q ~ fe STATE OF FLORIDA By oP AGENCY FOR HEALTH CARE ADMINISTRATION -- Api, On” “an ita, — © mg son asso Qo 4, Tenet St. Mary’s, Inc. d/b/a St. Mary’s “pyphge SG Me Ar, Medical Center, "Gs “Le DOAH No. 05-0299 Petitioner, AHCA No. 2005000564 CON No. 9811 vs. Agency for Health Care Administration and Wellington Regional Medical Center, Inc., Respondent. ey | FINAL ORDER The Agency for Health Care Administration (“AHCA”) and Wellington Regional Medical Center (“Wellington”), having entered into a Stipulation and Settlement Agreement among all parties (AHCA, Wellington and Petitioner “St. Mary’s”) and being otherwise well-advised in the premises, finds as follows: It is ORDERED that: 1. The Stipulation and Settlement Agreement is attached hereto and made a part hereof. The parties are directed to comply with the terms of the Stipulation and Settlement Agreement. 2. AHCA hereby approves the issuance of CON Application No. 9811 to Wellington Regional Medical Center to establish a 15-bed Level ITI Neonatal Intensive Care Unit, with the condition that it will set aside 28.9 percent of its patient days in the Level III NICU to Medicaid/Medicaid HMO and charity care patients on a combined basis. 3. For purposes of this Settlement Agreement, the term “charity care” shall mean that portion of hospital charges reported to the Agency for which there is no compensation, other than restricted or unrestricted revenues provided to a hospital by local governments or tax districts regardless of the method of payment, for care provided to a patient whose family income for the twelve (12) months preceding the determination is less than equal to two hundred percent (200%) of the federal poverty level, unless the amount of hospital charges due from the patient exceeds twenty-five prevent (25%) of the annual family income, 4. The above referenced case is hereby closed. - DONE and ORDERED this 1S day of _Juee , 2006, in Aen firing Alan Levine, Secretary Agency for Health Care Administration Tallahassee, Leon County, Florida. 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 THE AGENCY CLERK OF AHCA 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 OF PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE FLORIDA APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN THIRTY (30) DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies furnished to: Elizabeth Dudek, Deputy Secretary Managed Care and Health Quality Assurance Agency for Health Care Administrative 2727 Mahan Drive, Bldg.3, MS 9 Tallahassee, Florida 32308 (Interoffice Mail) Sandra E. Allen, Esquire Senior Attorney Agency for Health Care Administration 2727 Mahan Drive, Bldg. 3, MS 3 Tallahassee, Florida 32308 (Interoffice Mail) C. Gary Williams, Esquire Ausley & McMullen 227 South Calhoun Street Post Office Box 391 Tallahassee, Florida 32302 Robert D. Newell, Esquire Newell & Terry, P.A. 817 North Gadsden Street Tallahassee, Florida 32303 Charles A. Stampelos Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Janice Mills (Inter-office Mail) CERTIFICATE OF SERVICE I hereby certify that a true copy of the foregoing Final Order was served on the above-named person(s) and entities by U.S. Mail or the method designated on this /7* day of Care , 2026. Richard J. Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Bidg. 3, MS 3 Tallahassee, Florida 32308 (850) 922-5873 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS HEWELL 2, TERRY, PA TENET ST. MARY’S INC,, d/b/a ST. MARY'S MEDICAL CENTER, - Petitioner, BES . o vs. CASE NO, 05-028 961 S a i AGENCY FOR HEALTH CARE oN S ADMINISTRATION and WELLINGTON REGIONAL MEDICAL CENTER, Respondents. SETTLEMENT AGREEMENT This Settlement Agreement (“Settlement Agreement”) is entered into this -%4 Aanvary , 2006 day of May. Wed. by and between The State of Florida Agency for Health Care Administration (‘AHCA”), Wellington Regional Medical Center, Inc., d/b/a Wellington Regional Medical Center (“Wellington”) and Tenet St. Mary’s, Inc., d/b/a St, Mary’s Medical Center (“St. Mary’s”), WHEREAS, on or about September 8, 2004, Wellington filed Certificate of Need ("CON") Application No. 9811 in the second Hospitals and Other Projects batching cycle of 2004 to establish a 15-bed Level IIE Neonatal Intensive Care Unit: and WHEREAS, AHCA published notice in Vol. 30, No. 52, Florida Administrative Weekly, (December 23, 2004), of the Agency's preliminary decision to approve Wellington’s application for a 15-bed Level III Neonatal Intensive Care Unit; and WHEREAS, St. Mary’s and Bethesda timely filed petitions for a formal administrative hearing challenging AHCA’s published preliminary decision; and WHEREAS, Bethesda dismissed its petition in DOAH Case No, 05-0298 on April 26, 2005, and: WHEREAS, AHCA, Wellington and St. Mary’s wish to resolve this litigation amicably, and in a manner that will foster, facilitate, and further competition, as well as further the goals and objectives of the Florida Certificate of Need Law as set forth in Sections 408.035 through 408.045, Fla. Stat. (2001); and WHEREAS, Wellington projects that necessary construction to complete the project is not expected to be accomplished and completed until September 2008; and WHEREAS delay in the implementation of the project will give Wellington time to not only complete its necessary construction/renovation project but to also further develop its Level II NICU and train additional staff as may be required for the Level II NICU; and WHEREAS, Wellington represents to the parties and the parties agree that Wellington will not implement the CON for a 15-bed Level IIT NICU unit before December 31, 2008 (the implementation date); and WHEREAS the parties agree that in the event, subsequent to the date of this agreement, the Legislature abolishes the requirement for a CON for Level III NICU beds that Wellington will no longer be bound by the implementation date contained herein, NOW THEREFORE, in consideration of the mutual promises and covenants set forth herein, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties jointly stipulate and agree that Wellington's CON Application No. 9811 satisfies, on balance, the pertinent statutory and regulatory criteria for approval of a Certificate of Need in Florida, The parties further apree as follows: lL. All Recitals above are true and correct and are expressly incorporated herein by reference as if fully set forth below. 2, All parties agree that the above Recitals incorporated herein are binding on the parties. 3. All parties agree that immediately upon execution of this Settlement Agreement, St. Mary’s will file a notice of voluntary dismissal of its petition herein and this stipulation will be presented to the Administrative Law Judge with a motion asking DOAH to relinquish jurisdiction back to the Agency for entry of a final order consistent with this agreement. 4. The Agency agrees that, as soon as practicable following relinquishment of jurisdiction in DOAH Case No. 05-0299, the Agency will enter a Final Order: (a) approving Wellington’s Certificate of Need Application No. 9811 to establish a 15-bed Level III Neonatal Intensive Care Unit, with the condition that it will set aside 28.9 percent of its patient days in the Level [II NICU to Medicaid/Medicaid HMO and charity care patients on a combined basis, 5. For purposes of this Settlement Agreement, the term "charity care" shall mean that portion of hospital charges reported to the Agency for which there is no compensation, other than restricted or unrestricted revenues provided to a hospital by local governments or tax districts regardless of the method of payment, for care provided to a patient whose family income for the twelve (12) months preceding the determination is less than or equal to two hundred percent (200%) of the federal poverty level, unless the amount of hospital charges due from the patient exceeds twenty-five percent (25%) of the annual family income. However, in no case shall the hospital charges for a patient whose family income exceeds four times the federal poverty level for a family of four be considered charity. 6. Upon full execution of this Settlement Agreement and entry of a final order wholly consistent with this agreement, each party (a) agrees to waive any and all appeals and proceedings; and (b) agrees to waive compliance with the form of the Final Order (findings of fact and conclusions of law) to which it may be entitled including, but not limited to, an informal proceeding under Subsection 120.57(2), Florida Statutes, a formal proceeding under Subsection 120.57(1), Florida Statutes, appeals under Section 120.68, Florida Statutes, and declaratory and all writs of relief in any court or quasi-court (e.g., Division of Administrative Hearings) of competent jurisdiction, 7. Each party for itself and for its related or resulting organizations, its successors or transferees, attorneys, and executors or administrators, does hereby discharge the other parties and their respective employees, agents, representatives, and attomeys of and-from all claims, demands, actions, causes of action, suits, damages, losses, and expenses, of any and every nature whatsoever, arising out of or in any way related to this matter and the Agency's actions, including, but not limited to, any claims that were or may be asserted in any federal or state court or administrative forum by or on behalf of such party or any of its related facilities, 8. Each party shall bear its own costs and attorneys’ fees. 9. This Agreement shall become effective on the date upon which it is fully executed by all parties hereto. 10. - The parties each hereby represent and warrant that their undersigned representative is authorized to execute this Settlement Agreement on behalf of the party, and to bind the party to the terms and conditions herein, 11, The terms, conditions, covenants, provisions, promises, and agreements contained herein shall be binding upon and shall inure to the benefit of the parties hereto, and their successors and permitted assigns, 12, This Settlement Agreement contains the entire agreement between the parties hereto, and no representations or agreements, oral or otherwise, between the parties not embodied herein or attached hereto shall be of any force or effect. Any additions or amendments to this Settlement Agreement subsequent hereto shall be of no force or effect unless in writing and signed by all parties hereto. 13. This Settlement Agreement has been made and delivered in Leon County; Florida, and shall be construed and interpreted in accordance with the laws of the State of Florida, Should a legal action be instituted by any party hereto to enforce the terms and conditions of this Settlement Agreement, the venue for such legal action shall be Leon County, Florida, The parties agree that money damages would not provide an adequate remedy for violation of this Agreement, and that injunctive relief is available to enforce the terms of this Agreement. With the exception of AHCA, should legal action be instituted to enforce the terms and conditions of this Settlement Agreement, the prevailing party or parties shall be entitled to an award of reasonable attorney's fees and costs from the nonprevailing party or parties. WELLINGTON REGIONAL MEDICAL CENTER By: Kevin DiLallo, CEO AGENCY FOR HEALTH CARE ADMINISTRATION By: ens Ce l Christa Calamas os / Dy General Counsel Florida Bar No. 0142123 Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 TENET ST. MARY’S, INC. d/b/a St. Mary’s Medical Center By: Paul Walker, CEO Elizabeth Qudek Division of Health Quality Assurance Agency ealth Care Administration Bldg. 1, Rm. 170 2727 Mahan Drive, Mail Stop #9 Tallahassee, Florida 32308 the nonprevailing party or parties. WELLINGTON REGIONAL MEDICAL CENTER By: fs Kevin DiLallo, CEO TENET ST. MARY'S , INC. d/b/a St. Mary's Medical Center By: Paul Walker, CEO AGENCY FOR HEALTH CARE ADMINISTRATION By: Elizabeth Dudek, Deputy Secretary the nonprevailing party or parties. WELLINGTON REGIONAL MEDICAL CENTER By: Kevin DiLallo, CEO AGENCY FOR HEALTH CARE ADMINISTRATION By Elizabeth Dudek, Deputy Secretary

Docket for Case No: 05-000299CON