Findings Of Fact Petitioner, Good Samaritan Hospital (GSH), is a hospital with emergency room services located in West Palm Beach, Florida. GSH is licensed under Chapter 395, Florida Statutes. Respondent, Department of Health and Rehabilitative Services (DHRS), is the designated state agency responsible for the regulation of hospitals pursuant to Chapter 395, Florida Statutes. On or about June 12, 1989, DHRS filed an Administrative Complaint against GSH alleging that GSH had, on the evening of November 30, 1988, failed to provide neurosurgical treatment to a patient presented to its emergency room by the West Palm Beach Fire Department Emergency Medical Services in violation of Sections 395.0142, 395.0143, and 401.45, Florida Statutes. The Administrative Complaint notified GSH that DHRS intended to levy an administrative fine against it in the amount of $10,000.00. On February 1, 1989, Department of Health and Rehabilitative Services (DHRS) issued PDRL Letter Policy No. 02-89 (letter policy), which purports to discuss the requirements of Section 395.0142, Florida Statutes. The following appears as paragraph 9 of the letter policy under the portion styled "Policy Statement": 9. If a hospital provides an "ongoing" service and/or specialty and is specifically requested to accept a "stabilized" patient from a transferring hospital not providing such service and/or speciality, the hospital must accept such transfer for treatment. If specialized staff is not "on duty" or readily available, coverage for such service must be arranged by the hospital to which the patient will be transferred. Failure to accept will be considered a violation of this statute. The following findings of fact are based, in part, on the stipulation of the parties: As of November 30, 1988, the date of the incident which is the subject of the administrative complaint, DHRS had not notified GSH of any rule or policy interpreting Sections 395.0142, 395.0143, and 401.45, Florida Statutes. As of November 30, 1988, no rule existed which stated a specific requirement that hospitals which provide neurosurgery in their emergency rooms must staff or provide on-call neurosurgery services on a continuous basis, i.e., twenty-four (24) hours per day, 365 days per year. As of November 30, 1988, no rule had been promulgated which contained the requirements of paragraph 9 of the letter policy. The following findings are based, in part, on admissions made by DHRS: Paragraph 9 of the letter policy is an agency statement of general applicability that implements, interprets, or prescribes law or policy. Paragraph 9 of the letter policy is an agency statement which imposes a requirement not specifically required by statute or by an existing rule. The letter policy was distributed to hospital administrators at all of Florida's licensed hospitals. The letter policy was primarily drafted by Connie Cheren, Director of DHRS' Office of Licensure and Certification, and by Larry Jordan, Chief of DHRS' Office of Emergency Medical Services, following meetings and consultations with staff. Neither Ms. Cheren nor Mr. Jordan is an attorney. The letter policy was sent out over Ms. Cheren's name. The DHRS employees who investigated the incident which occurred at GSH on November 30, 1988, initially submitted a report dated March 7, 1989, which found no violation by GSH. Thereafter, the investigators were provided a copy of the policy letter by their supervisor and advised to submit an amended report based on paragraph nine. The letter policy was used and relied on by DHRS investigators, at the direction of their supervisor, to submit their Amended Investigative Report. The amended report found a violation by GSH. DHRS relied, in part, on the letter policy in determining whether to file an administrative complaint against GSH.
Findings Of Fact Ms. Skippy King applied for licensure as a midwife pursuant to Chapter 485, Florida Statutes. In her application (Exhibit 1) she provided all information required by Rule 10D-36.22,-- Florida Administrative Code, except the recommendation of the county health officer, Dr. John S. Neill. Included in her application was the affidavit of having attended, under the supervision of a licensed and registered physician, the requisite number of births within a one- year period, and recommendations by three physicians attesting to her qualifications and competency for licensure. One of the attesting physicians, a practicing obstetrician and gynecologist, testified to her competence and experience for licensure. After making application for licensure, Ms. King was visited by the head nurse for Hillsborough County Health Department who inspected the equipment used by Petitioner. When asked by this nurse how she sterilized the equipment on home deliveries, Petitioner showed her the autoclave used. No comment was made by the nurse or anyone else to Petitioner that the equipment used was inadequate or unsanitary. Nevertheless, the denial of licensure by Respondent was predicated solely on the refusal of Dr. Neill to furnish his written recommendation and his statement as reason there for that there "is not [sic] evidence to establish `the equipment and settings to be used in practice are safe and sanitary.'" Petitioner visited the County Medical Officer on at least two occasions, once in company with Dr. Jacobs, one of the physicians attesting to her competency in the application. At this visit Dr. Neill told them not to talk about midwifery. At the second meeting with Dr. Neill, Petitioner testified Dr. Neill stated he had spent twenty years getting women back in hospitals and that he didn't believe in home births. No other reason was given to Petitioner for his refusal to recommend her for licensure.
Findings Of Fact The Respondent is and at all times material hereto was a certified general contractor, having been issued license No. CG017743. That license is presently in inactive status. In August, 1980, the Respondent submitted an application to the Palm Beach County Construction Industry Licensing Board in order to take the examination for qualifying as a drywall contractor. A check for the required fee was submitted with the application. While the application was being processed, an official of the Board received a letter stating that the Respondent did not have the necessary experience to take the drywall examination. The Board official, Mr. Edward R. Flynn, contacted the Respondent and asked her to meet with him regarding the application. At the meeting, Respondent was confronted with the information that the experience resume, citizenship, and social security information were not true. Respondent became very tearful and asked to withdraw the application. Other than her statement that she had been a bookkeeper and done some estimating for a contracting firm, Respondent had very little to say in response to Mr. Flynn's questions. She provided no other specific information in the meeting. Mr. Flynn returned her check but did not return the application. The following information in the application was false: Her citizenship was shown on the application as a United States citizen when, in fact, she was a citizen of Canada. The social security number entered on the application was Respondent's Canadian social security number, not a U.S. social security number. The resume attached to the application reflects that Respondent worked from 1971 to 1973 as a laborer for Smith Plastering. This was not true. The resume also states that Respondent was a project supervisor for all phases of drywall, stucco, and insulation for five years. This information was false. Respondent did not work as a "project supervisor" with the listed employer, ALC Interior Systems of Florida, Inc. The application was signed by the Respondent before a notary on July 28, 1980. The Respondent also signed the resume as well as a verification of construction experience from Smith Plastering employment from 1971 to 1973. In May, 1980, Respondent filed her application with the Florida Construction Industry Licensing Board to take the State Certified Contractor's Examination. As a part of that application, the Respondent listed her experience from 1974 to May, 1980, as project supervisor supervising all phases of construction. This information was false. From 1974 to 1980, the Respondent was employed as controller of ALC Interiors. She performed bookkeeping and other financial related functions. She was not a project supervisor and did not supervise construction for ALC. The Respondent also placed her Canadian social security number on the state application. The Respondent signed the state application before a notary public on April 4, 1980. Pursuant to her state application, Respondent passed the State Certification Examination for General Contractors in October, 1980, and in February, 1981, was issued license number CG017743.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED: That Respondent's license as a certified general contractor be revoked. DONE and ENTERED this 20th day of July, 1983, in Tallahassee, Florida. MARVIN E. CHAVIS Hearing Officer Division of Administrative Hearings 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 20th day of July, 1983. COPIES FURNISHED: Michael J. Cohen, Esquire Mr. James Linnan 2715 East Oakland Park Boulevard Executive Director Suite 101 Construction Industry Ft. Lauderdale, Florida 33306 Licensing Board Post Office Box 2 Herbert P. Benn, Esquire Jacksonville, Florida 32202 Blank & Benn 1016 Clearwater Place West Palm Beach, Florida 33402 Mr. Fred Roche Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301
