Case Name: ST. JOSEPH HOSPITAL OF CHARLOTTE, FLORIDA, INC., Appellant, v. DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, and Fawcett Memorial Hospital, Appellees
Court: Florida District Court of Appeal
Jurisdiction: Florida
Decision Date: 1989-12-19
Citations: 559 So. 2d 595
Docket Number: Nos. 88-2432, 88-2878
Parties: ST. JOSEPH HOSPITAL OF CHARLOTTE, FLORIDA, INC., Appellant, v. DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, and Fawcett Memorial Hospital, Appellees.
Judges: ERVIN and ZEHMER, JJ., concur.
Reporter: Southern Reporter, Second Series
Volume: 559
Pages: 595–601

Head Matter:
ST. JOSEPH HOSPITAL OF CHARLOTTE, FLORIDA, INC., Appellant, v. DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, and Fawcett Memorial Hospital, Appellees.
Nos. 88-2432, 88-2878.
District Court of Appeal of Florida, First District.
Dec. 19, 1989.
On Denial of Rehearing April 12, 1990.
Judith S. Marber and James J. Breen, of Wampler, Buchanan & Breen, Miami, for appellant.
Edgar Lee Elzie, Jr., of MacFarlane, Ferguson, Allison & Kelly, Tallahassee, for appellee Health and Rehabilitative Services.
James C. Adkins, Leonard A. Carson, and John D.C. Newton, II, of Carson & Linn, Tallahassee, for appellee Fawcett Memorial.

Opinion:
WENTWORTH, Judge.
In this consolidated appeal, appellant, St. Joseph Hospital of Port Charlotte, Florida, Inc. (St. Joseph) seeks review of two final orders rendered by the Department of Health and Rehabilitative Services (HRS), one denying St. Joseph's petition for a formal administrative hearing on appellee Fawcett Memorial Hospital's application for a certificate of need (CON) for a cardiac catheterization laboratory, and the other order granting Fawcett Memorial Hospital (Fawcett Memorial) the CON for such a laboratory in HRS' District 8 after St. Joseph was denied intervention in the proceeding. We find initially that St. Joseph does not have standing to compel comparative review of its application with that of Fawcett Memorial because of its failure to timely apply for a CON. We also find that St. Joseph waived its clear point of entry to challenge HRS' decision to grant Fawcett Memorial a CON by failing to timely assert that it had a substantial interest in the proceeding, and affirm both final orders.
The relevant events culminating in this appeal arose over two years ago. In 1987, HRS adopted rule 10-5.008(2)(a), Florida Administrative Code, which provides for publication of the fixed need pools for a particular CON batching cycle prior to the letter of intent deadline for that batching cycle. In early September 1987, the time arrived for HRS to timely publish a fixed need pool for cardiac catheterization laboratories for the September 1987 batching cycle for District 8, but HRS failed to do so. Three health care providers in that district, including Fawcett Memorial, subsequently submitted CON applications for that cycle, but St. Joseph did not. The applications submitted by these three providers were then subjected to comparative review.
Subsequent to conducting the comparative review, HRS published its State Agency Action Report (SAAR) which announced HRS' intent to deny Fawcett Memorial a CON for a cardiac catheterization laboratory and to grant Doctors Hospital of Sarasota (Doctors Hospital) a CON in the same district. Because HRS utilized an incorrect divisor in one of its calculations in the SAAR and arrived at an inaccurate statement of need, Fawcett Memorial subsequently challenged HRS' intended denial of its application. In April 1988, HRS published a Notice of Litigation in the Florida Administrative Weekly which announced Fawcett Memorial's challenge to the intended denial. This notice stated: .
Resolutions of these requests for hearing by way of a grant or denial of the certificate of need at issue will determine substantial interests of person [sic]. Those persons whose substantial interests may be determined by these proceedings, including settlements, grants, and denials, are advised to govern themselves accordingly and may wish to exercise rights including intervention . HRS will not settle or otherwise reach a final resolution of these matters for a period of 30 days from the date of the publication.
In July 1988, Fawcett Memorial, HRS, and Doctors Hospital filed a settlement agreement with the Division of Administrative Hearings which provided that Fawcett Memorial would also receive a CON for a catheterization laboratory for the September 1987 batching cycle. The parties moved to remand the cause to HRS for implementation of the terms of the settlement. At this'point, St. Joseph petitioned to intervene in the proceedings between these parties for the first time and was denied intervention.
St. Joseph then petitioned for a formal administrative hearing, requesting comparative review of its application for a CON with that of Fawcett Memorial, and was denied a hearing by final order of HRS. In October 1988, HRS entered its final order granting Fawcett Memorial its CON for a cardiac catheterization laboratory. There ensued the two appeals now before us, taken by St. Joseph as to the final order denying it an administrative hearing and the final order granting the CON to Faw-cett after St. Joseph was denied intervention.
Section 381.709(5)(b), Florida Statutes, provides: "In administrative proceedings challenging the issuance or denial of a certificate of need, only applicants considered by the department in the same batching cycle are entitled to a comparative hearing on their applications." Generally, for a health care provider to compel comparative review of its application for a certificate of need, it must initially file its application in the same batching cycle with the applications of those providers with whom it seeks comparative review. "If an applicant fails to file in a particular batching cycle it thereby waives the right to comparative review with those health care providers that do file an application in that batching cycle." University Medical Center, Inc. v. Department of Health and Rehabilitative Services, 483 So.2d 712, 715-16 (Fla. 1st DCA 1986).
Although St. Joseph filed a letter of intent informing HRS of its intention to file an application for a CON for a catheterization laboratory to be reviewed in the September 1987 batching cycle, it ultimately failed to file any application for that cycle. St. Joseph's letter stated: "St. Joseph Hospital of Port Charlotte, Florida, Inc. would like you to consider this a Letter of Intent to file an application for a Certificate of Need for a Cardiac Catheterization Laboratory. The Hospital's application with all required information will be forwarded to you by the September 15, 1987 deadline. We conclude that this letter of intent is insufficient to establish St. Joseph as a competing applicant, under section 381.-709(5)(b), and thus, St. Joseph does not have a right to compel comparative review under that section.
St. Joseph argues in the alternative that HRS' failure to timely publish a fixed need pool for the September 1987 batching cycle improperly placed the burden on all interested health care providers to project the number of cardiac catheterization laboratories that would be needed based on existing rules and data. In addition, St. Joseph argues that with the erroneous calculation in the SAAR, HRS changed the projected need after the application deadline had passed and comparative review had begun. St. Joseph asserts that because it ultimately filed an application for a CON in September 1988, it is deserving of an opportunity to compete for this recalculated need under this court's analysis in Gulf Court Nursing Center v. Department of Health and Rehabilitative Services, 483 So.2d 700 (Fla. 1st DCA 1985).
HRS' failure to publish a computation of the fixed need pool before the batching cycle deadline, and its publication in the SAAR of a statement of need based on computations containing a clerical error, do not establish a violation of the rule this court enunciated in Gulf Court that competing applications which are bona fide, timely filed and directed towards the same "fixed pool of needed investments" are entitled to comparative review. Gulf Court at 705. The health council data and relevant rule methodology necessary to calculate the fixed need pool were available to all potential applicants for the September 1987 batching cycle. HRS did not alter the rule methodology applicable to the September 1987 cycle after the cycle began, and HRS' erroneous computation in April 1988 did not create additional need for that cycle. HRS' error would have been apparent to any applicant who had calculated the need and decided to apply before the batch ing cycle deadline in September 1987. St. Joseph failed to apply by the deadline for that cycle, and thus cannot claim that it was competing for the same fixed pool of need.
St. Joseph did not submit its application for a CON for a cardiac catheterization laboratory until September 1988. St. Joseph was on notice of the existence of some need in that district by the same data from the local health council that was available to other providers who did apply in September 1987. Because St. Joseph failed to apply for the September 1987 cycle, and because we find no similarity to Gulf Court, St. Joseph cannot reasonably claim an entitlement to comparative review under a Gulf Court analysis.
In addition, St. Joseph lacks standing under section 381.709(5)(b) to intervene in the process by which Fawcett Memorial was granted a CON. That section provides: "Existing health care facilities may initiate or intervene in such administrative hearing upon a showing that an established program will be substantially affected by the issuance of a certificate of need to a competing proposed facility or program within the same district...." The hearing officer properly found that the term "program" for purposes of establishing standing for intervention did not refer to "general services to a range of patients," but rather to a "specific licensed program or a program requiring a certificate of need." The hearing officer was also correct in finding that St. Joseph's treatment of patients with general cardiac problems is not a sufficient predicate for standing as an intervenor in a cardiac catheterization CON proceeding.
Even if St. Joseph had been able to assert that its substantial interests were being affected and that it was therefore entitled to an opportunity to be heard, St. Joseph nevertheless waived its opportunity. As we noted in Gulf Coast Home Health Services of Florida v. Department of Health and Rehabilitative Services, 515 So.2d 1009 (Fla. 1st DCA 1987), the notice of litigation (which was very similar to the notice involved here) was sufficient to provide any party whose substantial interests would be affected a clear point of entry into the administrative process. St. Joseph waived this clear point of entry by not attempting to intervene for the first time until more than three months after the notice of litigation was published, and well after the parties had come to an agreement and moved to remand the case to HRS for implementation of the terms of settlement. The fact that the remand had not been accomplished before St. Joseph petitioned to intervene does not operate to negate St. Joseph's waiver. Thus, under the circumstances, St. Joseph cannot challenge HRS' grant of a CON to Fawcett Memorial. St. Joseph lost the opportunity to assert any challenge to HRS' action when it waived the clear point of entry afforded by the published notice of litigation.
The final orders rendered by HRS by which St. Joseph was denied a formal administrative hearing and Fawcett Memorial was granted a CON for a cardiac catheteri-zation laboratory are affirmed.
ERVIN and ZEHMER, JJ., concur.
. St. Joseph has filed a similar appeal of a final order issued by HRS in a batching cycle subsequent to the cycle involved here. That appeal is currently pending in this court as St. Joseph Hospital of Port Charlotte, Florida Inc. v. Department of Health & Rehabilitative Services and Adventist Health Systems/Sunbelt, Case No. 89-2390.
. Although not dispositive of the issues involved here, we note that subsequent to the events involved in the case at bar HRS articulated its new policy on how it will treat changes or corrections to a fixed need pool that has already been published and errors in a published fixed need pool which are discovered after the cycle has begun. See Health Quest Corp. v. HRS, 11 F.A.L.R. 5427, 5430-33.