizabeth Dudek Health Quality Assurance St. Mary’s Medical Center — Tenet Florida Regional Business Office 4660 Communication Avenue Boca Raton, Florida 33231

Docket for Case No: 07-002309