STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

NORTH FLORIDA REGIONAL MEDICAL CENTER, INC.,

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2017 SEP 20 P 3: 53

vs.

Petitioner ,

DOAH CASE NO.: 17-3887CON AHCA CASE NO.: 2017006918 CON NO .: 10481

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

                                                                               I

MUNROE REGIONAL MEDICAL CENTER,

vs.

Petitioner ,

DOAH CASE NO.: AHCA CASE NO.: CON NO.:

17-3888CON

2017006819

10478

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION ,

Respondent.

                                                                               I

MARION COMMUNITY HOSPITAL, INC., d/b/a WEST MARION COMMUNITY HOSPITAL and OCALA REGIONAL MEDICAL CENTER,

vs.

Petitioners,

DOAH CASE NO.: AHCA CASE NO.: CON NO .:

17-3889CON

2017006914

10477

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION ,

Respondent.

                                                                               I

Filed September 22, 2017 12:07 PM Division of Administrative Hearings

SHANDS TEACHING HOSPITAL AND CLINICS, INC., d/b/a UF HEALTH SHANDS REHAB HOSPITAL,

Petitioner,

V.

DOAH CASE NO.: AHCA CASE NO.: CON NO.:

17-3902CON

2017007463

10480

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

                                                                               I

FINAL ORDER

THIS CAUSE is before the State of Florida, Agency for Health Care Administration ("the Agency") concerning the approval of Shands Teaching Hospital And Clinics, Inc., d/b/a UF Health Shands Rehab Hospital ("UF Health") Certificate of Need ("CON") Application No. 10480 to establish a 40-bed replacement comprehensive medical rehabilitation ("CMR") hospital in District 3, Alachua County. The Agency being fully advised in the premises finds as follows:

1. The Agency approved UF Health's CON Application No. 10480 to establish a 40- bed replacement comprehensive medical rehabilitation hospital in District 3, Alachua County.

2. UF Health's CON Application No. 10480 was reviewed at the same time as other applications seeking to establish new CMR units at existing hospitals. Marion Community Hospital, Inc. d/b/a West Marion Community Hospital and Ocala Regional Medical Center ("Marion Community") filed CON No. 10477 to establish a 30-bed CMR unit. Munroe HMA Hospital, LLC d/b/a Timberidge Hospital ("Munroe") filed CON No. 10478 to establish a 16-bed CMR unit and CON No. 10478P, a partial request for a 10-bed CMR unit. North Florida Regional Medical Center, Inc. d/b/a North Florida Regional Medical Center ("North Florida Regional") filed CON No. 10479 to establish a 20-bed CMR unit.

3. The Agency denied CON Nos. 10477, 10478, 10478P and 10479.

   
   

4. On June 23, 2017, Munroe filed a petition challenging the Agency's approval of UF Health's Application, and challenging the denial of its CON Application No. 10478 and 10478P.

5. On June 27, 2017, North Florida Regional filed a petition challenging the Agency's approval of UF Health's CON Application No. 10480 and challenging the denial of its CON Application No. 10479.

6. On June 27, 2017, Marion Community filed a petition challenging the Agency's approval of UF Health's CON Application No. 10480, and challenging the denial of its CON Application No. 10477.

7. UF Health filed a Petition to challenge any and all other co-batched applications, pursuant to Rule 59C-l .012, Florida Administrative Code. This petition filed by UF Health seeks that the Division of Administrative Hearings uphold the Agency's preliminary approval of UF Health's CON Application No. 10480, and uphold the denials of CON Application No. 10477, No. 10478, No. 10478P and No. 10479.

8. The Agency assigned the following CON numbers to applications at issue in this proceeding and rendered decision with regard to the beds sought as follows:

   CON #10480

   CON #10477

   CON #10478

   CON #10479

   Applicant UF Health Applicant Ocala Regional Applicant Munroe

   Applicant North Florida Regional

   Amount of Beds 40 Approved Amount of Beds 30 Denied Amount of Beds 16 Denied Amount of Beds 20 Denied

   
   

9. In Volume 43, Number 13, of the Florida Administrative Register, dated January 20, 2017, the Agency announced a need for zero (0) additional comprehensive medical rehabilitation beds in District 3, which consists of Alachua, Bradford, Citrus, Columbia, Dixie,

   Gilchrist Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee and Union counties. See Rule 59C-1.039(5)(a) - (c), Fla. Admin. Code.

10. UF Health filed CON Application No. 10480 to establish a replacement 40-bed replacement comprehensive medical rehabilitation hospital. UF Health did not seek to add any CMR beds through its application. UF Health's proposed replacement comprehensive medical rehabilitation hospital does not increase the number of comprehensive medical rehabilitation beds in District 3.

11. Each of the denied applicants filed applications to establish new comprehensive medical rehabilitation beds that would result in an increase in the number of comprehensive medical rehabilitation beds in District 3. Each argued that "special circumstances" justified the approval of their respective proposals, despite the absence of any predicted need, using the Agency's well-established methodology. See Fla. Admin. Code R. 59C-1.039(3)(d), (5)(e).

12. On July 3, 2017, the Agency published notice of the litigation initiated by the denied applicants. See Fla. Admin. Reg., Vol. 43, No. 128 (July 3, 2017). Pursuant to Rule 59C- 1.012(2)(a), Florida Administrative Code, the Agency's notice invited approved applicants, like UF Health, to file a petition in order to place competing applicants' denied applications at issue. Rule 59C-1.012(2)(a) provides a 10-day deadline to file any such petition.

13. The petitions filed by the denied applicants requested the denial of UF Health's

    
    

    preliminarily approved CON Application No. 10480.

    
    

14. The petitions were forwarded to the Division of Administrative Hearings and later consolidated for hearing.

15. On August 18, 2017, the following parties filed the following pleadings: North

    
    

    Florida Regional Medical Center, Inc., filed a Notice of Voluntary Dismissal; Munroe Regional

    Medical Center, filed a Notice of Voluntary Dismissal; Marion Community Hospital, Inc., d/b/a West Marion Community Hospital; and Ocala Regional Medical Center, filed a Notice of Voluntary Dismissal.

16. As a result of the filing of each respective Notice of Voluntary Dismissal there is not a challenge pending as to the preliminarily approved UF Health's Certificate of Need ("CON") Application No. 10480 to establish a 40-bed replacement comprehensive rehabilitation hospital in District 3, Alachua County. In addition, the challenging parties have dismissed their requests for approval of a certificate of need program.

It is therefore ORDERED:

1. The Agency's approval of UF Health's CON No. 10480 to establish a 40-bed replacement comprehensive medical rehabilitation hospital in District 3, Alachua County, is UPHELD and CON Application No. 10480 shall be issued to UF Health.

2. The Agency's denials of CON No. 10477, CON No. 10478 and CON No. 10479

are UPHELD.

ORDERED in Tallahassee, Florida, on this       fl_ day of 5            , 2017.

f1(: Justin . Senior, Secreta Agency For Health Care

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 of 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 the method designated to the persons named below on this z'h;of

,2017.

Richard J. Shoop, Agenc

Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3

Tallahassee, Florida 32308

(850) 412-3630

R. Bruce McKibben Administrative Law Judge

Division of Administrative Hearings (Electronic Filing)

Stephen A. Ecenia, Esquire Craig D. Miller, Esquire

J. Stephen Menton, Esquire Tana Storey, Esquire Rutledge Ecenia, P .A.

119 South Monroe Street, Suite 202

Tallahassee, Florida 32301 steve@rutledge-ecenia.com cmiller@rutledge-ecenia.com smenton@rutledge-ecenia.com tana@rutledge-ecenia.com roxanne@rutledge-ecenia.com vicki@rutledge-ecenia.com

Attorneys for North Florida Regional Medical Center, Inc. and West Marion Community Hospital and Ocala Regional Medical Center

(Electronic Mail)

Geoffrey D. Smith, Esquire Susan C. Smith, Esquire Sabrina B. Dieguez, Esquire Smith & Associates

3301 Thomasville Road, Suite 201

Tallahassee, Florida 32308 geoff@smithlawtlh.com susan@smithlawtlh.com sabrina@smithlawtlh.com katherine@smithlawtlh.com dianne@smithlawtlh.com

Attorneys for Munroe Regional Medical Center (Electronic Mail)

Seann M. Frazier, Esquire Marc Ito, Esquire

Suite 750,215 South Monroe Street, Tallahassee, Florida 32301 sfrazier@phrd.com

mito@phrd.com twd@phrd.com

Attorneys for UF Health Shands Rehab Hospital (Electronic Mail)

Jonathan L. Rue

Suite 3600, 303 Peachtree Street Northeast

Atlanta, GA 30308 jrue@phrd.com bmurphy@phrd.com

Attorney for UF Health Shands Rehab Hospital (Electronic Mail)

Richard Joseph Saliba, Senior Attorney

Lindsey L. Miller-Hailey, Assistant General Counsel Office of the General Counsel

Agency for Health Care Administration (Electronic Mail)

Janice K. Mills, Government Analyst II Facilities Intake Unit

Agency for Health Care Administration (Electronic Mail)

Marisol M. Fitch, Unit Manager Certificate of Need Unit

Agency for Health Care Administration (Electronic Mail)

Jack Plagge, Unit Manager

Hospital and Outpatient Services Unit Agency for Health Care Administration (Electronic Mail)

Docket for Case No: 17-003887CON

Orders for Case No: 17-003887CON