Conclusions WHEREAS, Respondent appealed her termination to the Pinellas County Sheriff's Civil Service Board (the “Board”); and WHEREAS, the appeal was transmitted to the Department of Administrative Hearings Administrative Law Judge for evidentiary hearing and recommended order; and WHEREAS, the Respondent, Pamela L. Wilson, voluntarily forfeited her right to appeal by letter to the Department of Administrative Hearings Administrative Law Judge dated September 23, 2013; and WHEREAS, Petitioner, Pinellas County Sheriffs Office, filed a Motion to Dismiss; and WHEREAS, in response to that Motion to Dismiss, the Administrative Law Judge issued an order (attached hereto and incorporated by reference) closing its file on the appeal and relinquishing jurisdiction to the Board; and “WHEREAS, Petitioner requested this Board take final agency action to accept the Administrative Law Judge’s disposition of the appeal; and WHEREAS, on October, 9, 2013, the Pinellas Board met at a duly noticed meeting to hear Petitioner’s request and reviewed the Respondent’s September 23, 2013 letter, the Petitioner’s Motion to Dismiss and the Administrative Law Judge’s Order Relinquishing Jurisdiction and voted to dismiss Pamela Wilson’s appeal by a vote of 5 to 0. NOW, THEREFORE, it is ordered and adjudged that: 1. The Board, by a unanimous vote of five (5) members, hereby dismisses the appeal of Pamela Wilson. Page 1 of 2 2. The parties are hereby notified of the right to appeal this Final Order to the Second District Court of Appeal by filing notice of intent to do so upon the Clerk of Court and the Pinellas County Sheriffs Civil Service Board within thirty (30) days of the date of this Order. IT IS SO ORDERED this_//zyw_ day of October, 2013. Lt. Col. Neal A. White, Chairman Pinellas County Sheriff’s Civil Service Board CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the above Final Order has been furnished by U.S. Regular Mail to: Paul G. Rozelle, Associate General Counsel Ms. Pamela Wilson Pinellas County Sheriff's Office 518 Still Meadows Circle West 10750 Ulmerton Road Palm Harbor, FL 34683 Largo, FL 33778 this | xe day of October, 2013. p Carole Sanzeri Senior Assistant County Attorney 315 Court Street, 6" Floor Clearwater, FL 33756 Phone: 727-464-3354 / Fax: 727-464-4147 Attorney for the Sheriff's Civil Service Board Copy to: Members of the Sheriff’s Civil Service Board Lizzie F. Bogan, Administrative Law Judge HAUSERS\ATYKB03\WPDOCS\CS\SHERIFF CIVIL SERVICE BOARD\APPEALS\WILSON PAMELA\FINAL ORDER.DOCX Page 2 of 2
The Issue Whether Respondent committed the violations alleged in the respective Administrative Complaints, and, if so, whether Petitioner should impose against Respondent an administrative fine, penalty, and survey fee.
Findings Of Fact DOAH Case No. 13-2011: Failure to Properly Train, Supervise, and Perform CPR Pine Tree Manor is licensed by the Agency for Health Care Administration to operate a 24-bed assisted living facility. The facility's license number is 8317, and it expires on November 13, 2014. On February 12, 2013, the date of the incident that provides the basis for the instant action, Aurelia Cristobal was employed as a staff member at the facility operated by Pine Tree Manor. Spanish is Ms. Cristobal's native language, and her ability to speak English is very limited. Brent Sparks, the owner and administrator at Pine Tree Manor, acknowledged, when interviewed as part of the post-incident investigation, that Ms. Cristobal struggles at times with English, especially when under stress. Mr. Sparks was aware of Ms. Cristobal's limitations with English prior to February 12, 2013. Within a few days of B.Y.'s death, Ms. Cristobal left the United States and is believed to be currently living in Mexico. Ms. Cristobal did not testify during the final hearing. For the period June 15, 2011, through June 15, 2013, Ms. Cristobal was certified by the American Safety & Health Institute in the areas of automated external defibrillation (AED), cardiopulmonary resuscitation (CPR), and basic first aid. In the spring of 2011, Ms. Cristobal received training from Pine Tree Manor in the areas of facility emergency procedures and do not resuscitate (DNR) orders. Pine Tree Manor's written emergency procedures provide, in part, as follows: In all emergencies, it is important to remain calm and display a sense of control. Upsetting our residents will only induce undue stress. DIAL "911" EMERGENCY in the following cases: A medical emergency such as serious injuries or life threatening incidences. Fires Bodily harm to staff or residents such as terrorism, robbery, inclement weather. Call the administrator if there is any question concerning injury or illness, a resident is missing, security of facility is in doubt, or inspectors enter the facility. In the case of any significant changes or emergency, call the family, guardian and a health care provider. Also, contact the administrator. In cases of non-emergency need for transportation to the hospital or emergency room, call SUNSTAR AMBULANCE SERVICE @ 530-1234. In all cases, use common sense and remain calm, and remember to contact the administrator if in doubt. Pine Tree Manor's policy regarding DNR orders provides that: In the event a resident with a signed DNR experiences cardiopulmonary arrest, our policy is for staff trained in CPR/AED to withhold resuscitative treatment. Staff will report to the administrator immediately and in turn notify [the] resident's medical providers and resident representative. For example, staff on duty shall call 911 to report the condition, or if on Hospice [place] a call to (727) 586-4432, the Lavender Team Patient Leader. B.Y. became a resident of Pine Tree Manor on or about December 23, 2010. B.Y. did not execute a DNR directive. On February 12, 2013, between the hours of approximately 5:00 p.m. and 7:00 p.m., Ms. Cristobal was the only employee on site at Pine Tree Manor. According to J.M., who on February 12, 2013, was a resident at Pine Tree Manor, B.Y. entered a common area of the facility where J.M. and other residents were located. J.M. advised that B.Y. sat on the sofa, and started watching television. While on the sofa, B.Y. stopped breathing. The evidence is inconclusive as to how long B.Y. was incapacitated before others learned of her condition. Although it is not clear from the testimony how Ms. Cristobal was informed of B.Y.'s peril, she did, at some point, learn that B.Y. was incapacitated and was experiencing a medical emergency. After learning of B.Y.'s situation, Ms. Cristobal, according to J.M., became nervous and "didn't know what to do." In fact, Ms. Cristobal was so nervous that she did not call 911, she did not check B.Y. for a pulse, and she did not perform CPR on B.Y. Ms. Cristobal did, however, make several attempts to contact Mr. Sparks. Ms. Cristobal eventually reached Mr. Sparks and advised him of the situation with B.Y. The evidence does not reveal how long B.Y. remained incapacitated before Ms. Cristobal was able to speak with Mr. Sparks. When Mr. Sparks received the call from Ms. Cristobal, he was at his residence in Hillsborough County. Pine Tree Manor is located in Pinellas County. Because Mr. Sparks was in Hillsborough County when he received the call from Ms. Cristobal, he was not able to call 911 and be immediately connected to an emergency operator in Pinellas County. Understanding this limitation, Mr. Sparks called the non-emergency number for the Pinellas County Sheriff's office, who, in turn, contacted the 911 operator and informed them of the emergency. In the course of discussing the emergency situation with Ms. Cristobal, Mr. Sparks learned that she had not called 911. Knowing the emergency nature of the situation and the fact that he could not call Pinellas County 911 directly, Mr. Sparks should have directed Ms. Cristobal to call 911, since she was located in Pinellas County, but he did not. Mr. Sparks should have also instructed Ms. Cristobal to start CPR on B.Y., but he did not. According to the Pinellas County Emergency Medical Services (EMS) Patient Care Report for B.Y., the 911 call was received by the 911 dispatcher at 6:11 p.m. and an EMS unit was dispatched to Pine Tree Manor at 6:12 p.m. The EMS unit arrived at the facility at 6:15 p.m. and commenced treating B.Y. at 6:16 p.m. EMS personnel worked for nearly 30 minutes to revive B.Y., but their efforts were unsuccessful. Richard Sherman (EMT Sherman) is a firefighter and paramedic for the Pinellas Suncoast Fire District. EMT Sherman was the first paramedic to arrive at Pine Tree Manor on the day in question. Upon arrival at the facility, EMT Sherman attempted to enter through the facility's main door, but could not gain immediate entry because the door was locked. EMT Sherman rang the doorbell and knocked on the door in an attempt to gain entry into the facility. Resident J.M. opened the door, and EMT Sherman entered the facility. Upon entry, EMT Sherman noticed that B.Y. was unresponsive on the sofa. He also observed at the same time that there were several residents in B.Y.'s immediate area and that there was no staff present. When EMT Sherman arrived, Ms. Cristobal was in another part of the facility assisting a resident who had become upset because the resident was having difficulty satisfying her toileting needs. Approximately a minute after EMT Sherman started resuscitation efforts on B.Y., Ms. Cristobal appeared in the area where B.Y. was located. Because Ms. Cristobal was wearing scrubs, EMT Sherman correctly identified her as a facility employee. EMT Sherman asked Ms. Cristobal if she knew anything about B.Y. and the circumstances surrounding her collapse. Ms. Cristobal did not respond to EMT Sherman's questions. EMT Sherman testified that Ms. Cristobal, after not responding to his questions, simply "looked at [him] and then turned and walked away" towards the main doors of the facility. While continuing to attempt to resuscitate B.Y., EMT Sherman noticed that Ms. Cristobal appeared to be locking the doors that he had just entered. EMT Sherman instructed Ms. Cristobal several times to not lock the doors because more emergency personnel would soon be arriving. Apparently not understanding EMT Sherman's directives, Mr. Cristobal locked the doors. A few minutes later, district fire chief John Mortellite arrived at the facility. EMT Sherman, while continuing to work on B.Y., heard District Chief Mortellite banging on the locked main doors in an effort to gain entry to the facility. A resident eventually unlocked the doors, and District Chief Mortellite entered the building. When asked why Ms. Cristobal would call him in an emergency situation and not 911, Mr. Sparks explained that it was Ms. Cristobal's practice to always call him in an emergency and that he would, in turn, manage the situation. Mr. Sparks, by allowing Ms. Cristobal "to always call him" in emergency situations instead of 911, created an alternative practice that was directly contrary to the facility's written policy which clearly directs employees to "DIAL '911'" when confronted with a medical emergency. Ms. Cristobal was, therefore, not properly trained. Mr. Sparks, by establishing and, indeed, encouraging a practice that shielded Ms. Cristobal from directly communicating with 911, placed B.Y. in a position where there was an unacceptable delay, though not precisely quantifiable, in contacting emergency personnel on her behalf. In a life or death situation such as that experienced by B.Y., every second matters because, as noted by EMT Sherman, "the longer the delay [in receiving medical treatment] the less probability of a positive outcome." When EMT Sherman arrived at Pine Tree Manor, he was completely unaware of the fact that the only employee on site spoke little, if any English. It is, therefore, reasonable to infer that Mr. Sparks failed to inform either the Pinellas County Sheriff's Office or the 911 operator of Ms. Cristobal's limitations with the English language. By Ms. Cristobal's not calling 911, and Mr. Sparks' not disclosing to the 911 operator that the only employee on site had limited English language skills, decedent B.Y. was placed in the unenviable position of having EMT Sherman's attention divided between resuscitation efforts and worrying about whether Ms. Cristobal was able to comply with his instructions. EMT Sherman testified that Pinellas County EMS, including 911 operators, has protocols in place for dealing with individuals that may not speak English. Had either Mr. Sparks disclosed to the 911 operator Ms. Cristobal's language limitations or had Ms. Cristobal herself called 911, protocols could have been implemented by emergency personnel that would have triggered certain safeguards designed to ensure that Ms. Cristobal's language limitations did not interfere with the delivery of emergency services to B.Y. DOAH Case No. 13-2397: Failure to Remain Generally Aware of the Whereabouts of Resident Most recently, R.D., on September 27, 2010, became a resident of Pine Tree Manor. A demographic data information survey was prepared as part of R.D.'s new resident intake process. R.D.'s intake data showed that he was independent in the areas of ambulation, bathing, dressing, toileting, eating, and transferring. R.D. was identified as needing supervision when performing tasks related to personal grooming. It was also noted that R.D. suffered from anxiety and panic attacks. According to R.D.'s brother Tom, R.D. was under the care of a psychiatrist for many years and "suffered from debilitating panic attacks." When suffering a panic attack, R.D. would often lay on the ground or floor, most often in a fetal position, and remain in this position until help arrived. As a part of the new resident intake process, R.D. was assessed for his risk of elopement. The assessment revealed that R.D. was not at risk for elopement and that he was free to "come and go [from the facility] as he pleases" and that he needed to "sign out" whenever leaving the facility. By correspondence dated March 14, 2011, the administration of Pine Tree Manor reminded R.D. that he needed to adhere to the facility's resident sign-out procedure whenever leaving from and returning to the facility. Approximately ten months after reminding R.D. of the facility's sign-out procedure, Mr. Sparks, on January 2, 2012, updated R.D.'s risk assessment form and again noted thereon that R.D. "may come and go as he pleases" and he "[n]eeds to remember to sign out" when leaving the facility. On May 23, 2012, R.D. was evaluated by a physician and it was noted, in part, that R.D. could function independently in the areas of ambulation, bathing, dressing, eating, grooming, toileting, and transferring. As for certain self-care tasks, the evaluating physician noted that R.D. needed assistance with preparing his meals, shopping, and handling his personal and financial affairs. It was also noted that R.D. needed daily oversight with respect to observing his well-being and whereabouts and reminding him about important tasks. The evaluating physician also noted that R.D. needed help with taking his medication.1/ The evaluation was acknowledged by Mr. Sparks as having been received on May 25, 2012. R.D.'s most recent itemization of his medications shows that on October 10, 2012, he was prescribed Clonazepam and Buspirone. The Clonazepam was administered three times a day at 8:00 a.m., noon, and 8:00 p.m. The Buspirone was administered four times a day at 8:00 a.m., noon, 5:00 p.m., and 8:00 p.m. These medications are often prescribed for anxiety, however, R.D.'s medications listing form does not expressly denote why the drugs were prescribed. At 7:58 a.m., on November 10, 2012, an ambulance from the Pinellas County EMS was dispatched to Pine Tree Manor. When the EMS unit arrived at 8:00 a.m., R.D. was found "on the ground or floor" and was complaining of feeling anxious. While being treated by EMS, R.D. took his 8:00 a.m. dose of Clonazepam and was transported to "Largo Med." Less than 24 hours later, EMS, at 4:29 a.m., on November 11, 2012, was dispatched to 13098 Walsingham Road, because R.D. was again complaining of feeling anxious. This location is apparently near Pine Tree Manor, as the EMS Patient Care Report for this service call notes that R.D. "walked to [the] store." Following the evaluation by EMS, R.D. was again transported to "Largo Med." At 12:24 p.m., on November 18, 2012, EMS was dispatched to a location near Pine Tree Manor where R.D. was found "lying supine on [the] sidewalk." According to the EMS report, R.D. advised that he became lightheaded and fell to the ground. R.D. did not complain of any other symptoms and was transported to a medical facility in Largo for further evaluation. At 1:27 p.m., on November 25, 2012, EMS was dispatched to a 7-11 store near Pine Tree Manor. Upon arrival at the store, EMS personnel found R.D. and, when questioned, he advised that he was again feeling anxious. Per R.D.'s specific request, as noted on the EMS report, he was transferred to St. Anthony's Hospital in St. Petersburg. On November 28, 2012, Mr. Sparks made an entry into R.D.'s file and noted that a neurosurgeon evaluated R.D.'s shunt on that date in an attempt to determine if a malfunction was the cause of R.D.'s panic attacks. Mr. Sparks noted in the record that the doctor advised that the shunt was working properly and that the shunt was ruled out as the "cause of [R.D.'s] panic attacks." As of November 28, 2012, Mr. Sparks was aware that R.D. had recently complained of experiencing panic attacks and that the cause of the same had not yet been determined. It was not confirmed, although it was certainly believed by Mr. Sparks, that R.D. was manipulating medical personnel at local treatment facilities for the purpose of securing medication beyond that prescribed by his regular treating physicians. This belief by Mr. Sparks is reasonable especially in light of R.D.'s request to EMS personnel on November 25, 2012, that he was to be transported to a medical facility other than "Largo Med" for treatment related to his feelings of anxiety.2/ R.D.'s medication record for December 4, 2012, shows that he was given his prescribed medication for the 8:00 a.m. dispensing time. Soon after receiving his medication, R.D. left Pine Tree Manor for the purpose of visiting his local congressman's office. According to the survey notes from the investigation related hereto, the congressman's office is located approximately two miles from Pine Tree Manor. Although it cannot be confirmed, it reasonably appears that R.D. walked to the congressman's office. R.D. did not sign out of the facility when he left Pine Tree Manor on the morning of December 4, 2012. R.D. did, however, inform facility staff that he was going to the congressman's office to discuss an issue.3/ Security video from the building where the congressman's office is located established that R.D. arrived at the congressman's office at 9:50 a.m. At approximately 10:45 a.m., a representative from the congressman's office called Pine Tree Manor and informed them that R.D. was ready to return to the facility. The person receiving the message from the congressman's office contacted Mr. Sparks and informed him that R.D. was requesting a ride back to Pine Tree Manor from the congressman's office. Mr. Sparks was assisting another resident at a local hospital when he received the request to transport R.D. and was, therefore, unable to transport R.D. from the congressman's office. Pine Tree Manor had no obligation to provide transportation services to R.D. Surveillance video from the building where the congressman's office is located confirmed that R.D. exited the building on December 4, 2012, at approximately 10:50 a.m. R.D.'s body was found on December 12, 2012. It is not known what happened to R.D. between the time he left the congressman's office and when his body was eventually discovered.4/ When Mr. Sparks returned to Pine Tree Manor on December 4, 2012, he was advised by staff that R.D. had not returned from the congressman's office. According to the posted work schedule for December 4, 2012, Mr. Sparks worked from 7:00 a.m. to 5:00 p.m. When Mr. Sparks left Pine Tree Manor on December 4, 2012, R.D. had not returned. Mr. Sparks, upon leaving the facility for the day, instructed staff (Aurelia Cristobal) to call him when R.D. returned. Ms. Cristobal's shift ended at 8:00 p.m. Pine Tree Manor employee Laura Munoz worked from 7:00 p.m. on December 4, 2012, to 7:00 a.m. on December 5, 2012. Ms. Munoz was not responsible for assisting R.D. with his medication, so it is unlikely that she would have known that R.D. missed receiving his medication prior to her arrival at work. Because Mr. Sparks left Pine Tree Manor on December 4, 2012, before Ms. Munoz arrived for work, he called Ms. Munoz after her shift started (precise time unknown) and requested that she call him upon R.D.'s return. There were no instructions given to Ms. Munoz by Mr. Sparks as to what she should do if R.D. did not return by some time certain. On December 4, 2012, Mr. Sparks knew that R.D. had never spent the night away from Pine Tree Manor without someone at the facility knowing R.D.'s whereabouts and that R.D. had never gone unaccounted for a period greater than 12 hours. On December 5, 2012, Mr. Sparks' scheduled work time was from 7:00 a.m. to 5:00 p.m. Prior to reporting to the facility on the morning of December 5, 2012, Mr. Sparks learned that R.D. had not returned to his room during the night shift. The exact time is not known when Mr. Sparks acquired this information, but it was likely sometime around 6:30 a.m. After learning that R.D. was still unaccounted for, Mr. Sparks immediately began canvassing the area near Pine Tree Manor. Around this same time, Mr. Sparks contacted R.D.'s brother and apprised him of the situation. At approximately noon on December 5, 2012, Mr. Sparks contacted the Pinellas County Sheriff's Office and reported R.D. missing. Pine Tree Manor has an elopement and missing residents policy that provides, in part, as follows: Residents may come and go as they please and shall not be detained unless family/resident representative and administrator agree supervision is required. A resident leaving the facility should either sign out by the front door or inform a staff member of their departure and provide an estimated time of return. The staff person should sign the resident out and notify other staff on duty. . . . If a resident . . . is deemed missing, staff shall immediately search the entire facility inside and around the facility grounds. . . . Whenever a resident is not found within the facility or its premises, the Administrator will: Notify the resident's representative. Notify the County Sheriff's Department by calling 911. Provide staff and searching parties with information and photo I. D. Instruct the staff to search inside the facility and the premises, the adjacent residential properties to the facility, up and down 131st Street, 102nd Avenue and the cross streets.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that Petitioner, Agency for Health Care Administration: Enter in Agency Case No. 2013002572 (DOAH Case No. 13-2397) a final order finding that Respondent, Pine Tree Manor, Inc., d/b/a/ Pine Tree Manor, committed a Class II violation and assessing an administrative fine of $5,000.00 and a survey fee of $500.00. Enter in Agency Case No. 2013004620 (DOAH Case No. 13-2011) a final order finding that Respondent, Pine Tree Manor, Inc., d/b/a/ Pine Tree Manor, committed a Class I violation and assessing an administrative fine of $8,000.00. It is also RECOMMENDED that the final order not revoke Respondent's license to operate an assisted living facility in the State of Florida, but, instead, suspend Respondent's license for a period of 60 days.7/ DONE AND ENTERED this 5th day of December, 2013, in Tallahassee, Leon County, Florida. S LINZIE F. BOGAN Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 5th day of December, 2013.
Conclusions THIS CAUSE comes before the State of Florida, Agency for Health Care Administration (“the Agency") concerning the denial of the Certificate of Need (“CON”) Application No. 10234, filed by North Brevard County Hospital District d/b/a Parrish Medical Center (“Parrish”). 1. On December 5, 2014, the Agency issued a State Agency Action Report (“SAAR”) preliminarily denying CON Application 10234 seeking to establish a new 20-bed comprehensive rehabilitation unit in District 7, Brevard County. The decision was published in Filed March 10, 2015 3:06 PM Division of Administrative Hearings the Florida Administrative Register on December 8, 2014. Exhibit 1. 2. On December 29, 2014, Parrish petitioned for a formal administrative proceeding to appeal the Agency’s initial denial of its CON application. The case was referred to DOAH and assigned Case No. 15-0133. 3. On December 29, 2014, Healthsouth of Sea Pines Limited Partnership, d/b/a Heaithsouth Sea Pines Rehabilitation Hospital (“HealthSouth Sea Pines”) petitioned for a formal administrative proceeding in support of the Agency’s preliminary denial of CON Application No. 10234. The case was referred to DOAH and assigned Case No. 15-0132. 4. On January 26, 2015, Parrish filed a Notice of Voluntary Dismissal of Case No. 15-0133. Exhibit 2. 5. On January 26, 2015, HealthSouth Sea Pines filed a Notice of Voluntary Dismissal of Case No. 15-0132. Exhibit 3. It is therefore ORDERED: 6. The denial of Parrish’s CON Application No. 10234 is UPHELD. ORDERED in Tallahassee, Florida, on this /O day on Liat ch, 2015. Elizabeth Dudek, Secretary Care Administration
Other Judicial Opinions 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, 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 rendition of the order to be reviewed. Page 2 of 3 CERTIFICATE OF SERVICE 1 CERTIFY that a true and correct copy of this Final Order was served on the below- _— named persons by the method designated on this bike of Ltt , 2015. Richard J. Shoop, Agency Clerk 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 www.doah.state.fl.us (Electronic Mail) Lorraine M. Novak, Esquire Office of the General Counsel Agency for Health Care Administration Lorraine.novak(@ahca.myflorida.com (Electronic Mail) David C. Ashburn, Esquire Michael J. Cherniga, Esquire M. Hope Keating, Esquire Greenberg Traurig, P.A. 101 East College Avenue Post Office Drawer 1838 Tallahassee, Florida 32301 ashburnd‘@gtlaw.com chernigam@gtlaw.com keatingh@gtlaw.com R. Terry Rigsby, Esquire Brian A. Newman, Esquire Pennington, Moore, Wilkinson, Bell and Dunbar, P.A. 215 South Monroe Street, Second Floor Post Office Box 10095 Tallahassee, Florida 32302 Turigsby@penningtonlaw.com Brian@penningtonlaw.com (Electronic Mail) Marisol Fitch Health Services & Facilities Consultant Certificate of Need Unit Agency for Health Care Administration Marisol .fitch@ahea.myflorida.com (Electronic Mail) Page 3 of 3 Miscellaneous AGENCY FOR HEALTH CARE ADMINISTRATION Certificate of Need DECISIONS ON BATCHED APPLICATIONS The Agency for Health Care Administration made the following decisions on Certificate of Need applications for Hospital Beds and Facilities batching cycle with an application due date of September 3, 2014: County: Brevard Service District: 7 CON #10233 Decision Date: 12/5/2014 Decision: A Applicant/Facility/Project: Indian River Behavioral Health, LLC Project Description: Establish a 74-bed child/adolescent psychiatric hospital Approved Cost: $16,737,262 County: Brevard Service District: 7 CON #10234 Decision Date: 12/5/2014 Decision: D Facility/Project: Parrish Medical Center Applicant: North Brevard County Hospital District Project Description: Establish a 20-bed comprehensive medical rehabilitation unit County: Broward Service District: 10-] CON #10235 Decision Date: 12/5/2014 Decision: A Facility/Project: Plantation General Hospital Applicant: Plantation General Hospital Limited Partnership Project Description: Establish a 200-bed replacement acute care hospital Approved Cost: $0 A request for administrative hearing, if any, must be made in writing and must be actually received by this department within 21 days of the first day of publication of this notice in the Florida Administrative Register pursuant to Chapter 120, Florida Statutes, and Chapter 59C-1, Florida Administrative Code. EXHIBIT 1 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE BEARINGS NORTH BREVARD COUNTY HOSPITAL DISTRICT d/b/a Parrish Medical Center, CASE NO.,: 15-0133CON CON NO. 10234 Petitioner, Vs. STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION. Respondents. / NOTICE OF VOLUNTARY DISMISSAL North Brevard County Hospital District d/b/a Parrish Medical Center. by and through its undersigned counsel, hereby provides notice of its voluntary dismissal of its Petition for Formal Administrative Proceedings, by which it initiated Case No. 05-0133CON on January 8, 2015. Respectfully submitted this 26" day of January, 2015. GREENBERG TRAURIG, P.A. 101 East College Avenue Post Office Drawer 1838 Tallahassee, FL 32302 ‘Velephone: (850) 222-6891 Facsimile: (850) 681-0207 MICHAEL {CHERNIGA Florida Bar No. 328014 chernigam@gtlaw.com Counsel for North Brevard County Hospital District d/b/a Parrish Medical Center EXHIBIT 2 Filed January 26, 2015 12:39 PM Division of Administrative Hearings CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that the foregoing was filed by eALJ with the Division of Administrative Hearings. The DeSoto Building, 1230 Apalachee Parkway, Tallahassee, Florida 32399-3060, and copy furnished 1o the following by electronic delivery this 26th day of January, 2015: Lorraine M. Novak, Esquire Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 Lorraine. Novak @ahca.myflorida.com Michael J. Chédiga _ TAL 451937932v1 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS HEALTHSOUTH OF SEA PINES LIMITED PARTNERSHIP, d/b/a HEALTHSOUTH SEA PINES REHABILITATION HOSPITAL, Petitioner, Case No. 15-0132CON VS. NORTH BREVARD COUNTY HOSPITAL DISTRICT, d/b/a PARRISH MEDICAL CENTER and AGENCY FOR HEALTH CARE ADMINISTRATION, Respondents. HEALTHSOUTH OF SEA PINES LIMITED PARTNERSHIP, d/b/a HEALTHSOUTH SEA PINES REHABILITATION HOSPITAL’S NOTICE OF VOLUNTARY DISMISSAL Petitioner. HealthSouth of Sea Pines Limited Partnership, d/b/a HealthSouth Sea Pines Rehabilitation Hospital, by and through the undersigned counsel, hereby voluntarily dismisses its petition in the above-styled proceedings. Respectfully submitted this Lo day of January, 2015. (a R. am RRY Y RIGSB Y Florida Bar Number: a BRIAN A. NEWMAN Florida Bar Number: 0004758 PENNINGTON, P.A. 215 South Monroe Street, Second Floor Post Office Box 10095 (32302-2095) Tallahassee, Florida 32301 Telephone: 850-222-3533 Facsimile: 850-222-2126 nie: cerati . EXHIBIT 3 Filed January 26, 2015 1:45 PM Division of Administrative Hearings E-Mail: — trigsby‘@penningtoniaw.com brian’@penningtonlaw.com Attorneys for HealthSouth Sea Pines Rehabilitation Hospital CERTIFICATE OF SERVICE I HEREBY CERTIFY that the foregoing was filed with by eALJ with the Division of Administrative Hearings. The DeSoto Building. 1230 Apalachee Parkway. Tallahassee, Florida 32399-3060, and copy furnished to the following by electronic delivery this ¢ day of January, 2015: Lorraine M. Novak, Esquire Agency for Health Care Administration Fort Knox Building III, Mail Stop 3 2727 Mahan Drive. Suite 3431 Tallahassee. Florida 32308 Lorraine. Novak ‘wahca.myflorida.com ae aaa in =f d — ATTORNEY oP 7D
Conclusions This matter, having come before the Pinellas County Sheriff's Civil Service Board, sitting as a quasi-judicial body, and the Board having reviewed the Administrative Law Judge’s July 21, 2014 Order Closing File And Relinquishing Jurisdiction, and being otherwise advised in the premises, it is: ORDERED AND ADJUDGED that: 1. The Board, by a unanimous vote of five (5) members finds that Respondent Adrian Nenu engaged in prohibited conduct in that Respondent violated Petitioner’s General Order 3-1.1, Rule and Regulation 5.4, (Duties and Responsibilities) and General Order 3-1.3, Rule and Regulation 3.36 (Omission of Information). 2. The seven day suspension of Respondent’s employment with the Pinellas County Sheriff's Office is upheld. 3. The parties are hereby notified of the right to appeal this Final Order to the Second District Court of Appeal by filing notice of intent to do so upon the Clerk of Court and the Pinellas County Sheriffs Civil Service Board within thirty (30) days of the date of this Order. DONE AND ORDERED this /@ zyw_ day of September, 2014. Page | of 2 Lt. Col. (R) Neal A. White, Chairman Pinellas County Sheriff's Civil Service Board CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the above Final Order has been furnished by email to Adrian Nenu at anenu@pcsonet.com and Regular U.S. Mail to Paul G. Rozelle, Esq. at Pinellas County Sheriffs Office 10750 Ulmerton Road Largo, FL 33778 this (2 th day of September, 2014. Carole Sanzeri Senior Assistant County Attorney 315 Court Street, 6" Floor Clearwater, FL 33756 Phone: 727-464-3354/Fax: 727-464-4147 Attorney for Sheriffs Civil Service Board Copy to: Members of the Sheriff’s Civil Service Board Vicki Troesch HAUSERS\ATYKBO07\Carole\Sheriff's Civil Services Board\Nenu\Final Order Draft Nenu.docx Page 2 of 2
The Issue The issue before the Florida Land and Water Adjudicatory Commission (FLWAC) in this proceeding is whether to grant the Petition for Establishment of the Tolomato Community Development District (Petition). The local public hearing was for the purpose of gathering information in anticipation of rulemaking by FLWAC.
Conclusions THIS CAUSE comes before the Agency For Health Care Administration (“the Agency") concerning Certificate of Need ("CON") Application No. 10183, which was filed by Rockledge HMA, LLC/Wuesthoff Medical Center-Rockledge (“Wuesthoff Rockledge”) in the first batching cycle of 2013, and preliminarily denied by the Agency. 1. On July 9, 2013, Wuesthoff Rockledge filed a Petition for Formal Administrative Proceeding contesting the preliminary denial to establish a 15-bed comprehensive medical rehabilitation unit, which was forwarded to the Division of Administrative Hearings (“DOAH”). 2. On July 11, 2013, HealthSouth of Sea Pines Limited Partnership d/b/a HealthSouth Sea Pines Rehabilitation Hospital (“HealthSouth”) filed a Petition for Leave to Intervene supporting the Agency’s denial of Wuesthoff Rockledge’s CON application. Filed July 14, 2014 10:32 AM Division of Administrative Hearings 3. On July 23, 2013, DOAH entered an Order Granting Petition to Intervene. 4. On June 18, 2014, Wuesthoff Rockledge filed a Notice of Voluntary Dismissal. It is therefore ORDERED: 1. The denial of CON Application 10183 is UPHELD. ORDERED in Tallahassee, Florida, on this /7 day of Tetley , 2014. Agency for Heglth Care Administration
Other Judicial Opinions A party that is adversely affected by this Final Order is entitled to seek 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, 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 rendition of the order to be reviewed. CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Final Orger has been furnished by US. Mail or interoffice mail to the persons named below on this [0 day of ety 2014. Richard J. Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 (850) 413-3630 Copies Furnished to: W. David Watkins Administrative Law Judge Division of Administrative Hearings (Via Electronic Mail) Geoffrey D. Smith, Esquire Susan Crystal Smith, Esquire Corinne T. Porcher, Esquire Smith and Associates Suite 201, 3301 Thomasville Road Tallahassee, Florida 32308 Attorneys for Rockledge HMA, LLC d/b/a Wuesthoff Medical Center-Rockledge (U.S. Mail) R. Terry Rigsby, Esquire Pennington, P.A. Post Office Drawer 10095 Tallahassee, Florida 32302 Attorney for HealthSouth of Sea Pines Limited Partnership d/b/a Healthsouth Sea Pines Rehabilitation Hospital (U.S. Mail) Richard Joseph Saliba Assistant General Counsel Agency for Health Care Administration (Electronic Mail) Facilities Intake Agency for Health Care Administration (Electronic Mail)
