STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

ALL CHILDREN’S HOSPITAL, INC. and ) VARIETY CHILDREN’S HOSPITAL d/b/a ) MIAMI CHILDREN’S HOSPITAL, )

)

Petitioners, )

)

vs. )

) STATE OF FLORIDA, AGENCY FOR ) HEALTH CARE ADMINISTRATION )

) CASE NO. 96-5531RU

Respondent, )

and )

) ST. JOSEPH’S HOSPITAL, INC., THE ) FLORIDA STATUTORY TEACHING ) HOSPITAL COUNCIL, SHANDS AT THE ) UNIVERSITY OF FLORIDA, SOUTH ) BROWARD HOSPITAL DISTRICT d/b/a ) MEMORIAL REGIONAL HOSPITAL, and ) HOSPITAL BOARD OF DIRECTORS OF LEE ) COUNTY d/b/a LEE MEMORIAL )

HOSPITAL, )

)

Intervenors. )

)

FINAL ORDER

On December 30, 1996, a formal administrative hearing was held in this case in Tallahassee, Florida, before Richard Hixson, Administrative Law Judge, Division of Administrative Hearings.

APPEARANCES

For Petitioners: Gerald B. Sternstein, Esquire All Children’s Frank P. Rainer, Esquire Hospital, Inc. RUDEN, McCLOSKY, SMITH, SCHUSTER

and Variety & RUSSELL, P.A.

Children’s 215 South Monroe Street, Suite 815 Hospital d/b/a Tallahassee, Florida 32301

Miami Children’s Hospital

For Respondent: Richard Ellis, Esquire Agency for Assistant General Counsel

Health Care Agency for Health Care Administration Administration 2727 Mahan Drive

Tallahassee, Florida 32308-5403

For Intervenors: R. Terry Rigsby, Esquire South Broward Wendy A. Delvecchio, Esquire Hospital Richard A. Lotspeich, Esquire District d/b/a BLANK, RIGSBY & MEENAN, P.A. Memorial 204 South Monroe Street

Regional Tallahassee, Florida 32301 Hospital d/b/a

Joe DiMaggio Children’s Hospital at Memorial

For Intervenor: Glenn Burton, Esquire

St. Joseph’s SHEAR, NEWMAN, HAHN & ROSENKRANZ

Hospital, Inc. 201 East Kennedy Boulevard, Suite 1000

Tampa, Florida 33601-2378

For Intervenor: Robert C. McCurdy, Esquire

Hospital Board Hospital Board of Directors of Lee County of Directors of Post Office Box 2218

Lee County d/b/a Ft. Myers, Florida 33902-2218 Lee Memorial

Hospital

For Intervenors: Mark K. Delegal, Esquire Florida John C. Taylor, Jr., Esquire

Statutory TAYLOR, DAY & RIO

Teaching 311 South Calhoun Street, Suite 206 Hospital Council Tallahassee, Florida 32301

and Shands Teaching Hospital and

Clinics, Inc. d/b/a Shands Hospital

STATEMENT OF THE ISSUES

The issues for determination in this case are: 1) whether Respondent, the Agency for Health Care Administration has made a nonrule policy statement which constitutes a “rule” as defined in Section 120.52(15), Florida Statutes, which in substance states that a hospital, licensed as a general hospital as defined in Section 395.002(10), Florida Statutes, may use the term “children’s hospital” and otherwise hold itself out and advertise as a “children’s hospital” without obtaining a license as a specialty hospital for children as defined in Section 395.002(27), Florida Statutes, and Rule 59A-3.02, Florida Administrative Code; 2) whether such agency policy statement, if made, constitutes a “rule” as defined in Section 120.52(15), Florida Statutes; 3) whether such agency policy statement, if made, has been adopted by rule as provided for in Section 120.54, Florida Statutes; and, 4) whether such agency policy statement, if made, constitutes an invalid exercise of delegated legislative authority as defined in Section 120.52(8), Florida Statutes.

PRELIMINARY STATEMENT

On December 19, 1996, Petitioners, ALL CHILDREN’S HOSPITAL, INC. and VARIETY CHILDREN’S HOSPITAL, d/b/a MIAMI CHILDREN’S

HOSPITAL, filed a Petition pursuant to Section 120.56, Florida Statutes, alleging that Respondent, FLORIDA AGENCY FOR HEALTH

CARE ADMINISTRATION (AHCA), had adopted the following nonrule policy statement:

The Agency for Health Care Administration takes the position that a hospital licensed as a general hospital, pursuant to Chapter 395, can designate itself as a “Children’s Hospital” and advertise such hospital status to the general public, without following the requirements of Rule 59A-3.202 and 59A- 3.201(65) and without obtaining a license as a Class II Specialty Hospital for Children.

Petitioners further alleged that this agency nonrule policy statement constituted a rule as defined in Section 120.52(15), Florida Statutes, that the statement had not been promulgated as a rule as required by Section 120.54, Florida Statutes, and that this agency policy statement was an invalid exercise of delegated legislative authority as set forth in Section 120.52(8), Florida Statutes.

Subsequent to the filing of the Petition, intervention was sought by the following hospitals: ST. JOSEPH’S HOSPITAL, INC.; THE FLORIDA STATUTORY TEACHING HOSPITAL COUNCIL, SHANDS AT THE UNIVERSITY OF FLORIDA; SOUTH BROWARD HOSPITAL DISTRICT d/b/a MEMORIAL REGIONAL HOSPITAL AND JOE DIMAGGIO CHILDREN’S HOSPITAL; and, HOSPITAL BOARD OF DIRECTORS OF LEE COUNTY d/b/a LEE MEMORIAL

HOSPITAL. Pursuant to the stipulations of the parties, the several petitions to intervene were granted.

Final hearing in this case was held December 30, 1996. At hearing Petitioners presented the testimony of two witnesses, J. Dennis Sexton, qualified as an expert in children’s hospital

administration and policy, and Tanya Williams, AHCA Bureau Chief for the Bureau of Health Facility Regulation. Petitioner also presented ten (10) exhibits which were admitted into evidence.

Respondent AHCA also presented the testimony of Tanya Williams, and four (4) exhibits which were admitted into evidence. During the hearing, the parties entered into several stipulations as more fully set forth below, in light of which Intervenors determined that no further evidentiary presentation was required.

A transcript of the proceedings was filed February 11, 1997. On March 12, 1997, the parties filed their proposed final orders. Subsequent to the filing of the proposed final orders Petitioner filed a Motion to Strike certain portions of Intervenors’ proposed final orders. For reasons more fully set forth below, it is determined that the nonrule policy statement made by AHCA is not a “rule” for purposes of Chapter 120, Florida Statutes, and accordingly Petitioner’s Motion to Strike such

portions of proposed final orders is DENIED as moot.

FINDINGS OF FACT

1. Petitioner, ALL CHILDREN’S HOSPITAL, INC. (ALL CHILDREN’S), is a licensed Class II Children’s Specialty Hospital located in St. Petersburg, Florida. ALL CHILDREN’S is licensed for 168 beds, including 108 acute care beds, 36 Level II neonatal intensive care (NICU) beds, and 24 Level III NICU beds. Historically, since its founding in 1926, ALL CHILDREN’S has been

   primarily committed to providing medical services to children, although ALL CHILDREN’S does provide limited services to adult patients, including a shared open heart surgery program with Bayside Medical Center.

2. Petitioner, VARIETY CHILDREN’S HOSPITAL, INC., d/b/a MIAMI CHILDREN’S HOSPITAL (VARIETY), is a licensed Class II children’s specialty hospital located in Miami, Florida. VARIETY is licensed for 268 beds, with 218 acute care beds, 20 psychiatric beds, 7 Level II NICU beds, and 23 Level III NICU beds.

3. Respondent, FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION (AHCA), is the agency of the State of Florida vested with the statutory authority for administering the provisions of Chapter 395, Florida Statutes, relating to hospital licensure and regulation.

4. Intervenor, ST. JOSEPH’S HOSPITAL INC. (ST. JOSEPH’S), is licensed as a Class I general acute care hospital located in Tampa, Florida. ST. JOSEPH’S is licensed for 883 beds, with 799 acute care beds, 42 adult inpatient psychiatric beds, 15 Level II NICU beds, and 27 Level III NICU beds. ST. JOSEPH’S operates a pediatric unit within the hospital which is designated as Tampa Children’s Hospital at ST. JOSEPH’S. ST. JOSEPH’S uses this designation in its publications and advertisements.

5. Intervenors, FLORIDA STATUTORY TEACHING HOSPITAL COUNCIL and SHANDS AT THE UNIVERSITY OF FLORIDA (SHANDS), intervened

   jointly; however, the primary party substantially affected by the issues raised in this case is SHANDS. SHANDS is a statutory teaching hospital located in Gainesville, Florida. SHANDS is licensed as a Class I general acute care hospital and has 568 beds including 484 acute care beds, 24 adult inpatient psychiatric beds, 18 child inpatient psychiatric beds, 30 Level II NICU beds, and 20 Level III NICU beds. SHANDS provides children’s health care services in a distinct pediatric unit within the hospital. SHANDS uses the term “children’s hospital” in its publications and advertisements regarding the provision of the services in its pediatric unit.

6. Intervenor, SOUTH BROWARD HOSPITAL DISTRICT d/b/a MEMORIAL REGIONAL HOSPITAL and JOE DIMAGGIO CHILDREN’S HOSPITAL (MEMORIAL), is licensed as a Class I general acute care hospital located in Ft. Lauderdale, Florida. MEMORIAL is licensed for 680 beds, including 515 acute care, 100 adult inpatient psychiatric beds, 36 comprehensive rehabilitation beds, 10 Level II NICU beds, and 19 Level III NICU beds. MEMORIAL operates the Joe DiMaggio Children’s Hospital (which MEMORIAL has registered as a fictitious name) as a distinct pediatric unit within MEMORIAL, and uses the term “children’s hospital” in its publications and advertisements.

7. Intervenor, HOSPITAL BOARD OF DIRECTORS OF LEE COUNTY d/b/a LEE MEMORIAL HOSPITAL (LEE), is licensed as a Class I general acute care hospital located in Ft. Myers, Florida. LEE

   is licensed for 427 beds, including 367 acute care beds and 60 comprehensive medical rehabilitation beds. LEE also is licensed for its Health Park campus which contains 220 beds. Within the hospital LEE operates a distinct pediatric unit which has been designated the “Children’s Hospital of Southwest Florida” (registered as a fictitious name), and which designation LEE uses in its publications and advertisements.

   THE AGENCY STATEMENT

   
   

8. As indicated above, the Petition filed in this case alleges that AHCA has made the following nonrule policy statement which constitutes a rule:

   The Agency for Health Care Administration takes the position that a hospital licensed as a general hospital, pursuant to Chapter 395, can designate itself as a “Children’s Hospital” and advertise such hospital status to the general public, without following the requirements of Rule 59A-3.202 and 59A- 3.201(65) and without obtaining a license as a Class II Specialty Hospital for Children.

9. In this respect, Rule 59A-3.202(1), Florida Administrative Code, provides that AHCA will license four classes of hospital facilities. In pertinent part, the rule provides:

   59A-3.202 Classification of Hospitals.

   1. The agency will license four classes of facilities:

      1. Class I or general hospitals which includes;

         1. General acute care hospitals with an average length of stay of 25 days or less for all beds;

         2. Long term care hospitals, which meet the provisions of 59A-3.201(31); and

         3. Rural hospitals designated under s. 395, Part III, F.S.

      2. Class II specialty hospitals offering the range of medical services offered by general hospitals, but restricted to a defined age or gender group of the population which includes;

         1. Specialty hospitals for children; and

         2. Specialty hospitals for women.

      3. Class III specialty hospitals offering a restricted range of services appropriate to the diagnosis, care, and treatment of patients with specific categories of medical or psychiatric illnesses or disorders which include;

         1. Specialty medical hospitals;

         2. Specialty rehabilitation hospitals;

         3. Specialty psychiatric hospitals, which may include beds licensed to offer Intensive Residential Treatment programs;

         4. Specialty substance abuse hospitals, which may include beds licensed to offer Intensive Residential Treatment programs; and

      4. Class IV specialty hospitals restricted

         to offering Intensive Residential Treatment Programs for Children and Adolescents, pursuant to s. 395.002(16), F.S.

         
         

10. Regulation of advertisement by licensed hospitals is provided for in Section 395.003(1)(b)1., Florida Statutes, which states:

    (b)1. It is unlawful for any person to use or advertise to the public, in any way or by any medium whatsoever, any facility as a “hospital” or “ambulatory surgical center” unless such facility has first secured a license under the provisions of this part.

    
    

11. For several years, and at least since 1990, concerns have been expressed to AHCA and its predecessor agency, the Florida Department of Health and Rehabilitative Services (HRS), regarding the use of the term “children’s hospital” by Class I general acute care hospitals.

12. While not adopting a specific agency position on this issue, Sharon M. Gordon-Girven, the former HRS Director of Community Health Services & Facilities Regulation and Health Facilities, by letter dated June 1, 1990, expressed the following concerns regarding the legal permissibility of the portrayal of pediatric beds within a general hospital as a separate and distinct licensed facility:

    The portrayal of the pediatric beds as a separate and district licensed entity from the licensee, Baptist Medical Center, may not be legally permissible. I call this to your attention so that you can obtain a legal interpretation concerning the provision of Chapter 395.003(1)(b)1.

13. Subsequently, by letter to ALL CHILDREN’S dated March 17, 1994, Gloria Crawford Henderson, then Director of the Division of Health Quality Assurance for AHCA, expressed continuing agency concerns:

    First, let me address the issue as it relates to unlicensed acute facilities. Let me assure you that it is this agency’s policy to vigorously enforce the prohibition in section 395.003(1)(a), Florida Statutes (F.S.), against the establishment or operation of any hospital without first obtaining a hospital license. This agency will respond to any allegation received of any unlicensed facility operating and advertising itself to the public as a children’s hospital.

    
    

    Second, if I am correctly interpreting your letter, your clients’ greater concern is about licensed general hospitals that advertise to the public that they are in whole or in part a children’s hospital, although they have not been licensed as a specialty hospital, as defined in section 395.002(27), F.S. I too, am concerned with public perception, as it relates to this matter.

    
    

    Specifically, a hospital license issued by this office represents an assurance to the public that a hospital meets certain standards of safe and quality care. Clearly, a specialty children’s license, or a general acute license that includes specialty children’s beds/services as approved by the certificate of need office, represents to the public that the hospital has fulfilled particular certificate of need and licensure regulatory requirements related to children’s services. The same assurances of specialized capability and quality of care cannot be made to the public in the absence of such a specialty license or specialty notation on a general license.

    I believe that the hospital licensure rule as written, Chapter 59A-3, F.A.C., does not adequately address this issue. The rule is presently being substantially revised and it is my intent to include this issue in the revision. It is my objective to clarify the circumstances under which a hospital may advertise children’s services, relative to the statutory licensure and certificate of need framework under which this office regulates hospital quality of care.

    We will keep you informed as to the status of our rulemaking efforts, and invite your input regarding proposed language. Again, I appreciate you bringing this matter to my attention, and trust that we will be able to achieve a resolution that is satisfactory to the industry as a whole while preserving the integrity of the licensure process and its assurances of public safety and quality of care.

14. On January 20, 1995, AHCA published proposed Rule 59A- 3.202(2) which provided the following restrictions on advertising by licensed hospitals:

    (2) Licensed hospitals may not advertise to the public, by any medium whatsoever, that they are a specialty hospital, unless they have been licensed as a specialty hospital, as defined in s. 395.002(27), F.S.

    
    

15. Proposed Rule 59A-3.202(2), as set forth above was thereafter challenged under Chapter 120, Florida Statutes. AHCA then withdrew the proposed rule on advertising restrictions, and on July 13, 1995, the proposed rule challenge case was closed by the Division of Administrative Hearings.

16. By letter dated April 11, 1996, in response to an inquiry by SHANDS, Daryl Barowicz, Supervisor of Hospital and

    Outpatient Services for AHCA, made the following statements regarding the agency’s position:

    This is in response to your recent letter and your subsequent telephone conversation with Mr. Elmo Elrod regarding Shands Hospital proposal to establish a Children’s Hospital within a Hospital.

    
    

    You will recall from your conversation with Mr. Elrod, that last year they agency proposed Rule 59A-3.202(2), which in essence would have prohibited licensed hospitals from advertising to the public that they are a specialty hospital, unless they had been licensed as a specialty hospital, as defined in s. 395.002(27), Florida Statute.

    
    

    The rule was challenged and the agency subsequently withdrew the rule, with the plan to develop standards for children’s hospitals in the coming months. The first workshop for developing children’s hospital standards was held on January 12. These standards will apply to free-standing premises, as well as portions of hospitals. Any facility that does not meet the requirements once they are established, will no longer be allowed to advertise itself as a “Children’s Hospital.”

    
    

    Although the present rules would not prohibit Shands from doing what they are proposing to do, we believe that they should consider the potential ramifications of this new rule, once it is adopted.

    
    

17. The evidence does not establish that Respondent AHCA has made the specific statement set forth in the allegations of the Petition filed in this case; however, at final hearing in this case, the agency representative, Tanya Williams, AHCA’s Bureau Chief for the Bureau of Health Facility Regulation, testified that it is AHCA’s current position that the provisions of Sections 395.002 and 395.003, Florida Statutes, do not vest

    the agency with the statutory authority to regulate advertising by licensed hospitals beyond the express limitations of Section 395.003(1)(b)1., Florida Statutes. Because the statute contains no express limitation regarding specialty designations in advertising by licensed hospitals, the agency has taken the position that a rule prohibiting the use of the term “children’s hospital” in advertising by Class I general hospitals is without legislative authority. Accordingly, the agency has in substance adopted the nonrule policy statement at issue in this case.

    Status of Agency Rulemaking

    
    

18. Subsequent to the agency’s withdrawal of proposed Rule 59A-3.202(2) in 1995, the agency has continued development of rules regarding standards for children’s hospitals, and conducted workshops for the development of such rules.

19. The rules currently under development by the agency do not provide for restrictions on advertisement by licensed hospitals.

    Operation and Advertisement of Children’s Hospitals

    
    

20. As indicated above, AHCA is in the process of developing rules regarding standards for children’s hospitals in Florida. On a national level, the National Association of Children’s Hospitals and Related Institutions (NACHRI) has promulgated criteria for children’s hospitals. Membership in NACHRI is limited to those hospitals and institutions which meet NACHRI’s membership criteria. The membership criteria require a

    commitment to providing children’s medical services, and include specific medical staff training and teaching, organizational support for the pediatric program, appropriate resource allocation, and community involvement.

21. Petitioners, ALL CHILDREN’S and VARIETY, are the only hospitals in Florida with full institutional membership in NACHRI. Intervenor SHANDS has associate membership in NACHRI.

22. Several charitable organizations, including the Children’s Miracle Network raise funds for children’s medical needs. ALL CHILDREN’S currently holds the franchise for the Children’s Miracle Network in central Florida.

23. Advertising for charitable contributions for children’s medical needs may enhance the contributions to a medical institution.

24. AHCA has not received any complaints regarding deceptive or misleading advertisements regarding children’s hospitals.

    CONCLUSIONS OF LAW

    
    

25. The Division of Administrative Hearings has jurisdiction over the subject matter and the parties pursuant to Section 120.56, 120.569 and 120.57, Florida Statutes.

1. The initial burden of proof in this proceeding is on the Petitioners to establish by a preponderance of the evidence that the agency nonrule policy statement violates the provisions of Section 120.56(4), Florida Statutes. Agrico Chemical Co. v.

   State Department of Environmental Regulation, 365 So.2d 759 (Fla. 1st DCA 1979); Dravo Basic Material Co. v. State Department of Transportation, 602 So.2d 632 (Fla. 2nd DCA 1992).

2. The parties stipulated to standing, and each party, including intervenors, is deemed to have standing to participate in this proceeding.

3. Section 120.56(4), Florida Statutes, provides:

   
   

   CHALLENGING AGENCY STATEMENTS DEFINED AS RULES; SPECIAL PROVISIONS.-

   1. Any person substantially affected by an agency statement may seek an administrative determination that the statement violates s. 120.54(1)(a). The petition shall include the text of the statement or a description of the statement and shall state with particularity facts sufficient to show that the statement constitutes a rule under s. 120.52 and that the agency has not adopted the statement by the rulemaking procedure provided by s. 120.54.

4. The initial question is whether the nonrule policy statement was made by the agency. As set forth in paragraph 17, above, while the evidence fails to establish that the Agency made the specific statement alleged in the Petition, it is clear that AHCA has expressed and adopted the policy that AHCA does not have the statutory authority to regulate advertising by licensed hospitals except as specifically provided by Section 395.003(1)(b)1., Florida Statutes.

5. Specifically, AHCA’s position on the regulation of hospital advertising, as testified to by Tanya Williams, is that AHCA lacks “authority to govern, enforce, and regulate”

   advertising by licensed hospitals. The statement of agency position, however, constitutes a reiteration or restatement of the agency’s existing interpretation of Chapter 395, Florida Statutes. The statement does not alter an existing rule, nor does it purport to create rights or adversely affect rights of the parties. For purposes of Section 120.56(4), Florida Statutes:

   an agency interpretation of a statute which simply reiterates the legislature’s statutory mandate and does not place upon the statute an interpretation that is not readily apparent from its literal reading, nor in and of itself purport to create rights, or require compliance, or to otherwise have the direct and consistent effect of the law, is not an unpromulgated rule, and actions based upon such an interpretation are permissible without requiring the agency to go through rule-making.

   See St. Francis Hospital, Inc. v. Department of Health and Rehabilitative Services, 553 So.2d 1351, 1354 (Fla. 1st DCA 1989); See also Balsam v. Department of Health and Rehabilitative Services, 452 So.2d 976 (Fla. 1st DCA 1984); All Children’s Hospital, Inc. v. Agency for Health Care Administration, 18 FALR 807 (DOAH 1996).

   
   

6. The evidence fails to establish that AHCA’s governing statutes vest express statutory authority to regulate advertising by hospitals. Accordingly, AHCA lacks statutory authority to require that a hospital holding a Class I general hospital license obtain a Class II specialty hospital license in order to advertise its pediatric services as a children’s hospital.

7. AHCA’s statement of policy that it lacks statutory authority to regulate hospital advertising is not an invalid exercise of delegated legislative authority, but a recognition by AHCA of the limits placed on its authority to enact rules regulating advertising by hospitals. Chapter 120, Florida Statutes, requires specific authority for promulgation of such a rule.

   A grant of rulemaking authority is necessary but not sufficient to allow an agency to adopt a rule; a specific law to be implemented is also required. An agency may adopt only rules that implement, interpret, or make specific the particular powers and duties granted by the enabling statute. No agency shall have authority to adopt a rule only because it is reasonably related to the purpose of the enabling legislation and is not arbitrary and capricious, nor shall and agency have the authority to implement statutory provisions setting forth general legislative intent or policy. Statutory language granting rulemaking authority or generally describing the powers and functions of an agency shall be construed to extend no

   further than the particular powers and duties conferred by the same statute. Chapter 96- 159, Section 9(1), Laws of Florida.

   
   

8. The evidence fails to establish that the agency has violated the provisions of Chapter 120.56, Florida Statutes.

RECOMMENDATION

Based on the foregoing Findings of Fact and Conclusions of Law, it is

ORDERED that the Petition filed in this matter is hereby DISMISSED.

DONE and ENTERED this 7th day of April, 1997, in Tallahassee, Florida.

RICHARD HIXSON

Administrative Law Judge

Division of Administrative Hearings DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060

(904) 488-9675 SUNCOM 278-9675

Fax Filing (904) 921-6847

Filed with the Clerk of the Division of Administrative Hearings this 7th day of April, 1997.

COPIES FURNISHED:

Gerald B. Sternstein, Esquire Frank P. Rainer, Esquire RUDEN, MCCLOSKY, SMITH,

SCHUSTER and RUSSELL, P.A.

215 South Monroe Street, Suite 815 Tallahassee, Florida 32301

Richard P. Ellis, Esquire

Agency for Health Care Administration 2727 Mahan Drive, Building 3

Tallahassee, Florida 32308

Carroll Webb, Executive Director Administrative Procedures Committee Holland Building, Room 120 Tallahassee, Florida 32399-1300

R. Terry Rigsby, Esquire Wendy Delvecchio, Esquire Richard A. Lotspeich, Esquire BLANK, RIGSBY & MEENAN

204 South Monroe Street Tallahassee, Florida 32301

Mark K. Delegal, Esquire John C. Taylor, Jr., Esquire TAYLOR, DAY & RIO

311 South Calhoun Street, Suite 206 Tallahassee, Florida 32301

Glenn Burton, Esquire

SHEAR, NEWMAN, HAHN & ROSENKRANZ

201 East Kennedy Boulevard, Suite 1000 Tampa, Florida 33601-2378

Robert C. McCurdy, Esquire

Hospital Board of County Commissioners Post Office Box 2218

Ft. Myers, Florida 33902-2218

Sam Power, Agency Clerk

Fort Knox Building 3, Suite 3431

2727 Mahan Drive

Tallahassee, Florida 32308

NOTICE OF RIGHT TO JUDICIAL REVIEW

A party who is adversely affected by this final order is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings are commenced by filing one copy of a notice of appeal with the agency clerk of the Division of Administrative Hearings and a second copy, accompanied by filing fees proscribed by law, with the District Court of Appeal, First District, or with the District Court of Appeal in the appellate district where the party resides. The notice of appeal must be filed within thirty (30) days of rendition of the order to be reviewed.

Docket for Case No: 96-005531RU

Orders for Case No: 96-005531RU