STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 1008 JUN 2089 FREI O® GUA JFK MEDICAL CENTER, 7 DIVISIGH or . A MAS Tiv Petitioner, DOAH CASE NO. 07- NTR ve AHCA NO. 2007006014 ~ v. DETERMINATION NO. 20070510-007 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / FINAL ORDER THIS CAUSE concerns a Petition for Formal Administrative Hearing (“Petition”) that the Petitioner filed on May 29, 2007. On June 14, 2007, the Petition was forwarded to the Division of Administrative Hearings by the Agency and assigned to an Administrative Law Judge (“ALJ”). On August 6, 2007, the Petitioner filed a Notice of Voluntary Dismissal, stating that the Petitioner wished to withdraw its Petition. On August 7, 2007, the ALJ assigned to the case entered an Order Closing File, relinquishing jurisdiction back to the Agency. Based upon the foregoing, IT IS THEREFORE ORDERED AND ADJUDGED THAT: The Petitioner’s Petition is dismissed with prejudice and the Agency’s May 18, 2007, Dismissal is hereby upheld. Petitioner shall govern itself accordingly. DONE and ORDERED this /7 Biay of Gtx Z- ; 2008, in Tallahassee, Florida. HOLLY BENSON, Secre AGENCY FOR HEALTH CARE ADMINISTRATION NOTICE OF RIGHT TO JUDICIAL REVIEW A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW, WHICH SHALL BE INSTITUTED BY FILING THE ORIGINAL NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A COPY ALONG WITH THE FILING FEE PRESCRIBED BY LAW WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE FLORIDA APPELLATE RULES.: THE NOTICE OF APPEAL MUST BE FILED WITHIN 30 DAYS OF THE RENDITION OF THE ORDER TO BE REVIEWED. CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furnished by U.S. or interoffice mail to the persons named below on this {&§ day of in Jere, 2008. RICHARD J. SHOOP, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, MS #3 Tallahassee, Florida 32308 (850) 922-5873 COPIES FURNISHED TO: Lisa Shearer Nelson Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Mari H. McCully, Esquire Department of Financial Services Division of Worker’s Compensation 200 East Gaines Street Tallahassee, Florida 32399-4229 Pamela G. Zahler, General Counsel Post Office Box 1629 Orange Park, Florida 32067 Amerisure Insurance Company Post Office Box 10790 St. Petersburg, Florida 33733 Jan Mills Facilities Intake Elizabeth Dudek Health Quality Assurance MCMC 701 Technology Drive Suite 100 Canonsburg, Pennsylvania 15317 Qmedtrix Systems, Inc. 700 NE Multnomah Street, #1200 Portland, Oregon 97232

Docket for Case No: 07-002684