STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
TRUSTEES OF MEASE HOSPITAL, ) INC., d/b/a MEASE HOSPITAL ) DUNEDIN, )
)
Petitioner, )
)
vs. ) CASE NO. 90-6255
)
) DEPARTMENT OF HEALTH AND ) REHABILITATIVE SERVICES, )
)
Respondent, )
)
and )
) ALL CHILDREN'S HOSPITAL, INC.,) and MORTON F. PLANT HOSPITAL, ) INC., )
)
Intervenors. )
) ALL CHILDREN'S HOSPITAL, INC.,)
)
)
Petitioner, )
)
vs. ) CASE NO. 90-6256
) DEPARTMENT OF HEALTH AND ) REHABILITATIVE SERVICES, )
)
)
Respondent, )
)
and )
) MORTON F. PLANT HOSPITAL, ) INC., )
)
Intervenor. )
)
)
RECOMMENDED ORDER
These consolidated cases were heard by Eleanor M. Hunter, the Hearing Officer designated by the Division of Administrative Hearings, from July 8 - 12, 1991, in Tallahassee, Florida.
APPEARANCES
For Petitioner: Patricia Renovitch, Esquire Trustees of Mease Oertel, Hoffman, Fernandez, Hospital, Inc., d/b/a & Cole, P.A.
Mease Hospital Dunedin Post Office Box 6507
Tallahassee, Florida 32314-6507
For Respondent: Richard Patterson, Esquire Dept. of Health and 2727 Mahan Drive Rehabilitative Services Suite 103
Tallahassee, Florida 32308
For Intervenor/Petitioner: Gerald Sternstein, Esquire All Children's Hospital, McFarlain, Sternstein, Inc. Wiley & Cassedy, P.A.
Post Office Box 2174 Tallahassee, Florida 32316
For Intervenor: Cynthia Tunnicliff, Esquire Morton F. Plant Hospital, Carlton, Fields, Ward,
Inc. Emmanuel, Smith & Cutler Post Office Drawer 190 Tallahassee, Florida 32302
STATEMENT OF THE ISSUES
Whether Trustees of Mease Hospital, Inc., d/b/a Mease Hospital Dunedin ("Mease") is entitled to be included on the Neonatal Intensive Care Unit ("NICU") inventory, as authorized to provide Level III NICU services in five (5) Level III beds in Department of Health and Rehabilitative Services ("HRS") District 5.
Whether All Children's established its standing to intervene in Case No. 90-6255, as an existing provider of Level III NICU services in HRS District 5.
Whether Morton Plant established is standing to intervene in the consolidated cases, as an existing provider of Level II NICU services in HRS District 5.
PRELIMINARY STATEMENT
In Case No. 90-6255, Mease filed a petition timely challenging the inventory of hospitals authorized to provide NICU Level III beds in HRS District
Mease petitioned specifically for the inclusion of five Level III beds at Mease, based on Florida Administrative Code, Rule 10-5.042 (previously numbered Rule 10-5.011), subsection (14)(f)(2), which provides, in relevant part:
(f) Providers Not Authorized Under Certificate of Need or Licensure Provisions. Providers claiming to have provided Level II or Level III neonatal intensive care services prior to October 1, 1987 and continuously since then, but which were not authorized by certificate of need consistent with paragraph (14)(a) or by license consistent with paragraph (14)(b), will be authorized to provide Level II or Level III neonatal intensive care services provided the conditions of subparagraphs (14)(f)1. or (14) (f)2., below, are met.
***
A provider will be deemed to have had operational Level III neonatal intensive care services prior to October 1, 1987 if:
Level III neonatal intensive care services were being provided on or before September
30, 1987 under the direction of a neonatologist or a group of neonatologists who were on the active staff of the hospital
with unlimited privileges and provided 24-hour coverage, and who were either board certified or board eligible in neonatal-perinatal medicine; and
The provider submits documentation that for the period October 1, 1986 through September 30, 1987 at least one of the following was true:
***
(III) At least 50 percent of all neonates admitted to neonatal intensive care services, regardless of reported Level II or Level III status, were classified into Diagnosis Related Groups (DRGs) 385, 386, 387 or 388.
The definition of Level III NICU services, given in Florida Administrative Code Rule 10-5.042(2)(e)3, is as follows:
"Level III Neonatal Intensive Care Services." Services which include the provisions of continuous cardiopulmonary support services, 12 or more hours of nursing care per day, complex pediatric surgery, neonatal cardiovascular surgery, pediatric neurology and neurosurgery, and pediatric cardiac catheterization, shall be classified as Level III neonatal intensive care services.
These services cannot be performed in a facility with Level II neonatal intensive care services only. Facilities with Level III neonatal intensive care services may perform all neonatal care services. A facility with a Level III neonatal intensive care service that does not provide treatment of complex major congenital anomalies that require the services of a pediatric surgeon, or pediatric cardiac catheterization and cardiovascular surgery shall enter into a written agreement with a facility providing Level III neonatal intensive care services in the same or nearest service area for the provision of these services. All other services shall be provided at each facility with Level III neonatal intensive care
services. The provision of pediatric cardiac catheterization or pediatric open heart surgery each requires a separate certificate of need.
In Case No. 90-6256, All Children's Hospital, Inc., ("All Children's") timely challenged the inclusion of Mease in the Level II NICU inventory for HRS District 5. The previously assigned Hearing Officer granted Mease's motion to consolidate cases 90-6255 and 90-6256, and granted All Children's petition to intervene in Case No. 90-6255, subject to All Children's demonstrating a substantial interest in the proceedings at hearing. On April 9, 1991, the Hearing Officer also entered an Order Granting Mease's Motion for Partial Summary Recommended Order, without objection, recommending that Mease be included in the HRS final inventory for five Level II beds.
On April 29, 1991, a petition to intervene in the consolidated cases filed on behalf of Morton F. Plant Hospital, Inc. ("Morton Plant") was granted, over objections of Mease.
Pending motions resolved at the commencement of the final hearing included:
Mease's Motion for Summary Recommended Order to determine that Morton Plant lacked standing, which was denied;
All Children's Motion in Limine to Exclude the entire deposition of Dr. Louis Gluck, which was denied, and instead rulings were made on specific objections and motions to strike contained within the Gluck deposition;
All Children's Motion to Exclude the deposition testimony of Judith Scollo, R.N., in which All Children's failed to participate, on which ruling was initially reserved pending notice of the witness' physical health and whether she would in fact be testifying in person, and ultimately resolved by allowing the deposition to continue subsequent to the hearing;
Mease's Motion to Exclude documents listed on All Children's Notice of Intent to Rely on Summary Exhibits, as not having been timely exchanged, which was resolved by order for immediate production, so that Mease was able to review the documents to determine, prior to the presentation of All Children's case, if they were prejudicial or were demonstrative summaries of previously exchange information; and
Mease's Motion to Compel Morton Plant to produce its contract for neonatology services and its Level II nursery procedures and policies, ruling was reserved pending in camera inspection of the documents, after which the documents were determined to be irrelevant to this proceeding.
At final hearing, Mease presented the testimony of its CON/Regulatory Manager, Odalys Capote, its Assistant Director of Medical Records, Mary Beth Bumbarger, its Medical Records Coder Supervisor, Mary Alice Roberts, its Director of Management Analysis, Cheryl Kayes, Health Planner, Mark M. Richardson, and Mease Neonatology Director, Mary Newport, M.D.
By depositions, Mease also presented the testimony of Steven Lesser, M.D., Harvey Levin, M.D., James Dwyer, M.D., Charles T. Frock, Louis Gluck, M.D., Dean
H. Farber, M.D., Thomas Hennessy, Harry Motter, and Julia Mullins. Mease also presented the first part of the deposition of Mary W. Walters, R.N., Director of Specialty Service of All Children's. Mease Exhibits one (1) through forty-seven
were initially offered in evidence, although Exhibits 12, 25, and 39 were withdrawn by Mease. Exhibit 28 was not admitted, and Exhibits 49 and 50 were partially excluded based on relevance.
HRS presented the testimony of Supervisor Elfie Stamm of the Office of Comprehensive Health Planning and offered Exhibits 1 through 12 which were received in evidence.
All Children's presented the testimony of All Children's Neonatologists Roberto Sosa, M.D., and Jeane McCarthy, M.D., its Director of Specialty Services Mary W. Walters, R.N., expert neonatologist John S. Curran, M.D., expert health care consultant and financial analyst Scott L. Hopes. All Children's Exhibits 1 through 19 were received in evidence, including the second part of the deposition of Mary Walters, R.N., which was received over objection by Mease.
Morton Plant presented the testimony of its Director of Planning Donna Reynolds and offered two exhibits which were received in evidence.
The transcript of the hearing was filed on August 8, 1991, and proposed findings of fact and conclusions of law were filed on September 20, 1991.
Rulings on proposed findings of fact are in the Appendix to this Recommended Order.
FINDINGS OF FACT
On September 14, 1990, Mease a 278-bed acute care hospital, located in Dunnedin, Florida, timely challenged the inventory of neonatal intensive care beds published for District 5 (Pasco and Pinellas Counties) by HRS. The preliminary inventory, published on August 24, 1990, authorized five (5) Level II and no Level III beds at Mease.
All Children's is a 168-bed specialty children's hospital, which has a 24-bed Level III NICU, located in St. Petersburg, Florida, in Pinellas County.
Morton Plant is a 750-bed acute care hospital with Level II NICU beds, located in Clearwater, Florida, in Pinellas County.
Of the 2,670 babies delivered at Morton Plant in 1990, 598 came from the Mease area; 569 of the 2,670 were classified as not normal or in need of some NICU services, and 148 of the 569 not-normal newborns came from the Mease service area.
HRS is the department with responsibility for promulgating NICU rules pursuant to legislation passed in May 1987, effective in October 1987. See, Section 381.702(20) and 381.706(1)(a), (e), (h), and (m), Florida Statutes (1989).
The NICU rule became final in August 1990, and included a "grandfather" provision for providers of NICU services prior to October 1, 1987, to avoid any disruption in the availability of NICU services.
The grandfather provision includes, as one of three tests for determining if NICU services were offered prior to October 1, 1987, the requirement that 50% of the neonates admitted to Level II and III units from October 1, 1986 through September 30, 1987, were classified in Diagnostic Related Groups (DRGs) 385, 386, 387 or 388. See, Florida Administrative Code, Rule 10-5.042(14)(f) (2)(b) (III).
In August 1987, HRS, in preparation for the promulgation of the NICU rule, mailed surveys to various hospitals, including Mease, requesting information about the provision of NICU services at those hospitals.
Using the Guidelines for Perinatal Care to distinguish the level of services it was providing, Mease responded to the August 1987 survey by reporting that it had three (3) Level II beds and no Level III beds.
In response to the survey questions, Mease also reported that its NICU services began on April 1, 1987, coinciding with the time that a neonatologist, Mary Newport, M.D., joined the staff at Mease.
In March 1987, Board Certified Neonatologist Mary Newport began providing 24-hour coverage at Mease, receiving final approval for active staff privileges in early May 1987, so that Mease could treat rather than transfer sick neonates.
Mease resubmitted the August 1987 survey in February 1989, reporting that it had increased from three to six Level II beds, after October 1, 1987, and from one to four Level III beds beginning on October 1, 1987, although such changes required certificate of need ("CON") approval effective October 1, 1987.
HRS sent out a second survey in April 1989, to which Mease responded that it currently had six Level II beds and no Level III services, under the more stringent requirements included within the proposed rule as compared to the Guidelines for Perinatal Care standards used in the first survey.
In August 1989, Mease resubmitted the second survey and reported a current total of six Level II beds and four Level III beds of which three Level II beds and one Level III bed were operating on September 30, 1987.
Mease, in the August resubmittal of the second survey, also reported that 37 neonates were admitted to the Level III bed for 63 patient days and that a total of 188 neonates were admitted to both Level II and Level III beds, from October 1, 1986 through September 30, 1987.
Of the 188 neonates admitted to Level II and Level III beds from October 1, 1986 through September 30, 1987, Mease claimed that 87 of those had DRG's 385, 386, 387 or 388.
On September 10, 1990, Mease submitted documentation to HRS showing that from October 1, 1986 through September 30, 1987, NICU admissions totaled
122 patients, of which 77 were in DRGs 385, 386, 387 or 388.
Subsequently, Mease claimed to have had 18 fewer admissions.
On December 18, 1990, Mease claimed to have had 107 NICU patients, of which 69 were in DRGs 385, 386, 387 or 388.
At the final hearing, Mease claimed that its review of the available records of 1512 of the 1520 deliveries from October 1, 1986 through September 30, 1987, showed that, when diagnoses and codes were changed retrospectively, there were 126 NICU admissions, of which 74 were in DRGs 385, 386, 387, and 388.
The number of neonates in intensive care and the number of neonates in the specified DRGs asserted by Mease are both unreliable.
There is no credible evidence to support Mease's claim that it started offering NICU services upon the arrival of Dr. Newport on the courtesy staff on March 28, 1987, or upon her becoming a member of the active staff in early May, 1987.
Credible expert testimony was presented that a time lag occurs between the arrival on staff of a neonatologist and the initiation of NICU services.
In fact, Dr. Newport testified that after she arrived at Mease, she tried out various rented equipment and evaluated it before making purchases, and altered the locations of the nurseries.
The Mease Perinatal Committee Agenda dated May 26, 1987 included an item "Task Force for Development of Level II Facility."
Even assuming arguendo that Mease did establish NICU services on April 1, 1987, as reported to HRS in response to the first HRS survey, a substantial number of the neonates Mease claimed to have served in its NICU were, in fact, discharged from Mease prior to April 1, 1987. 1/
Mease has failed to submit documentation that it had neonatal intensive care services from October 1, 1986 through September 30, 1987.
Mease has failed to submit documentation that it admitted 126 neonates to intensive care services from October 1, 1986 through September 30, 1987.
Mease has failed to submit documentation that 74 neonates were classified into DRGs 385, 386, 387 or 388.
Credible expert testimony supports the conclusion that retrospective changes in diagnoses are not reliable, in view of the fact that observation of a patient, not just the patient's record, is significant in making a diagnosis.
Mease reported to the Health Care Cost Containment Board that it had no revenue from the operation of a NICU from October 1, 1986 to September 30, 1987.
CONCLUSIONS OF LAW
The Division of Administrative Hearings has jurisdiction over the parties and the subject matter pursuant to Section 120.57(1), Florida Statutes, and Rule 10-5.042(15), Florida Administrative Code.
During the hearing, All Children's Hospital established that the erroneous inclusion of Mease on the inventory for Level III NICU beds would substantially adversely affect All Children's. All Children's is an existing provider of Level III NICU services in HRS District 5 and is one of the receiving facilities for neonates transferred from Mease for intensive care services.
During the hearing, Morton Plant established that the erroneous inclusion of Mease on the inventory for Level III NICU beds would substantially adversely affect Morton Plant. Morton Plant is an existing provider of Level II NICU services in HRS District 5, a Mease competitor with a service area which overlaps that of Mease. Morton Plant's ability to compete with Mease as an equally qualified facility would be adversely affected if Mease received a designation as a facility capable of providing a higher level of neonatal intensive care than that available at Morton Plant. In addition, the distinction between Level II and Level III neonates, except for that based on birth weight, is not always an objective determination.
At hearing, Mease failed to demonstrate that it meets the requirements in the grandfather provision of the NICU rule. Mease failed to show that the unit was established during the specified time frame. No records exist to show which neonates received intensive care services at Mease prior to October 1, 1987.
Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a Final Order be entered:
Including Mease on the final inventory as an authorized Level II neonatal intensive care unit with five beds, based on the Summary Recommended Order of April 9, 1991, entered without objection; and
Excluding Mease from the final inventory as an authorized provider of Level III neonatal intensive care services.
DONE and ENTERED this 1st day of November, 1991, at Tallahassee, Florida.
ELEANOR M. HUNTER
Hearing Officer
Division of Administrative Hearings The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-1550
(904) 488-9675
Filed with the Clerk of the Division of Administrative Hearings this 1st day of November, 1991.
ENDNOTES
1/ See, Mease Exhibit 5, Patient Audit Sheets No. 1, 2, 3, 4, 5, 7, 8, 9, 10,
13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 48, 53, 54,
55, 56, 69, 70, 82, 83, 84, 85, 86, 87, 88, 108, 109, 110, 111, 112, 113, 114,
115, 116, 117, 118, 119, 120, 121, 122 and 126.
APPENDIX TO RECOMMENDED ORDER
Rulings on findings proposed by Mease:
Subordinate to Preliminary Statement.
Adopted in Preliminary Statement.
Subordinate to Preliminary Statement.
Adopted in Preliminary Statement.
Adopted in Findings of Fact 1 and 2.
Adopted, in relevant part, in Finding of Fact 1.
Rejected as not relevant.
Adopted, in relevant part in, Finding of Fact 3.
Subordinate to Finding of Fact 24.
Rejected, in relevant part, in Finding of Fact 27.
Subordinate to Finding of Fact 7.
Subordinate to Finding of Fact 24.
13 - 18. Rejected as unnecessary.
Subordinate to Finding of Fact 11.
Rejected as unnecessary.
21 and 22. Subordinate to Finding of Fact 24.
Rejected in Finding of Fact 27.
Subordinate to Finding of Fact 11.
Adopted in Findings of Fact 8 - 10 and 12.
Adopted in Finding of Fact 13.
Adopted in Finding of Fact 15.
Subordinate to Finding of Fact 16.
Subordinate to Finding of Fact 20.
Adopted in Finding of Fact 27.
Adopted, in relevant part, in Finding of Fact 31.
Rejected as irrelevant.
Adopted in Finding of Fact 14.
34 - 38. Subordinate to Finding of Fact 20.
Adopted in Finding of Fact 17.
Adopted in Finding of Fact 19.
41 - 43. Subordinate to Finding of Fact 20.
44 - 48. Rejected in Finding of Fact 30.
49. Rejected in Finding of Fact 28.
50 - 52. Subordinate to Finding of Fact 7.
Rejected as not relevant.
Subordinate to Finding of Fact 7.
Adopted in Finding of Fact 7.
Subordinate to Finding of Fact 7.
Subordinate to Finding of Fact 7.
Subordinate to Finding of Fact 20.
Subordinate to Finding of Fact 7.
60 and 61. Rejected in Finding of Fact 20.
62. Rejected in Finding of Fact 21.
63 and 64. Rejected in Finding of Fact 20.
65. Subordinate to Finding of Fact 20.
66 and 67. Rejected in Finding of Fact 30.
Rejected in Finding of Fact 28.
Rejected in Finding of Fact 29.
Rejected in Finding of Fact 21.
Subordinate to Finding of Fact 26.
Rejected in Finding of Fact 28.
73 - 85. Rejected as unnecessary.
86. Rejected as irrelevant. See, p. 27 of St. Mary's Hospital, Inc. v. DHRS, et al., DOAH Case No. 89-5417R et. seq., June 12, 1990.
87 and 88. Rejected as unnecessary.
Rejected as irrelevant.
Subordinate, first sentence, to Finding of Fact 7. Rejected, second sentence, in Finding of Fact 20.
Rejected in Finding of Fact 22.
92 and 93. Subordinate to Finding of Fact 23.
94 and 95. Subordinate to Finding of Fact 24.
96. Rejected as unnecessary.
97 and 98. Rejected as irrelevant.
Adopted in Finding of Fact 20.
Rejected, first phrase, in Finding of Fact 31. Adopted, second phrase, in Finding of Fact 28.
Subordinate to Finding of Fact 20.
Rejected as irrelevant.
Subordinate to Finding of Fact 25.
Rejected as irrelevant.
Rulings on findings proposed by DHRS:
Subordinate to Preliminary Statement.
Adopted in Finding of Fact 2.
3 and 4. Subordinate to Preliminary Statement.
Adopted in Findings of Fact 5 and 8.
Adopted, in relevant part, in Findings of Fact 6 and 9.
Adopted, in relevant part, in Findings of Fact 8 and 9.
Adopted in or subordinate to Finding of Fact 12.
9 and 10. Adopted in Finding of Fact 13.
Adopted in Finding of Fact 16.
Adopted in Finding of Fact 17.
Adopted in Finding of Fact 18.
Adopted in Findings of Fact 19 and 20.
Adopted, in relevant part, in Finding of Fact 28.
Subordinate to Preliminary Statement.
Adopted, in relevant part, in Findings of Fact 22 - 25 and 31.
Adopted, in relevant part, in Conclusions of Law.
Rulings on findings proposed by All Children's Hospital, Inc.:
1. Adopted in Finding of Fact 1.
2 and 3. Subordinate to Preliminary Statement.
Adopted in Preliminary Statement and Finding of Fact 2.
Adopted in Preliminary Statement
Adopted in Preliminary Statement and Recommendation 1.
Adopted in Finding of Fact 6.
Adopted, in relevant part, in Finding of Fact 8.
Subordinate to Finding of Fact 5.
Adopted in Preliminary Statement and Subordinate to Finding of Fact 6.
Adopted, in relevant part, in Finding of Fact 6.
Rejected as not relevant.
Adopted, in relevant part, in Finding of Fact 8.
Adopted, in relevant part, in Finding of Fact 9.
15 and 16. Adopted in Finding of Fact 12.
17 and 18. Adopted in Finding of Fact 13.
Adopted, in relevant part, in Finding of Fact 14.
Subordinate to Preliminary Statement and Finding of Fact 9.
Subordinate to Finding of Fact 9.
Subordinate to Findings of Fact 9 and 13.
Subordinate to Findings of Fact 10, 23 and 24.
24 and 25. Subordinate to Finding of Fact 11.
Subordinate to Finding of Fact 5.
Adopted, in relevant part, in Findings of Fact 22 and 23.
Subordinate to Findings of Fact 24 and 26.
Subordinate, first sentence, to Findings of Fact 22 and 23. Rejected, second sentence, as irrelevant.
30 - 34. Rejected as irrelevant.
Subordinate to Finding of Fact 24.
Subordinate to Finding of Fact 27.
Rejected as irrelevant.
Subordinate to Finding of Fact 24.
39 and 40. Subordinate to Finding of Fact 27.
41 and 42. Subordinate to Finding of Fact 20.
Adopted in Finding of Fact 27.
Subordinate to Finding of Fact 20.
45 and 46. Rejected in Finding of Fact 7.
47 and 48. Adopted in Finding of Fact 21.
Subordinate to Finding of Fact 20.
Subordinate to Finding of Fact 30.
Adopted in Finding of Fact 30.
52 and 53. Subordinate to Finding of Fact 24.
Subordinate to Finding of Fact 23.
Subordinate to Finding of Fact 20.
Subordinate to Finding of Fact 27.
Adopted, in relevant part, in Finding of Fact 27.
58 and 59. Rejected as unnecessary.
Adopted in Finding of Fact 31.
Adopted, in relevant part, in Finding of Fact 21.
Rulings on findings proposed by Morton F. Plant Hospital:
Adopted in Finding of Fact 1.
Adopted in Finding of Fact 2.
Adopted, in relevant part, in Finding of Fact 3.
Subordinate to Finding of Fact 7.
Adopted in Preliminary Statement.
Rejected as unnecessary.
Adopted in Finding of Fact 27.
8 and 9. Subordinate to Finding of Fact 27.
Rejected as unnecessary.
Adopted in Finding of Fact 11.
Adopted, in relevant part, in Finding of Fact 22.
Rejected in Finding of Fact 23.
14 and 15. Subordinate to Finding of Fact 27.
Adopted in Finding of Fact 25.
Adopted in Finding of Fact 6.
Adopted in Finding of Fact 9.
Adopted, in relevant part, in Findings of Fact 9 and 10.
20 and 21. Adopted in Finding of Fact 12.
22 and 23. Adopted in Finding of Fact 13.
Adopted in Finding of Fact 14.
Adopted in Findings of Fact 14 and 15.
Subordinate to Findings of Fact 10 and 12 - 14. 27.
28. Adopted, in relevant part (first sentence), in Finding of Fact 15.
29 and 30. Subordinate to Finding of Fact 7.
Adopted in Findings of Fact 19 and 20.
Adopted in Finding of Fact 27.
Adopted in Finding of Fact 16.
Rejected.
Adopted in Finding of Fact 30.
36 and 37. Rejected as unnecessary.
38 - 40. Subordinate to Finding of Fact 28.
Subordinate to Finding of Fact 21.
Adopted in Finding of Fact 31.
Adopted in Finding of Fact 3.
Subordinate to Conclusion of Law.
Adopted in Findings of Fact 3 and 4.
Subordinate to Conclusion of Law.
COPIES FURNISHED:
Richard Patterson, Esquire Department of Health and
Rehabilitative Services 2727 Mahan Drive
Tallahassee, Florida 32308
Kenneth F. Hoffman, Esquire Patricia A. Renovitch, Esquire OERTEL HOFFMAN FERNANDEZ & COLE
Post Office Box 6507 Tallahassee, Florida 32314-6507
Gerald Sternstein, Esquire McFARLAIN STERNSTEIN WILEY
& CASSEDY, P.A.
600 First Florida Bank Building Post Office Box 2174 Tallahassee, Florida 32316-2174
Cynthia S. Tunnicliff, Esquire CARLTON, FIELDS, WARD, EMMANUEL,
SMITH AND CUTLER, P.A.
Post Office Drawer 190 Tallahassee, Florida 32302
Sam Power, Agency Clerk Department of Health and
Rehabilitative Services 1323 Winewood Boulevard
Tallahassee, Florida 32399-0700
John Slye, General Counsel Department of Health and
Rehabilitative Services 1323 Winewood Boulevard
Tallahassee, Florida 32399-0700
NOTICE OF RIGHT TO SUBMIT EXCEPTIONS
All parties have the right to submit written exceptions to this Recommended Order. All agencies allow each party at least 10 days in which to submit written exceptions. Some agencies allow a larger period within which to submit written exceptions. You should contact the agency that will issue the final order in this case concerning agency rules on the deadline for filing exceptions to this Recommended Order. Any exceptions to this Recommended Order should be filed with the agency that will issue the final order in this case.
| Issue Date | Proceedings |
|---|---|
| Dec. 03, 1991 | Final Order filed. |
| Nov. 01, 1991 | Recommended Order sent out. CASE CLOSED. Hearing held 7/8-12/91. |
| Sep. 20, 1991 | Proposed Recommended Order of All Children's Hospital, Inc. filed. |
| Sep. 20, 1991 | Respondent's Proposed Recommended Order filed. |
| Sep. 20, 1991 | Proposed Recommended Order filed. (From Cynthia Tunnicliff) |
| Sep. 12, 1991 | Order Granting Motion for Extension of Time to File Proposed Recommended Order sent out. |
| Sep. 10, 1991 | All Children's Hospital's Motion to Extend Time For Filing Proposed Recommended Order filed. (From Gerald B. Sternstein) |
| Aug. 30, 1991 | (Petitioner) Amended Response of Mease Hospital Dunedin to Amended Motion to Strike by All Childrens Hospital w/Atts. filed. |
| Aug. 26, 1991 | (Petitioner) Response of Mease Hospital Dunedin to All Children's Motion to Strike filed. (From Patricia A. Renovitch) |
| Aug. 26, 1991 | Deposition of Judith Scollo filed. |
| Aug. 20, 1991 | Notice of Hearing ; All Children's Hospital, Inc.'s Motion to Strike and Exclude Testimony w/Exhibit A-C filed. (From Gerald B. Sterstein) |
| Aug. 08, 1991 | Transcript (10 Vols) filed. |
| Jul. 18, 1991 | Notice of Taking Deposition filed. (from Patricia A. Renovitch) |
| Jul. 08, 1991 | Transcript filed. |
| Jul. 08, 1991 | (All Children's) Prehearing Stipulation of All Children's Hospital, Inc. filed. (From Gerald B. Sternstein) |
| Jul. 08, 1991 | Motion in Limine to Exclude Testimony of Louis Gluck, M.D. filed. |
| Jul. 08, 1991 | Written Response to Motion in Limine of Mease Hospital filed. |
| Jul. 08, 1991 | Final Hearing Held 7/8-12/91; for applicable time frames, refer to CASE STATUS form stapled on right side of Clerk's Office case file. |
| Jul. 05, 1991 | (Petitioner) Motion to Compel Morton Plant to Produce Requested Documents; Motion For Sanctions Against Morton F. Plant w/Exhibit-A filed. (From Patricia A. Renovitch) |
| Jul. 05, 1991 | (All Children's Hospital) Notice of Intent to Rely Upon Summary Exhibits; Second Notice of Filing Deposition of Lewis Gluck, M. D. filed. |
| Jul. 03, 1991 | Amended Notice of Taking Deposition filed. (from G. Sternstein) |
| Jul. 03, 1991 | Motion to Exclude Tesimony or Grant Other Alternative Relief (+ att's) filed. |
| Jul. 02, 1991 | Amended Prehearing Stipulation of Trustees of Mease Hospital, Inc d/b/a Mease Hospital Dunedin filed. |
| Jul. 02, 1991 | Reply to Morton Plant's Response to Motion for Summary Recommended Order on the Issue of Morton Plant's Standing filed. |
| Jul. 02, 1991 | Ltr. to P. Renovitch from G. Sternstein w/cc: EH filed. |
| Jul. 02, 1991 | Notice of Prehearing Conference (set for 7-3-91; 10:00a) filed. |
| Jul. 01, 1991 | (Morton Plant) Response to Motion for Summary Recommended Order; CC of Deposition of Donna Reynolds filed. . |
| Jul. 01, 1991 | (Morton Plant) Witness and Exhibit List filed. |
| Jul. 01, 1991 | (Morton Plant) Response to Request for Documents filed. |
| Jul. 01, 1991 | Notice of Filing Answers to First Interrogatories of Trustees of Mease Hospital, Inc. d/b/a Mease Hospital Dunedin filed. |
| Jun. 26, 1991 | Motion For Protective Order w/Exhibits A-D filed. (From Patricia A. Renovitch) |
| Jun. 25, 1991 | Order on Motions for Protective Orders sent out. |
| Jun. 25, 1991 | Supplemental Response to Motion For Protective Order filed. (From C. Tunnicliff) |
| Jun. 24, 1991 | Motion For Summary Recommended Order on the Issue of Morton Plant's Standing to Intervene in The Proceeding Regarding The Level III Nicu Preliminary Inventory w/Exhibits A-D filed. (From Kenneth F. Hoffman) |
| Jun. 21, 1991 | (Trustees of Mease Hospital, Inc.) Motion For Protective Order filed.(From Patricia A. Renovitch) |
| Jun. 21, 1991 | Amended Notice of Taking Deposition filed. (From Cynthia Tunnicliff) |
| Jun. 21, 1991 | Amended Notice of Taking Deposition filed. (From Cynthia Tunnicliff) |
| Jun. 20, 1991 | Reply to Resopnse of Morton Plant Hospital, Inc. to Mease's Motion For Protective Order w/Exhibit-A filed. (From Patricia A. Renovitch) |
| Jun. 19, 1991 | Response of Morton Plant Hospital, Inc. to the Motion For Protective Order Filed by Trustees of Mease Hospital, Inc. & cover ltr filed. (From Cynthia S. Tunnicliff) |
| Jun. 19, 1991 | Fifth Amended Notice of Taking Deposition Duces Tecum filed. (From Patricia A. Renovitch) |
| Jun. 19, 1991 | Fourth Amended Notice of Taking Depositions Duces Tecum and Notice Cancelli8ng Specified June 19 Depositions filed. (From Patricia A. Renovitch) |
| Jun. 18, 1991 | Mease's Response to All Children's Motion in Limine to Exclude Testimony of Louis Gluck, M.D. filed. (From Patricia A. Renovitch) |
| Jun. 18, 1991 | Amendment to Mease's Motion For Protective Order filed. (From Patricia A. Renovitch) |
| Jun. 17, 1991 | (Petitioner) Request for Production of Documents; Notice of Service of Interrogatories filed. (From Patricia A. Renovitch) |
| Jun. 17, 1991 | Third Amended Notice of Taking Deposition Duces Tecum and Notice Cancelling Second Deposition of Marcia Wiseman; Motion For Expedited Discovery From Morton Plant and All Children's filed. (from Patricia Renovitch) |
| Jun. 17, 1991 | (Trustees of Mease Hospital d/b/a) Motion For Protective Order filed.(From Patricia A. Renovitch) |
| Jun. 17, 1991 | Motion Requesting Pre-Hearing Conference; Notice of Taking Depositionfiled. (From Gerald B. Sternstein) |
| Jun. 14, 1991 | Notice of Taking Deposition filed. (From Cynthia S. Tunnicliff) |
| Jun. 13, 1991 | Notice of Taking Deposition Duces Tecum filed. (From Patricia A. Renovitch) |
| Jun. 12, 1991 | Second Amended Notice of Taking Deposition Duces Tecum; Notice of Intent to Rely Upon Summary Exhibits; Response to Motion For Protective Order filed. (From Patricia A. Renovitch) |
| Jun. 11, 1991 | (Morton Plant) Motion For Protective Order w/exhibits A-D filed. (From Cynthia S. Tunnicliff) |
| Jun. 11, 1991 | CC Letter to Patricia A. Renovitch from C. Tunnicliff (re: Depositionnotice) filed. |
| Jun. 11, 1991 | Amended Notice of Taking Deposition Duces Tecum filed. (From PatriciaA. Renovitch) |
| Jun. 05, 1991 | Notice of Taking Deposition Duces Tecum filed. (From P. A. Renovitch) |
| May 30, 1991 | Order Denying Motion for Reconsideration sent out. |
| May 28, 1991 | Transcript filed. |
| May 23, 1991 | Amended Notice of Taking Deposition Duces Tecum filed. (from P. A. Renovitch) |
| May 23, 1991 | Amended Notice of Taking Deposition Duces Tecum filed. (From P. A. Renovitch) |
| May 21, 1991 | Notice of Hearing on Mease's Motion For Reconsideration filed. (From Patricia A. Renovitch) |
| May 21, 1991 | Notice of Exception by All Children's Hospital, Inc. to Trustees of Mease Hospital, Inc. d/b/a Mease Hospital Dunedin Allegations in Reply to Morton Plant's Response w/Composite Exhibit-A filed. (From Gerald Sternstein) |
| May 15, 1991 | Transcript filed. |
| May 10, 1991 | Mease's Reply to Morton Plant's Response to Meases' Motion For Reconsideration w/exhibit-1 filed. (From Patricia A. Renovitch) |
| May 09, 1991 | Notice of Taking Deposition Duces Tecum filed. (From Patricia A. Renovitch) |
| May 09, 1991 | Response to Motion For Reconsideration filed. (From Cynthia Tunnicliff) |
| May 02, 1991 | Corrected Order Granting Intervention and Denying Motion to Dismiss sent out. |
| May 02, 1991 | (Petitioner) Motion For Reconsideration of Hearing Officer's Order Granting Intervention and Denying Motion to Dismiss filed. (From Robert C. Downie) |
| Apr. 30, 1991 | Reply to Respondent to Motion to Dismiss filed. (From Robert Downie) |
| Apr. 29, 1991 | Order Granting Intervention and Denying Motion to Dismiss sent out. (For Morton F. Plant Hospital, Inc). |
| Apr. 24, 1991 | Response to Motion to Dismiss filed. (From Cynthia Tunnicliff) |
| Apr. 24, 1991 | Notice of Administrative Reassignment of Cases (to Hearing Officer Eleanor Hunter) sent out. |
| Apr. 15, 1991 | (Petitioner) Motion to Dismiss w/exhibit-A filed. (From robert C. Downie) |
| Apr. 09, 1991 | Order Granting Mease's Motion for Partial Summary Recommended Order (Level II NICU Beds) sent out. |
| Apr. 03, 1991 | (Morton F. Plant Hospital, Inc.) Petition to Intervene filed. |
| Mar. 20, 1991 | Second Amended Notice of Hearing sent out. (hearing set for 7/8-12/91; at 9:00am; in Talla) |
| Mar. 18, 1991 | Ltr. to VED from P. Renovitch re: availability for hrg. filed. |
| Mar. 06, 1991 | Order Granting Continuance, Establishing Final Discovery Deadlines and Requiring Alternative Hearing Dates (parties have until 3/18/91 to give HO proposed hearing dates) sent out. |
| Mar. 04, 1991 | Motion for Continuance or in The Alternative Motion in Limine to Exclude; Notice of Hearing (March 5, 1991: 10:30) filed. |
| Mar. 01, 1991 | (Petitioner) Prehearing Stipulation of Trustees of Mease Hospital, Inc., d/b/a Mease Hospital Dunedin filed. |
| Feb. 25, 1991 | Amended Final Withess and Exhibit List of All Children's Hospital, Inc. filed. |
| Feb. 22, 1991 | cc: Letter to P. Renovitch from G. Sternstein (Re: Requesting that deposition be rescheduled) filed. |
| Feb. 22, 1991 | Letter to G. Sternstein from P. Renovitch (Re: Depositions Taken) filed. |
| Feb. 21, 1991 | Trustees of Mease Hospital, Inc., d/b/a Mease Hospital Dunedin's Second Request for Production of Documents to All Children's Hospital, Inc. filed. |
| Feb. 21, 1991 | (Mease Hospital) Supplemental Notice of Taking Depositions Duces Tecum; Notice of Taking Deposition Duces Tecum filed. |
| Feb. 20, 1991 | All Childrens Hospital, Inc.'s Third Request to Produce to Mease Health Care, Inc., d/b/a Mease Hospital Dunedin; Notice of Taking Depositions Duces Tecum filed. |
| Feb. 19, 1991 | (Petitioner) Notice of Taking Deposition Duces Tecum filed. |
| Feb. 15, 1991 | Order Limiting Scope of Discovery, Scheduling Discovery Deadlines, Scheduling Prehearing Conference, Requiring Prehearing Stipulation sent out. |
| Feb. 15, 1991 | Mease Hospital Dunedin's Responses to All Children's Second Request to Produce and All Children's Supplemental Request to Second Request toProduce; Motion in Limine w/exhibits A&B filed. (From Patricia A. Renovitch) |
| Feb. 12, 1991 | Emergency Motion for Prehearing Conference Regarding Discovery and Motion For Protective Orders; Notice of Hearing filed. (From Gerald B. Sternstein) |
| Feb. 12, 1991 | The Sworn Statements of Cheryl Kayes, R. N. Mary Newport, M.D. and Odalys Capote; Response to Motion to Compel Filed by All Children's Hospital filed. |
| Feb. 12, 1991 | Intervenor's, All Children's Hospital, Inc., Final Witness and Exhibit List (second original) filed. |
| Feb. 12, 1991 | (All Children's Hospital) Notice of Hearing (motion hearing set for 2/19/91; 9:30am; Talla) filed. |
| Feb. 11, 1991 | Intervenor's, All Children's Hospital, Inc., Final Witness and Exhibit List filed. (From Gerald B. Sternstein) |
| Feb. 07, 1991 | (Petitioner) Motion to Amended Mease Hospital Dunedin's Witness List;Mease Hospital Dunedin's Supplemental Request to Produce to All Children's Hospital filed. (From Patricia A. Renovitch) |
| Feb. 07, 1991 | (Petitioner) Motion to Shorten Time For Responses to Mease Hospital Dunedin's Supplemental Request to Produce to All Children's Hospital filed. (From Patricia A. Renovitch) |
| Feb. 05, 1991 | Motion to Shorten Time For Responses to All Children's Hospital, Inc.'s Second Request and Supplemental Request to Produce to Mease Hospital filed. (From Gerald B. Sternstein) |
| Feb. 05, 1991 | (All Children's Hospital) Motion to Compel; All Children's Hospital, Inc.'s Supplemental Request to Second Request to Produce to Mease Health Car, d/b/a Mease Hospital Dunedin filed. (from Gerald B. Sternstein) |
| Feb. 04, 1991 | (Intervenor) Notice of Filing Mease Hospital's Responses to All Children's Hospital's Second Interrogatories w/exhibits A&B filed. (From Gerald B. Sternstein) |
| Feb. 01, 1991 | Amended Notice of Taking Deposition Duces Tecum filed. (From Gerald B. Sternstein) |
| Jan. 31, 1991 | Third Amended Notice of Taking Deposition Duces Tecum filed. (From Patricia A. Renovitch) |
| Jan. 30, 1991 | Second Amended Notice of Taking Deposition Duces Tecum filed. (from Patricia A. Renovitch) |
| Jan. 29, 1991 | (All Children's Hospital, Inc.) Notice of Taking Deposition Duces Tecum; All Children's Hospital, Inc.'s Second Request to Produce to MeaseHealth Care, Inc., d/b/a Mease Hospital Dunedin filed. (From Gerald B. Sternstein) |
| Jan. 28, 1991 | HRS Final Witness and Exhibit Lists filed. (From Richard A. Patterson) |
| Jan. 25, 1991 | Amended Notice of Taking Deposition Duces Tecum filed. (From Ken A. Hoffman) |
| Jan. 24, 1991 | Trustees of Mease Hospital, Inc., d/b/a Mease Hospital Dunedin's Final Witness List; Trustees of Mease Hospital, INc., d/b/a Mease HospitalDunedin's Final Exhibit List filed. (From Patricia A. Renovitch) |
| Jan. 18, 1991 | Notice of Taking Deposition Duces Tecum; Trustees of Mease Hopsital, INc., d/b/a Mease HOspital Dunedin's Responses to All Children's FirstRequest to Produce; Notice of Service of Responses to Interrogatoriesfiled. (From Patricia A. Renovitch/) |
| Jan. 15, 1991 | Trustees of Mease Hospital, Inc., d/b/a Mease Hospital Dunedin's Response to HRS'S Request to Produce filed. (from Patricia A. Renovitch) |
| Jan. 14, 1991 | (Petitioners) Notice of Taking Deposition filed. (From Patricia A. Renovitch) |
| Jan. 10, 1991 | Order Granting Motion for Extension of Time (Petitioner has until Jan. 15, 1991 to respond to Motion for Partial Summary Recommended Order of Mease) sent out. |
| Jan. 10, 1991 | Amended Notice of Hearing sent out. (hearing set for March 6-8, 1991:9:00 am: Tallahassee) |
| Jan. 07, 1991 | Motion for Extension of Time in Which to File Response to Mease's Motion For Summary Recommended Order filed. (from Gerald B. Sternstein) |
| Jan. 03, 1991 | Trustees of Mease Hospital, Inc., d/b/a Mease Hospital Dunedlin's Preliminary Witness List filed. (From Patricia A. Renovitch) |
| Jan. 02, 1991 | All Children's Hospital, Inc.'s Corrected Response to First Request For Production From Trustees of Mease Hospital, Inc., d/b/a Mease Hospital Dunedin filed. (from G. B. Sternstein) |
| Jan. 02, 1991 | HRS' Notice of Service of Answers to First Interrogatories filed. (from Richard A. Patterson) |
| Dec. 28, 1990 | (Children's Hospital) Notice of Service of Responses to Interrogatories; All Children's Hospital, Inc.'s Response to First Request For Production From Trustees of Mease Hospital, Inc., d/b/a Mease Hospital Dunedin filed. (from G. B. Sternstein) |
| Dec. 28, 1990 | (Respondent) Request For Production of Documents filed. (From RichardA. Patterson) |
| Dec. 26, 1990 | Mease's Motion for Partial Summary Recommended Order (Level II NICU Beds) (+ exhibits) filed. |
| Dec. 26, 1990 | Mease's Memorandum in Support of Its Motion for Partial Summary Recommended Order filed. |
| Dec. 24, 1990 | Intervenor's, All Children's Hospital, Inc., Preliminary Witness Listfiled. |
| Dec. 21, 1990 | HRS' Preliminary Witness List filed. (From Richard A. Patterson) |
| Dec. 21, 1990 | Notice of Service of Response to Interrogatories filed. (From Ken F.Hoffman) |
| Dec. 19, 1990 | (Petitioner) Notice of Serving Second Interrogatories of All Children's Hospital, Inc. tpoMease Health Care, Inc., d/b/a Mease Hospital Dunedin filed. (from Gerald B. Sternstein) |
| Dec. 19, 1990 | All Children's Hospital, Inc.'s First Request to Produce to Mease Health CAre, Inc., d/b/a Mease HOspital Dunedin filed. (From GErald B. Sternstein) |
| Dec. 10, 1990 | Order Granting All Children's Hospital, Inc.'s Petition To Intervene |
| Dec. 10, 1990 | Order Establishing Prehearing Schedule sent out. |
| Nov. 30, 1990 | Motion For Entry of Order Establishing Prehearing Schedule filed. (From G. B. Sternstein) |
| Nov. 30, 1990 | Notice of Service of Interrogatories filed. (From P. A. Renovitch) |
| Nov. 30, 1990 | Letter to VED from P. A. Renovitch (re: issues that need resolving) filed. |
| Nov. 29, 1990 | (Petitioner) Notice of Service of Interrogatories filed. (From P. A. Renovitch) |
| Nov. 29, 1990 | (Petitioner) Request for Production of Documents filed. (From P. Renovitch) |
| Nov. 28, 1990 | Amended Notice of Taking Deposition filed. (from P. A. Renovitch) |
| Nov. 26, 1990 | (Petitioner) Notice of Serving First Interrogatories of All Children's Hospital, Inc. to Mease Health Care, Inc., d/b/a MEase Hospital Dunedin filed. (From Gerald B. Sternstein) |
| Nov. 26, 1990 | Response of HRS and Mease to All Children's Petition to Intervene filed. |
| Nov. 26, 1990 | (Mease Hospital) Notice of Taking Depositions filed. |
| Nov. 19, 1990 | Order Revoking Previous Order Granting Petition to Intervene and Rescheduling Hearing (Hearing set for Dec. 4, 1990: 9:00 am: Tallahassee) sent out. |
| Nov. 15, 1990 | (Petitioner) Response to Hearing Officer's Order Granting All Children's Hospital, Inc.'s Petition to Intervene filed. (From Patricia A. Renovitch) |
| Nov. 07, 1990 | Order Granting All Childrens Hospital, Inc.'s Petition to Intervene |
| Nov. 07, 1990 | Order of Consolidation sent out. Consolidated case are: 90-6255 and 90-6256 |
| Nov. 07, 1990 | Notice of Hearing sent out. (hearing set for Feb. 4-5, 1991: 8:00 am: Tallahassee) |
| Oct. 29, 1990 | Notice of Prehearing Conference (Nov. 5, 1990: 10:30 am: Tallahassee)sent out. |
| Oct. 26, 1990 | (Intervenor) Petition to Intervene filed. (From Gerald B. Sternstein) |
| Oct. 18, 1990 | (Trustees of Mease Hospital, Inc.) Motion to Consolidate (with DOAH Case No. 90-6256) filed. (From Patricia a. Renovitch) |
| Oct. 18, 1990 | (Trustees of Mease Hopital, Inc.) Response to Initial Order filed. (From Patricia A. Renovitch) |
| Oct. 09, 1990 | Initial Order issued. |
| Oct. 01, 1990 | Notice; Petition for Formal Administrative Proceeding, other supporting documents attached filed. |
| Jan. 07, 1990 | (All Children's Hospital) Motion for Continuance filed. (From Gerald B. Sternstein) |
| Issue Date | Document | Summary |
|---|---|---|
| Dec. 01, 1991 | Agency Final Order | |
| Nov. 01, 1991 | Recommended Order | Neonatal intensive care unit level III grandfather not applicable. |
