STATE OF FLORIDA ro For en AGENCY FOR HEALTH CARE ADMINISTRATION , ty MY SEBASTIAN HOSPITAL, INC., d/b/a SEBASTIAN RIVER MEDICAL CENTER, Petitioner, AHCA No.: 2004011065 VS. eenamanmaanaement DOAH No.: 04-4639 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. a FINAL ORDER The Agency for Health Care Administration (AHCA), having entered into a Stipulation and Settlement Agreement with Sebastian Hospital, Inc., d/b/a_ Sebastian River Medical Center_ (Petitioner), and being. otherwise well advised in the premises, finds and concludes as follows: It is ORDERED that: 1. The Stipulation and Settlement Agreement is approved and adopted as a part of this Final Order and is attached hereto and made a part hereof. The parties are directed to comply with the terms of the Stipulation and Settlement Agreement. 2. Petitioner will provide to AHCA an executed Agreement between the Department of Health and Petitioner to provide health care services to low-income persons. 3. AHCA shall reinstate CON Exemption Number 9900261. 4. The above styled case is hereby dismissed. DONE and ORDERED this S/day of CMae4 | , 2005, in Tallahassee, Leon County, Florida. Alan Levine) Secretary Agency ealth Care Administration A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH AGENCY CLERK AND A SECOND COPY, ALONG WITH FILING FEE AS PRESCRIBED BY LAW, IN THE DISTRICT COURT OF APPEAL WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW PROCEEDINGS Copies furnished to: Nelson E. Rodney, Esq. Assistant General Counsel Agency for Health Care Administration 8350 NW 52 Terrace, Suite 103 Miami, Florida 33166 (Interoffice Mail) Elizabeth Dudek Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive Bldg #1 Mail Stop Code #9 Tallahassee, Florida 32308 (Interoffice Mail) Kellie D. Scott, Esq. Blank, Meenan & Smith, P.A. 204 South Monroe Street Tallahassee, Florida 32301 (U.S. Certified Mail) Kathy Burke, CEO Sebastian Hospital, Inc., d/b/a Sebastian River Medical Center 13695 U.S. Highway 1 Sebastian, Florida 32978-0838 (U.S. Certified Mail) Hon. John G. Van Laningham Administrative Law Judge we we Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (U.S. Mail) Wendy Adams (Inter-office Mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true copy of the foregoing was mailed to the above-named addressees on this LY “day of Jane. ' 2005. 5 ——.. Richard Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32303 (850) 922-5873 STATE OF FLORIDA : DIVISION OF ADMINISTRATIVE HEARINGS SEBASTIAN HOSPITAL, INC. d/b/a SEBASTIAN RIVER MEDICAL CENTER, Petitioner, vs. Case No. 04-4639 ofaTE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. a lad r wee / SETTLEMENT AGREEMENT This Settlement Agreement is entered between the State of Florida, Agency for Health Care Administration (“AHCA”) and Sebastian Hospital, Inc. d/b/a Sebastian River Hospital — €“Sebastian River”), on this- jf day of May; 2005;—-——-—— = BACKGROUND On November 16, 2004, Sebastian River submitted an Adult Diagnostic Cardiac Catheterization Annual Report Form to AHCA indicating that Sebastian River performed 364 adult diagnostic cardiac catheterization procedures during the July 2003 — July 2004 time period. The Adult Diagnostic Cardiac Catheterization Annual Report Form reported zero as the number of adult diagnostic cardiac catheterization procedures provided to Medicaid and charity care admissions during the same time period. On November 23, 2004, AHCA notified Sebastian River that its Adult Diagnostic Cardiac Catheterization Certificate of Need (“CON”) Exemption Number 9900261 hadexpired due to Sebastian River’s alleged failure to provide services to Medicaid and charity patients for the annual reporting period ending July 2004. On December 8, 2004, Sebastian River timely challenged AHCA’s initial determination and denied all allegations that its actions did not comply with Florida law. The parties wish to resolve the pending formal administrative hearing without the necessity of further time consuming and costly litigation. THEREFORE, it is stipulated and agreed as follows: 1. Within two (2) weeks of the execution of this Settlement Agreement, Sebastian River will enter. into a Volunteer Health Care Provider Program Agreement with the State of Florida Department of Health, to provide charity adult diagnostic cardiac catheterizations through the Indian River Local Health Department. A copy of the Agreement is attached as Exhibit A. Sebastian River will provide a copy of the executed Agreement to AHCA. 2. Immediately after receipt of the executed Volunteer Health Care Provider ——— Program Agreement, AHCA shall reinstate CON Exemption Number 9906261 provided to ~-—-—-—~----- Sebastian River to implement its adult cardiac catheterization program at Sebastian River Medical Center and shall provide written confirmation of the reinstatement to Sebastian River. 3. No later than seven days after Sebastian River receives written confirmation from AHCA that its CON exemption to implement its adult cardiac catheterization program has been reinstated, Sebastian River will dismiss its petition, DOAH Case No. 04-4639. 4. The terms and conditions of this Settlement Agreement are for purposes of resolving the pending proceeding only, and are based on the specific facts and circumstances, and shall not be used as evidence or precedent in any other proceeding or future determinations w by AHCA,, a. RR 5. Each party shall bear its own costs and expenses in this proceeding. 6. This Agreement may be executed in counter-parts, and a facsimile signature may serve as the original. 7. The signatories below verify that they have the authority to enter into this agreement and legally bind the party for which they are executing the Agreement. FOR THE AGENCY FOR HEALTH illiam Robert: Acting General Counsel ~ Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3 Agency for Health Care Administration. . Tajlahassee, Florida 32308 Building 1, Room 205 (850) 922-5873 2727 Mahan Drive Florida Bar No. 0586617 Tallahassee, Florida 32308 DATE: (850) 487-2, _ DATE: __ & < FOR SEBASTIAN HOSPITAL, INC. d/b/a SEBASTIAN RIVER MEDICAL CENTER PA Scott de b _ Kathy Burke Blank, Meenan & Smith, P.A. Chief Executive Officer 204 South Monroe Street. Sebastian Hospital, Inc. d/b/a Sebastian Tallahassee, Florida 32301 River Medical Center (850) 681-6710 13695 U.S. Highway 1 Florida Bar No. # 432600 Sebastian, Florida 32978-0838 DATE: 0 (772) 581-2040 DATE: fil 28 SAAC wt CLIENT FILES\26903 HMA Sebastian Hosp Termination\Pleadings\Settlement Agreement.doc

Docket for Case No: 04-004639