Case Name: HEALTH CARE MANAGEMENT, INC., Appellant, v. DEPARTMENT OF HEALTH & REHABILITATIVE SERVICES, Appellee
Court: Florida District Court of Appeal
Jurisdiction: Florida
Decision Date: 1985-11-21
Citations: 479 So. 2d 193
Docket Number: No. BE-347
Parties: HEALTH CARE MANAGEMENT, INC., Appellant, v. DEPARTMENT OF HEALTH & REHABILITATIVE SERVICES, Appellee.
Judges: ERVIN, J., concurs.
Reporter: Southern Reporter, Second Series
Volume: 479
Pages: 193–197

Head Matter:
HEALTH CARE MANAGEMENT, INC., Appellant, v. DEPARTMENT OF HEALTH & REHABILITATIVE SERVICES, Appellee.
No. BE-347.
District Court of Appeal of Florida, First District.
Nov. 21, 1985.
Rehearing Denied Jan. 3, 1986.
Robert D. Newell, Jr., and Martha J. Edenfield, of Oertel & Hoffman, Tallahassee, for appellant.
Harden King, Asst. Gen. Counsel, Dept, of Health and Rehabilitative Services, Tallahassee, for appellee.

Opinion:
WENTWORTH, Judge.
Appellant seeks review of an administrative order by which its application for a certificate of need (CON) was denied by the Department of Health and Rehabilitative Services (HRS). We. find that no point of reversible error has been presented for our review, and we therefore affirm the order appealed.
Appellant obtained a CON in 1981 for the construction of a nursing home in Lee County, with 78 authorized beds. In 1983 appellant submitted a CON application seeking authorization for an additional 42 beds at the subject facility. HRS indicated its intent to deny the CON application, and appellant then obtained a formal administrative hearing, asserting that a consideration of the criteria contained in § 381.-494(6)(c), Florida Statutes, and Rule 10-5.-11, FAC, establishes a need for additional nursing care beds in Lee County. Appellant argued that HRS had improperly considered only the limited mathematical bed need methodology specified in Rule 10-5.-11(21). .
After the presentation of evidence at the administrative hearing appellant submitted a proposed recommended order which included 94 proposed findings of fact. These proposed findings generally embraced appellant's theory that Lee County has a present shortage of nursing care beds thus necessitating the use of distant nursing care facilities, or local acute care facilities, by "medically indigent" Lee County residents in need of nursing care. Suggesting that this circumstance produces adverse consequences with regard to patient cost and the availability of support services for local Medicaid and VA recipients, appellant requested a conclusion that "an exceptional circumstance" of patient out-migration has historically existed in Lee County. Appellant asserted that such a conclusion would warrant the approval of its CON application for additional nursing home beds for Medicaid and VA patients despite the contrary result mandated by the mathematical bed need methodology of Rule 10-5.11(21).
The hearing officer entered a recommended order which noted that Lee County is a sub-district of HRS District VIII for nursing home bed need determinations. Finding that District VIII as a whole has excess nursing care beds and no additional bed need pursuant to the methodology specified in Rule 10-5.11(21), the hearing officer acknowledged appellant's argument with regard to the asserted historical out-migration of Medicaid and VA patients from Lee County. However, the hearing officer expressly found that:
. The record in this cause fails to contain any competent, credible evidence to establish that Medicaid and VA recipients in Lee County have been so historically underserved as to merit the granting of the 42 additional nursing home beds requested .
The hearing officer further concluded that appellant had not established that additional beds otherwise approved for Lee County would not meet the area need. It was therefore determined that appellant had failed to demonstrate exceptional circumstances which would warrant the granting of the requested CON, and it was thus recommended that appellant's CON application be denied. Appellant filed exceptions to the hearing officer's recommended order, and HRS then entered a final order by which it adopted and incorporated the hearing officer's recommended findings and conclusions, and appellant's CON application was denied.
Appellant urges on appeal that it was entitled to an administrative order which specifically addressed each proposed finding of fact which appellant submitted. Section 120.59(2), Florida Statutes, does provide that if proposed findings have been submitted the agency order "shall include a ruling upon each proposed finding...." It was indicated in Stuckey's of Eastman, Georgia v. State of Florida Department of Transportation, 340 So.2d 119 (Fla. 1st DCA 1976), that this statutory mandate requires "explicit agency rulings on all findings proposed by a party_" Accord, Forrester v. Career Service Commission, 393 So.2d 1 (Fla. 1st DCA 1980). However, this requirement necessitates a specific ruling only as to such proposed findings as are pertinent and which are not subordinate, immaterial, or unnecessary. See Forrester v. Career Service Commission, 361 So.2d 220 (Fla. 1st DCA 1978); see also Wong v. Career Service Commission, 371 So.2d 530 (Fla. 1st DCA 1979). Furthermore, the failure to explicitly address a proposed finding would require reversal of the agency action only when such failure has the effect of impairing the fairness of the proceeding or the correctness of the action. See Parekh v. Career Service Commission, 346 So.2d 145 (Fla. 1st DCA 1977); see generally Adult World Inc. v. State of Florida Division of Alcoholic Beverages and Tobacco, 408 So.2d 605 (Fla. 5th DCA 1982); § 120.68(8), Florida Statutes.
In the present case appellant's position below was predicated upon the contention that an historical and continuing out-migration of Medicaid and VA patients in Lee County produced exceptional circumstances warranting the granting of a CON for additional nursing care beds. The hearing officer's recommended order, which was adopted by the agency, expressly found that the record evidence did not establish the asserted historical underservice of Medicaid and VA recipients in the county, or that additional beds otherwise approved would not sufficiently serve local needs. The final order thus clearly reveals the agency rationale and provides an adequate written foundation for appellate review as required by McDonald v. Department of Banking & Finance, 346 So.2d 569 (Fla. 1st DCA 1977), and Schomer v. Department of Professional Regulation, Board of Optometry, 417 So.2d 1089 (Fla. 3d DCA 1982). The agency's explicit ruling, which is not now challenged, renders appellant's further proposed findings subordinate, immaterial, and unnecessary. The absence of a specific ruling as to these subordinate proposals has not been shown to have impaired the fairness of the proceeding below or the correctness of the agency action, and does not constitute reversible error.
The order appealed is affirmed.
ERVIN, J., concurs.
ZEHMER, J., dissents with written opinion.
. The hearing officer's recommended order also includes a statement that:
To the extent that those proposed findings of fact are not contained in this recommended Order, they have been specifically rejected as being either irrelevant or unnecessary to a determination of the issues in this cause, or as not having been supported by evidence of record.
Such a blanket statement does not facilitate judicial review and does not comport with the rationale of Pelham v. Superintendent of the School Board of Wakulla County, 436 So.2d 951 (Fla. 1st DCA 1983), wherein it was indicated that the agency should delineate which proposed findings are deemed immaterial and which are unsupported by the evidence. We thus find this blanket statement to be inadequate to discharge the agency's duty of explication. However, as did the Third District in Schomer v. Department of Professional Regulation, Board of Optometry, 417 So.2d 1089 (Fla. 3d DCA 1982), we decline to elevate form over substance and we find that the agency order in the present case did, in its entirety, adequately address appellant's pertinent and material proposed findings.