STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
FLORIDA LIFE CARE, INC. d/b/a ) BENEVA NURSING PAVILION, )
)
Petitioner, )
)
vs. ) CASE NO. 86-2418
)
DEPARTMENT OF HEALTH AND )
REHABILITATIVE SERVICES, )
)
Respondent. )
) FLORIDA LIFE CARE, INC. d/b/a ) VENICE NURSING PAVILION NORTH, )
)
Petitioner, )
)
vs. ) CASE NO. 86-2419
)
DEPARTMENT OF HEALTH AND )
REHABILITATIVE SERVICES, )
)
Respondent. )
)
RECOMMENDED ORDER
The formal administrative hearing was held in this case on February 9, 1987, in Tallahassee, Florida. Appearing for the parties were:
APPEARANCES
For the Petitioners: Michael J. Bittman, Esquire
R. Bruce McKibben, Esquire Dempsey & Goldsmith, P.A. Post Office Box 1980 Orlando, Florida 32802
For the Respondent: Theodore E. Mack, Esquire
Department of Health and Rehabilitative Services 1323 Winewood Boulevard
Building 1, Room 407
Tallahassee, Florida 32399
At issue in this case is whether the Petitioners may retrospectively amend Medicaid cost reports for the period ending September 30, 1983. Also at issue with respect to Petitioner Beneva Nursing Pavilion is whether the Department correctly applied section V.B.f.2. of the Florida Title XIX Long Term Care Reimbursement Plan effective April 1, 1983, commonly known as "the Gainesville Plan." Finally, at issue is whether Petitioners requests for formal
administrative hearing as to these issues was timely. This last issue was reserved by HRS in the transmission of the petitions to the Division of Administrative Hearings, raised by memorandum of HRS and response of the Petitioners, and left pending for resolution at the formal administrative hearing.
Petitioners presented twenty exhibits and Respondent presented one exhibit, all of which were admitted into evidence. Both parties presented proposed recommended orders. There is a transcript.
FINDINGS OF FACT
Florida Life Care, Inc., d/b/a Beneva Nursing Pavilion (Beneva) and Florida Life Care, Inc., d/b/a Venice Nursing Pavilion North (Venice), the Petitioners in these cases, are both nursing homes that participate in the Florida Medicaid program and the Medicare program. T. 16.
In order to receive reimbursement from Florida's Medicaid program, the Petitioners were required to submit to the Department of Health and Rehabilitative Services (HRS) a Medicaid cost report. T. 123. The Medicaid cost report is a report by the provider of its costs and other statistics and is the basis for calculation of the Medicaid reimbursement rate for that facility. Id. The provider is responsible for the correctness of its Medicaid cost report. T.
163. The Medicaid cost report is an accounting estimate. T. 169, 162.
The Florida Title XIX Long-Term Care Reimbursement Plan is commonly called the Gainesville Plan, and was adopted on April 1, 1983. P. Ex. 14. The Gainesville Plan is incorporated by reference in rule 10C-7.0482, Florida Administrative Code, and establishes the manner in which Medicaid cost reports must be submitted and evaluated. P. Ex. 15.
Beneva filed its first Medicaid cost report for the period covering September 7, 1982, through September 30, 1983. T. 24-25. Venice also filed its Medicaid cost report for the year ending September 30, 1983. T. 24. Both reports were filed by the Petitioners' accountants, Touche Ross & Co., on March 14, 1984, and were timely filed. P. Exs. 1 and 2; T. 24.
Each of the Medicaid cost reports contained an adjustment for estimated Medicare costs. The adjustment appears in the Medicare Adjustment Schedule (MAS) of the Medicaid cost report. In so doing, the Petitioners were electing to use old cost reporting forms which allowed use of data from the Medicare cost report. Had they elected to use the new forms, there technically would have been no Medicare adjustment because the cost report calculates a Medicaid rate in a way that makes it unnecessary to delete Medicare costs. T. 143-144.
The Medicare adjustment in the Medicaid cost report is designed to comply with the Gainesville Plan. T. 123. It is intended to prevent double reimbursement for the same costs. T. 124.
The Medicare adjustment was taken directly from the Medicare cost report which each Petitioner had earlier submitted to Medicare. T. 25-26. The Medicare cost report is an accounting estimate, T. 169, and is the best and most reasonable estimate of costs associated with Medicare at the time that it is filed, but is subject to change after desk review, audit, or appeal. T. 12. There is no requirement imposed by HRS that changes occurring in the Medicare cost report be reported to HRS with respect to the Medicaid cost report.
Venice reported a Medicare adjustment in its Medicaid cost report of
$1,242,501. Beneva reported a Medicare adjustment in its Medicaid cost report of $1,798,107. T. 26.
HRS audited the Medicaid cost reports of the Petitioners. HRS transmitted the audit of Venice by letter dated August 16, 1985, and transmitted the audit of Beneva by letter dated August 27, 1985. T. 29; P. Exs. 5 and 6. As a result of the audits, Venice had to reimburse HRS $43,637.57, and Beneva had to reimburse HRS $101,849.55. T. 36-37.
Both letters of transmittal described in the last paragraph stated that the provider had 30 days in which to request a formal administrative hearing to contest any audit adjustment in dispute or disagreement. T. 29.
Neither Petitioner requested a formal administrative hearing at that time because neither objected to the audit reports. T. 31.
On August 25, 1985, the Medicare cost reports of both Beneva and Venice were substantially reduced (by hundreds of thousands of dollars) as a result of a federal audit. T. 32-35, 154. Petitioners did not know that these costs would be reduced in these amounts until the federal audit was completed. T. 35.
The Medicare cost reductions are the subject of a pending appeal. T.
The Medicare cost reductions may change again depending upon the result of the appeal. Id. Petitioners contend that if the numbers change again on appeal, they will have to again change their Medicaid cost report for the year ending September 30, 1983. T. 74.
Accounting issues which arise with respect to the Medicaid cost report are resolved by reference first to the Gainesville Plan, then to the Medicare Health Insurance Manual (HIM) 15, and then to generally accepted accounting principles. T. 78.
Section IV.E. of the Gainesville Plan provides:
The prospectively determined individual nursing home's rate will be adjusted retroactively to the effective date of the affected rate . . . under the following circumstances:
An error was made by HRS in the calculation of the provider's rate.
A provider submits an amended cost report used to determine the rate in effect. An amended cost report may be submitted in the event of a change of one percent in the reimbursement rate. The amended cost report must be filed by the filing date of the subsequent cost report.
Further desk or on-site audits of cost reports used in the establishment of the prospective rate disclose a change in allowable costs in those reports.
HRS interprets subparagraph 1 above to be available to correct either mathematical errors or misstatements of fact that existed at that time. T. 129.
It is the policy of HRS to use the best data available with respect to the Medicaid cost report, and thus it is the policy of HRS to use the Medicare cost report as a basis for estimating Medicare costs for the Medicaid cost report when it is the best information available. T. 138, 125. This policy is reasonable.
HRS relied upon the Medicaid cost report as submitted by the Petitioners' accountants in establishing the Medicaid rates for the Petitioners. As discussed above, the Medicaid cost report contained estimates of Medicare costs which were the best estimates then available. These estimates were not in error at that time (that is, these estimates were not erroneous statements of fact) even though later changed by audit. T. 133. HRS did not commit any mathematical errors in the use of Petitioners' Medicare cost estimates. HRS did not commit any error in relying upon the data submitted to it by the Petitioners. T. 128.
Petitioners did not, pursuant to subparagraph 2 of the Gainesville Plan set forth above, file an amended cost report by the filing date of the subsequent Medicaid cost report. In fact, they could not have availed themselves of this provision since the deadline for filing such an amended cost report was December 31, 1984, and the Medicare cost report audit adjustment did not occur until eight months later. T. 153-154.
When the Gainesville Plan was implemented, HRS no longer used or relied upon Medicare desk or on-site audits. HRS interprets subparagraph 3 of the Gainesville Plan, set forth above, to apply only to changes in allowable costs disclosed in Medicaid desk or on-site audits. T. 131.
Audited information is better information than an initial report which is not audited, and is preferable to unaudited information. T. 140. It, therefore, is the policy of HRS to use audited information if it is available. This policy is reasonable.
It is a generally accepted accounting principle that a change in an accounting estimate is defined as the result of new information, changing conditions, more experience, or additional information that requires revision of previous estimates. T. 133; HRS Ex. 20. It is a generally accepted accounting principle that a change in an accounting estimate should not be accounted for by restating the prior year final statements, but should be accounted for in the period in which the change occurs. T. 132. See also P. Ex. 20, p. 125.
Petitioners' accounting firm, Touche Ross & Co., prepared the original Medicaid cost report, but have not returned to that report as a result of the change in Medicare cost to file a restatement of the Medicaid cost report. T. 78.
Pursuant to the principles and policies described above in findings of fact 21 through 23, it is the policy of HRS to recognize material changes to the Medicare adjustment which results from an audit of the Medicare cost report; HRS recognizes such changes by recognizing a change in the Medicaid cost report, but only in the current period. T. 126, 139, 142.
If the change in Medicare costs for Beneva and Venice from the year ending September 30, 1983, are accounted for in the current period (1986), the effect on current allowable reimbursement rates will be negligible because most of the effect would be to cause the reimbursement rates to exceed the reimbursement ceilings established by HRS. T. 70-71. If a provider's
reimbursement rate is already at the ceiling, there is no benefit from an adjustment that would otherwise have increased the rate. T. 144. Petitioners are already at that ceiling. T. 146.
If the change in Medicare costs were accounted for by revision of the 1983 costs reports, Beneva and Venice would be entitled to substantial amounts of reimbursement. T. 94-95. The parties have stipulated that the exact amounts of reimbursement are not at issue in this formal administrative proceeding, but would be determined informally should the Petitioners prevail on the legal issues presented. T. 92-93.
The Petitioners applied to HRS for a retroactive revision of its 1983 Medicaid cost reports. P. Ex. 16 and 17.
By letter dated February 28, 1986, HRS denied the request for retroactive revision of the 1983 Medicaid cost reports. P. Ex. 18. The letter of denial did not inform the Petitioners of their right to request a formal administrative hearing regarding the denial, and did not specify the time in which such a request could be made. Id.
Within 30 days of the date of the letter denying the request for retroactive revision of the 1983 Medicaid cost reports, the Petitioners in writing requested formal administrative hearings concerning the denials as to that issue. P. Ex. 19.
HRS has never allowed a retroactive amendment of a closed cost report in the circumstances presented in this case. T. 127, 191-92. Were it to do so, it would turn the Medicaid reimbursement plan into a retroactive reimbursement plan because cost reports would continue to be changed retrospectively as changes in the underlying data occur. T. 127, 171.
A second issue in this case is whether HRS has correctly applied the low occupancy provision of the Gainesville Plan to Beneva. On October 30, 1985, some eight days after being notified by HRS that HRS intended to make a low occupancy adjustment to Beneva, Beneva wrote to HRS asserting that it had incorrectly applied a low occupancy adjustment to Beneva. T. 46; P. Ex. 14. Prior to this time, HRS had not informed Beneva of a right to request a formal administrative hearing as to this issue, or the time limits for making such a request. There then ensued several conferences between HRS and the Petitioners concerning the low occupancy adjustment and the Medicare adjustment. T. 54, 90-
On February 7 and 21, 1986, Petitioners wrote to HRS concerning the dispute over the Medicare adjustment. P. Exs. 16 and 17. No mention is made in these letters of the low occupancy issue. As discussed in finding of fact 27, by letter dated February 28, 1986, HRS denied the Petitioners' requests with respect to the Medicare adjustment. The denial does not mention the low occupancy adjustment, and only refers to the letters of February 7 and 28, 1986.
P. Ex. 18. On March 26, 1986, the Petitioners requested a formal administrative hearing only with respect to the Medicare issue. P. Ex. 19. However, on June 5, 1986, Beneva filed a petition for formal administrative hearing (actually a first amended petition), and paragraph 7 of that petition raises the issue of the low occupancy adjustment. Prior to June 5, 1986, HRS had not informed Beneva of its right to request a formal administrative hearing as to this issue or the time limits for making such a request.
Section V.B.7.e. of the Gainesville Plan calculates an adjusted per diem by multiplying each of the per diem components by a fraction that has as
its numerator the individual facility occupancy level." P. Ex. 15, p. 33. Thus, the lower the individual facility occupancy level, the smaller the fraction, resulting in lower per diem allowance.
Section V.B.7.f.2. of the Gainesville Plan provides that the occupancy adjustment in subparagraph e above "will not apply to . . . facilities with 18 or fewer months of operating experience." P. Ex. 15, p. 33.
Beneva commenced operation as a nursing home on September 7, 1982. T.
25.
On the day that it opened, the occupancy of Beneva was very low. It
increased during the first year, and had an average occupancy of about 57 percent in the first 13 months. T. 43. The average annual occupancy of Beneva in 1984 was 83 percent. In 1985 it was 95 percent. T. 47; P. Ex. 14. HRS could have obtained these statistics from Beneva if it had wanted to. T. 201.
HRS applied the low occupancy adjustment to the per diem rates at Beneva for the months beginning April 1, 1984, to June 30, 1985. T. 43, 50, 63. April 1984, was the nineteenth month from the commencement of operations at Beneva. T. 194.
HRS used the occupancy rate for the first 13 months of operation (57 percent) in this low occupancy adjustment. T. 43. The reason for using the occupancy rate for the first 13 months is that HRS uses the occupancy rate for the last cost report (in this case, the first cost report for the period ending September 30, 1983) to set rates for the prospective period. T. 200. HRS reasons that the same cost report used to set the prospective rates should be used for all purposes, including ascertainment of the "individual facility occupancy level," the numerator in the occupancy adjustment fraction in section
V.B.7.e. of the Gainesville Plan. T. 202. It further reasons that this is required in order that the Medicaid reimbursement program be a prospective plan (based upon a fixed historical operation period, including all statistics associated with that cast) rather than upon current data. T. 212, 222-224.
A new facility is expected to have low occupancy during its initial months of operation. T. 195. However, since some patient care costs are relatively fixed, a lower occupancy results in a higher per diem because the per diem cost is simply costs divided by patient days. T. 195-96. In this sense, start-up per diem cost rates are temporarily high due to the temporarily low occupancy. Id. The low occupancy adjustment has the effect of containing health care costs by adjusting this temporarily and unusually high per diem downward.
T. 196-197, 192. It serves to partially preclude the receipt of an unwarranted high per diem cost reimbursement in a period when occupancy is relatively high. Id.
HRS's interpretation of the method for applying the occupancy adjustment in the Gainesville Plan is an unwritten HRS policy. T. 202-203. HRS has applied this interpretation in the same manner to other Medicaid providers. T. 195, 214.
As a result of application of the low occupancy adjustment, Beneva had its per diem reimbursement reduced by $15 to $18. T. 45, 233.
If HRS had used the occupancy rate for 1984 (83 percent), there would have been very little impact upon Beneva's per diem rates. T. 207.
CONCLUSIONS OF LAW
Petitioners' requests for formal administrative hearing were timely filed. The Petitioners were given valid points of entry to seek a formal administrative hearing with respect to "any audit adjustment in dispute or disagreement" arising from the August 1985, HRS audits of the Petitioners' Medicaid cost reports, and they waived those points of entry. Findings of fact 9, 10, and 11. But the issues presented in this case did not yet exist at that time between the parties. Subsequently, HRS did not provide the Petitioners with a valid point of entry as to the Medicare adjustment issue or as to the low occupancy adjustment issue because Petitioners were never clearly advised of their right to request a formal administrative hearing as to these issues, or the time limits for making such a request. See findings of fact 27 and 30. Petitioners have thus made timely requests for formal administrative hearing as to both of these issues. See findings of fact 28 and 30. Manasota-88 v. Department of Environmental Regulation, 417 So.2d 846 (Fla. 1st DCA 1982).
The Division of Administrative Hearings has jurisdiction of these cases.
The Gainesville Plan, P. Ex. 15, is incorporated by reference in Rule 10C-7.0482, Florida Administrative Code, and establishes the manner in which Medicaid cost reports must be submitted and evaluated.
The Gainesville Plan, section IV.E., establishes the circumstances when "the prospectively determined individual nursing home's rate will be adjusted retroactively. Ex. 15.
The first circumstance is if "an error was made by HRS in the calculation of the provider's rate." Section IV.E.1., P. Ex. 15. (E.S.) HRS did not make an error in the calculation of the provider's rate. The Medicaid cost report, as well as the Medicare cost report, are accounting estimates. An estimate, by definition, is not expected to be actuality. The evidence shows that Petitioners supplied HRS with the best estimates it then had available, and that HRS properly relied upon these estimates. The Medicare audit change did not even exist when the time for amendment of the cost report had expired. Moreover, the Petitioners did not provide HRS with the Medicare audit information until after HRS had completed its audit of the Medicaid cost reports. See findings of fact 13, 17, 18, and 19. Thus, the first basis in the Gainesville Plan for retrospective rate adjustment is not applicable in this case.
The second circumstance for retrospective rate adjustment in the Gainesville Plan, section IV.E.2., P. Ex. 15, is not applicable in this case because the Medicare audit and other issues arose long after the deadline for filing the amended cost report. Finding of fact 19.
The third circumstance contained in the Gainesville Plan for retrospective rate adjustment is when "further desk or on-site audits of cost reports used in the establishment of the prospective rate disclose a change in allowable costs in those reports." IV.E.3., P. Ex. 15. (E.S.) The cost report used to establish the prospective rate is the Medicaid cost report. See findings of fact 2 and 3. The Medicare cost report in this case was only used to provide subsidiary data for the Medicaid cost report. The Medicare cost report was subsidiary in another sense as well because use of the Medicare cost report occurred only because the Petitioners elected to use the old forms. See findings of fact 5 and 20. Thus, section IV.E.3. of the Gainesville Plan
applies only to desk or on-site audits of the Medicaid cost report, the audits conducted and completed by HRS in August 1985. Since those audits did not disclose any change in allowable costs, the third circumstance in the Gainesville Plan which permits retroactive alteration of rates does not exist in this case, and the exception does not apply.
The Medicare and Medicaid cost reports are both accounting estimates. Findings of fact 2 and 7. The change in the Medicare cost report resulting from the Medicare audit is a change in an accounting estimate. Pursuant to HRS policy, such change can be accounted for only in the current period. Finding of fact 24. This policy is consistent with generally accepted accounting principles. Finding of fact 22. It is also consistent with the prospective reimbursement character of the Medicaid program. Finding of fact 30. The policy is reasonable. Pursuant to the policy, the change in the Medicare cost report should not be accounted for retrospectively.
Section V.B.7.f.2. of the Gainesville Plan provides that the occupancy adjustment in subparagraph e above "will not apply to . . . facilities with 18 or fewer months of operating experience." P. Ex. 15, p. 33. (E.S.) HRS did not apply the occupancy adjustment to a facility with 18 or fewer months of operating experience. It applied it to a facility (Beneva) that at the time of application had more than 18 months of operating experience. Moreover, it applied it only to the months of operating experience of that facility beyond the first eighteen. Thus, in both senses, HRS has properly followed section
V.B.7.f.2. of the Gainesville Plan in the case of Beneva.
Section V.B.7.e. of the Gainesville Plan calculates an adjusted per diem by multiplying each of the per diem components by a fraction that has as its numerator the "individual facility occupancy level." P. Ex. 15, p. 33. The section does not explicitly establish the period of time in which such occupancy level should be calculated.
Determination of the period of time for calculation of the "individual facility occupancy level" must be accomplished with an eye toward the purpose of this subsidiary calculation. The ultimate goal is not to reimburse Beneva for costs incurred during the year of the Medicaid cost report (ending September 30, 1983), but to establish the proper prospective reimbursement rate based upon the historic cost behavior of Beneva in the year ending September 30, 1983. If costs from that year are used, other operational aspects of that year should be used as well. As well-explained by HRS's witness, it is to be expected, generally speaking, that lower start-up year occupancy levels will result in artificially higher per diem costs. It would be wrong to allow reimbursement in a future year of normal occupancy based upon historic costs which were temporarily high on a per diem basis due to low occupancy. See findings of fact
37 and 38. Thus, calculation of the "individual facility occupancy level" from the same period of time as the rest of the Medicaid cost report is reasonable.
For these reasons, it is recommended that the Department of Health and Rehabilitative Services enter its final order or orders denying retrospective adjustment to the fiscal year 1983 Medicaid cost reports of the Petitioners, and denying the requested alteration to the occupancy adjustment as applied to the Petitioner, Florida Living Care, Inc., d/b/a Beneva Nursing Pavilion.
DONE and RECOMMENDED this 1st of June 1987, in Tallahassee, Florida.
WILLIAM C. SHERRILL, JR.
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 1st day of June 1987.
Appendix to Recommended Order
in DOAH Case Numbers 86-2418 and 86-2419
The following is an explanation of the reasons for rejection of findings of fact proposed by the parties. The numbers correspond to the numbers used by the parties. Proposed findings of fact not discussed in this appendix have been adopted as findings of fact in this Recommended Order.
Findings of fact proposed by the Petitioners:
13. In the last sentence, the verb "would" is rejected as a matter of law in this Recommended Order. The sentence has, however, been adopted as the contention of the Petitioners.
15. This proposed finding has been adopted with the addition of the finding that the recalculation is to be done only in the current period.
27. While the occupancy rates for 1983, 1984, and 1985 are provided by the evidence, there does not appear to be any evidence as to the occupancy rate on April 1, 1984.
31, 33, 37, 38, 40, 42, 44, 45, and 47. These proposed findings of fact are subordinate to findings of fact adopted in the Recommended Order, and are not necessary.
The only portion of this proposed finding that is marginally relevant is the matter of efficiency of operation. Moreover, HRS had adequately explained its policy for interpretation of the low occupancy adjustment, and did not have to have specific evidence as to the efficiency of Beneva. If Beneva thought that that evidence would be useful, it could have presented it. The remainder of the proposed finding concerns whether HRS had evidence that Beneva was receiving a reimbursement rate higher than similar providers, or was receiving reimbursement in excess of its allowable cost on April 1, 1984.
Again, HRS adequately explained its incipient policy in general terms, and did not need to present specific evidence concerning Beneva. But more important, the issue is whether the per diem costs of Beneva as reported to HRS for the year ending September 30, 1983, were normal, or unusually high as assumed by HRS in its interpretation of the Gainesville Plan. The reimbursement rate of Beneva is not relevant.
There is no testimony at the record cited that Beneva was operating efficiently. The witness did not respond to the question and give any evidence concerning efficiency of operation. With respect to the remainder of the proposed finding of fact, whether or not Beneva was operating at a reimbursement rate under the caps on April 1, 1984, sheds little light on whether Beneva's
Medicaid costs for the period ending September 30, 1983, as reported in the Medicaid cost report at issue in this case were normal, or unusually high as assumed by HRS in its interpretation of the Gainesville Plan. See the discussion with respect to proposed finding of fact 35.
46. Rejected for the reasons discussed in finding of fact 18. Moreover, it would have been error for HRS to have allowed the revisions requested by Mr. Fox because it would have been incorrect to revise previous accounting estimates. A change in an accounting estimate is to be made in the current period. Finding of fact 22.
50. This proposed finding of fact is not relevant because double reimbursement is not an issue raised by any party.
Findings of fact proposed by the Respondent:
4. Whether the August 1985, audit reports gave the Petitioners a "point of entry" is a question of law. It is true that these were points of entry, but not with respect to the issues raised in these cases. Thus, the proposed finding is irrelevant as well.
12. The record does not support the proposed finding that FLC "did not wish to incorporate the change in the Medicare adjustment in its later cost reports." There is no evidence of what FLC wished to do. A finding has been made that it would not have benefited FLC to have sought such a revision.
19. This proposed finding is a conclusion of law.
COPIES FURNISHED:
Gregory L. Coler, Secretary Department of Health and
Rehabilitative Services 1323 Winewood Boulevard
Tallahassee, Florida 32399-0700
John Miller, Esquire Acting General Counsel Department of Health and
Rehabilitative Services 1323 Winewood Boulevard Building One, Suite 407
Tallahassee, Florida 32399-0700
Sam Power, Clerk Department of Health and
Rehabilitative Services 1323 Winewood Boulevard Building One, Suite 407
Tallahassee, Florida 32399-0700
Theodore E. Mack, Esquire Assistant General Counsel Department of Health and
Rehabilitative Services 1323 Winewood Blvd.
Building One, Room 407 Tallahassee, Florida 32399-0700
Michael J. Bittman, Esquire
R. Bruce McKibben, Esquire Jonathan S. Grout, Esquire DEMPSEY & GOLDSMITH
P. O. Box 10651 Tallahassee, Florida 32302
| Issue Date | Proceedings |
|---|---|
| Jun. 01, 1987 | Recommended Order (hearing held , 2013). CASE CLOSED. |
| Issue Date | Document | Summary |
|---|---|---|
| Jul. 07, 1987 | Agency Final Order | |
| Jun. 01, 1987 | Recommended Order | Retrospective adjustment to Medicaid cost report and altering occupancy rate denied. Cost report only estimate and occupancy rate not historic. |
