TALLAHASSEE MEM. v. Tallahassee Med. Ctr.

681 So. 2d 826
CourtDistrict Court of Appeal of Florida
DecidedOctober 11, 1996
Docket95-1400
StatusPublished
Cited by39 cases

This text of 681 So. 2d 826 (TALLAHASSEE MEM. v. Tallahassee Med. Ctr.) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
TALLAHASSEE MEM. v. Tallahassee Med. Ctr., 681 So. 2d 826 (Fla. Ct. App. 1996).

Opinion

681 So.2d 826 (1996)

TALLAHASSEE MEMORIAL REGIONAL MEDICAL CENTER, INC., Appellant,
v.
TALLAHASSEE MEDICAL CENTER, INC., d/b/a Tallahassee Community Hospital, Appellee.

No. 95-1400.

District Court of Appeal of Florida, First District.

October 11, 1996.

*828 Robert P. Smith of Hopping, Green, Sams & Smith, P.A., John D. Buchanan of Henry, Buchanan, Mick, Hudson & Suber, P.A., Tallahassee, for appellant.

Robert L. Hinkle and Elizabeth McArthur of Radey, Hinkle, Thomas & McArthur, Tallahassee, for appellee.

OPINION ON MOTION FOR REHEARING

WOLF, Judge.

We grant appellant's motion for rehearing and substitute the following opinion for the original.

Tallahassee Memorial Regional Medical Center, Inc. (TMRMC), formerly Tallahassee Memorial Hospital (TMH), challenges a final summary judgment determining that section 18 of Leon County ordinance 90-22 (section 18) does not impose a duty upon appellee, Tallahassee Community Hospital (TCH), which is enforceable by way of a private tort action. TMRMC also challenges the determination in the final summary judgment that the ordinance does not create a private cause of action because such an interpretation would 1) be preempted by state statute, and 2) would result in the ordinance being unconstitutional as it would not relate to a legitimate public purpose.[1] We determine that the ordinance on its face creates a private cause of action and that state statutes do not preempt a county ordinance from determining how to subsidize emergency ambulance services. We also find, however, that the portion of the ordinance which makes a receiving hospital primarily responsible for payment for ambulance services expressly conflicts with section 395.1041(3)(k)(1), Florida Statutes. We, therefore, affirm the ultimate decision of the trial court, denying TMRMC's request to enforce section 18, but reverse and remand those portions of the final judgment which determine that no private cause of action was created, and that the Legislature had preempted the entire field of financing local ambulance service. It is, therefore, unnecessary to address the constitutional due process issue. TMRMC also asserts that the portion of the summary judgment striking counts II-IV of their complaint was in error. We find no error, and affirm as to that portion of the summary judgment without further discussion.

TMH was Tallahassee's first acute-care hospital, owned and operated by the city of Tallahassee. In 1972, the city, through TMH, began operating the local ambulance service; therefore, the ambulance service was part of the city government. In 1979, when Tallahassee Community Hospital (TCH) opened as Tallahassee's second acute-care hospital, TMH reorganized as a private not-for-profit corporation and was renamed Tallahassee Memorial Regional Medical Center (TMRMC). The city of Tallahassee leased all the hospital property, including land, buildings, and equipment to TMRMC. TMRMC continued to provide all the services previously provided by TMH. Those services included the ambulance service.

After TCH began emergency room services, the Florida Attorney General's office investigated complaints that TMRMC's ambulance service was violating the antitrust laws by discriminating in favor of TMRMC's hospital. In order to settle antitrust charges, TMRMC entered an agreement under which its ambulance service was to deliver patients to TCH and TMRMC without discrimination. The agreement afforded TCH various means of attempting to assure *829 compliance, including the right to audit TMRMC's records, the right to monitor certain TMRMC ambulance staff meetings, and the right to bring concerns to an independent nongovernmental ombudsman. In exchange, TCH agreed to pay TMRMC its charges, less an agreed discount, for each patient delivered to TCH. The agreement could be cancelled by the attorney general with or without cause.

The attorney general eventually cancelled the agreement at the request of TCH. The attorney general noted that it was possible for competition in the ambulance business to take place in Tallahassee, and that no agreement of the type originally entered was needed; therefore, the attorney general recommended adoption of a county ordinance under which such competition could take place. TMRMC challenged the cancellation of the agreement and was unsuccessful. Tallahassee Memorial Regional Medical Center, Inc. v. Butterworth, 557 So.2d 38 (Fla. 1st DCA 1989) (per curiam affirmance).

At the suggestion of the attorney general, TCH proposed that Leon County adopt an ordinance setting forth standards for certificates of public convenience and necessity to regulate the provision of ambulance service, as authorized by state law governing ambulance providers. The Leon County Commission appointed a committee and developed a draft ordinance that did not include any provision for payment by TCH for ambulance service.

TMRMC prepared a provision for insertion in the ordinance (section 18) requiring each hospital to pay the ambulance service for services rendered to patients delivered to or picked up from that hospital. TCH objected to the payment provision of the proposed ordinance, asserting that it would be invalid; however, the commission adopted the proposed ordinance as amended, Leon County Ordinance 90-22.

Section 18 of the Leon County ordinance states in pertinent part as follows:

Section 18. Financial responsibility of hospitals. As long as the County's Advanced Life Support Certificate Holder is a private not-for-profit corporation and as long as its Ambulance Service is operated at a loss on an annual basis, then each hospital in the County will assist in maintaining the financial integrity of the Ambulance Service by ensuring payment for services rendered to patients brought to each respective hospital. By accepting the services provided by the Ambulance Service, each hospital agrees to pay the Ambulance Service for patients brought to it. Each hospital will also pay the Ambulance Service for services rendered in taking patients to and from its facility to receive special service elsewhere or to be transferred to another facility or location. As long as the Ambulance Service operates at an annual loss, each hospital will pay the Ambulance Service its designated rates. Each hospital is expected to seek reimbursement from the patients brought to it. Payments made by hospitals to the ambulance service will be due within (30) days of billing by the ambulance service.

Section 13 of Leon County Ordinance No. 90-22 provides in pertinent part as follows:

Section 13. Civil remedies.
The board or an aggrieved person may have recourse to such remedies in law and in equity as may be necessary to ensure compliance with the provisions of this ordinance, including injunctive relief to enjoin and restrain any person from violating its provisions.

In a four-count complaint, TMRMC complained that TCH had been billed in excess of $400,000 pursuant to the terms of the ordinance and that no payments whatsoever had been made. TMRMC's complaint sought recovery from TCH in four counts: Count I sought recovery under section 18 of the ambulance ordinance; count II sought recovery under an alleged implied contract between TMRMC and TCH (TMRMC asserted that the triage agreement addressing which patients should be delivered to which hospital was impliedly an agreement for payment); count III sought recovery in quantum meruit; count IV sought recovery under the theory of unjust enrichment.

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Cite This Page — Counsel Stack

Bluebook (online)
681 So. 2d 826, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tallahassee-mem-v-tallahassee-med-ctr-fladistctapp-1996.