STATE OF FLORIDA a ce AGENCY FOR HEALTH CARE ADMINISTRATION ied “ 2008 SUNOS 5] g®@ 2 Ub _GIISION oF Petitioner, DOAH CASE NO. 07-3261) STRAT VE AHCA NO. 2007007166 =ARINGS v. _ DISMISSAL NO. 20070403-011 Northside Hospital, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, . Respondent. FINAL ORDER THIS CAUSE concerns a Petition for Formal Administrative Hearing (“Petition”) that the Petitioners filed on June 25, 2007. On July 17, 2007, the Petition was forwarded to the Division of Administrative Hearings by the Agency and assigned to an Administrative Law Judge (“ALJ”). On July 25, 2007, the Petitioner filed a Notice of Voluntary Dismissal With Prejudice, requesting that the ALJ close the DOAH case. On July 26, 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 June 5, 2007, Dismissal is hereby upheld. Petitioner shall govern itself accordingly. DONE and ORDERED this 4 Bay of en , 2008, in Tallahassee, Florida. HOLLY BENSON, Secrétary 7 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 gn this { 7 day of \ Jene—, 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: Bram D.E. Canter Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Katherine M. Balonis HCA Patient Account Services- Tampa Bay 31975 US Highway 19 North Palm Harbor, Florida 34684 Mari H. McCully, Esquire Department of Financial Services Division of Worker’s Compensation 200 East Gaines Street Tallahassee, Florida 32399-4229 Amerisure Insurance Company 140 Fountain Parkway Suite 200 St. Petersburg, Florida 33733 MCMC 701 Technology Drive, Suite 100 Canonsburg, PA 15317 QMedtrix Post Office Box 15349 Portland, OR 97293-5349 Jan Mills Facilities Intake Elizabeth Dudek Health Quality Assurance

Docket for Case No: 07-003261