هيثم الفقى
04-10-2009, 03:23 AM
Supreme Court of Florida
_____________
No. SC07-2423
_____________
JODI BENJAMIN, etc.,
Petitioner,
vs.
TANDEM HEALTHCARE, INC., etc.,
Respondent.
[December 23, 2008]
WELLS, J.
In this case, we consider a certified question inquiring whether article X, section 25 of the Florida Constitution, titled "Patients' Right to Know About Adverse Medical Incidents" and also known as Amendment 7, encompasses nursing homes. In Tandem Healthcare, Inc. v. Benjamin, 969 So. 2d 519 (Fla. 4th DCA 2007), the Fourth District Court of Appeal certified this question to be of great public importance:
WHETHER "NURSING HOMES" OR "SKILLED NURSING FACILITIES" FALL WITHIN THE DEFINITION OF "HEALTH CARE FACILITY" OR "HEALTH CARE PROVIDER" AS
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CONTEMPLATED BY AMENDMENT 7 TO THE FLORIDA CONSTITUTION?
Id. at 521-22. We have jurisdiction. See art. V, § 3(b)(4), Fla. Const. We approve the decision of the Fourth District and answer the certified question in the negative, finding that nursing homes do not fall within the definition of "health care facility" or "health care provider" in article X, section 25.
The Fourth District described the unfortunate facts underlying this case:
Jodi Benjamin, as personal representative of the estate of Marlene Gagnon, sued Tandem [Healthcare, Inc., a nursing home,] for negligence resulting in the death of Gagnon, a patient at the home. Gagnon suffered cardiac failure and brain damage when food became lodged in her airway [due to Tandem's alleged failure to serve her food in compliance with her treatment plan]. Benjamin requested that Tandem produce "all reports or records of any `Adverse Medical Incident'" involving Gagnon, as provided by Article X, section 25, of the Florida Constitution. [Benjamin] also requested peer review documents and quality assurance records.
Tandem Healthcare, 969 So. 2d at 520. The trial court granted Benjamin's discovery request, and Tandem Healthcare appealed to the Fourth District. The Fourth District noted that the requested materials would normally be privileged as peer review and quality assurance records under Florida law. Id. Benjamin argued, however, that those peer review and quality assurance privileges had been abrogated when Florida's voters approved article X, section 25 of the Florida Constitution.
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Article X, section 25 of the Florida Constitution was adopted in 2004.1 This provision, also referred to as Amendment 7 because of its numbering seventh on
1. The provision states in full:
Section 25. Patients' right to know about adverse medical
incidents.--
(a) In addition to any other similar rights provided herein or by general law, patients have a right to have access to any records made or received in the course of business by a health care facility or provider relating to any adverse medical incident.
(b) In providing such access, the identity of patients involved in the incidents shall not be disclosed, and any privacy restrictions imposed by federal law shall be maintained.
(c) For purposes of this section, the following terms have the following meanings:
(1) The phrases "health care facility" and "health care provider" have the meaning given in general law related to a patient's rights and responsibilities.
(2) The term "patient" means an individual who has sought, is seeking, is undergoing, or has undergone care or treatment in a health care facility or by a health care provider.
(3) The phrase "adverse medical incident" means medical negligence, intentional misconduct, and any other act, neglect, or default of a health care facility or health care provider that caused or could have caused injury to or death of a patient, including, but not limited to, those incidents that are required by state or federal law to be reported to any governmental agency or body, and incidents that are reported to or reviewed by any health care facility peer review, risk management, quality assurance, credentials, or similar committee, or any representative of any such committees.
(4) The phrase "have access to any records" means, in addition to any other procedure for producing such records provided by general law, making the records available for inspection and copying upon formal or informal request by the patient or a representative of the patient, provided that current records which have been made publicly available by publication or on the Internet may be "provided" by reference to the location at which the records are publicly available.
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the November 2004 ballot, gave patients "a right to have access to any records made or received in the course of business by a health care facility or provider relating to any adverse medical incident." Art. X, § 25(a), Fla. Const. It defines "health care facility" and "health care provider" as "hav[ing] the meaning given in general law related to a patient's rights and responsibilities." Id. § 25(c)(1).
Petitioner contends that nursing homes fall under this definition.
The Fourth District concluded that article X, section 25, does not encompass nursing homes because section 25(c)(1) of that provision defines the terms as having the meaning given in "general law related to a patient's rights and responsibilities." Tandem Healthcare, 969 So. 2d at 522. The Fourth District read the term "patient's rights and responsibilities" as a specific reference to section
381.026, Florida Statutes, titled "Florida Patient's Bill of Rights and Responsibilities." In reaching this conclusion, the Fourth District agreed with and relied upon the First District's opinion in Avante Villa at Jacksonville Beach, Inc.
v. Breidert, 958 So. 2d 1031 (Fla. 1st DCA 2007), stating:
The petitioner in Avante Villa was a nursing home, and the order on review, as in this case, compelled discovery of documents which the nursing home claimed were privileged. The [First D]istrict . . . concluded that the nursing home was not subject to the amendment. Id. at 1032.
The district court focused on the following language of Article X, section 25: "The phrases `health care facility' and `health care
Art. X, § 25, Fla. Const.
- 4 -
provider' have the meaning given in general law related to a patient's rights and responsibilities." Art. X, § 25(c)(1), Fla. Const. (emphasis added). It noted that while there are provisions of general law that include nursing homes within the meaning of "health care facility" or "health care provider," only one statute deals with "a patient's rights and responsibilities," and that statute was section 381.026, enacted in
1991. That was the only statute using that language at the time Amendment 7 was adopted. The court, therefore, concluded that "the specific language in Amendment 7 requiring that the definition be `related to a patient's rights and responsibilities' can be reasonably interpreted as adopting the definitions used in the Florida Patient's Bill of Rights and Responsibilities." Id. at 1033.
Tandem Healthcare, 969 So. 2d at 521. Accordingly, the Fourth District concluded that nursing homes were not encompassed by article X, section 25.2
ANALYSIS
2. Neither the parties nor amici have argued in this case that nursing homes fall under the definitions of section 381.026. Section 381.026 states:
(b) "Health care facility" means a facility licensed under chapter 395.
(c) "Health care provider" means a physician licensed under chapter 458, an osteopathic physician licensed under chapter 459, or a podiatric physician licensed under chapter 461.
§§ 381.026(2)(b)-(c), Fla. Stat. (2004). Chapter 395 addresses licensing of hospitals, ambulatory surgical centers, and mobile surgical facilities. See, e.g., §
395.022, Fla. Stat. (2004) (defining terms under chapter 395); § 395.001, Fla. Stat. (2004) (describing the intent of the Legislature in chapter 395). Chapters 458, 459, and 461 address licensing of physicians, osteopathic physicians, and podiatric physicians, respectively. See, e.g., § 458.301, Fla. Stat. (2004) (stating Legislative intent as to chapter 458); § 458.305, Fla. Stat. (2004) (defining terms); § 459.001, Fla. Stat. (2004) (stating Legislative intent as to chapter 459); § 459.003, Fla. Stat. (2004) (defining terms); § 461.001, Fla. Stat. (2004) (stating Legislative intent as to chapter 461); § 461.003, Fla. Stat. (2004) (defining terms).
_____________
No. SC07-2423
_____________
JODI BENJAMIN, etc.,
Petitioner,
vs.
TANDEM HEALTHCARE, INC., etc.,
Respondent.
[December 23, 2008]
WELLS, J.
In this case, we consider a certified question inquiring whether article X, section 25 of the Florida Constitution, titled "Patients' Right to Know About Adverse Medical Incidents" and also known as Amendment 7, encompasses nursing homes. In Tandem Healthcare, Inc. v. Benjamin, 969 So. 2d 519 (Fla. 4th DCA 2007), the Fourth District Court of Appeal certified this question to be of great public importance:
WHETHER "NURSING HOMES" OR "SKILLED NURSING FACILITIES" FALL WITHIN THE DEFINITION OF "HEALTH CARE FACILITY" OR "HEALTH CARE PROVIDER" AS
- 1 -
CONTEMPLATED BY AMENDMENT 7 TO THE FLORIDA CONSTITUTION?
Id. at 521-22. We have jurisdiction. See art. V, § 3(b)(4), Fla. Const. We approve the decision of the Fourth District and answer the certified question in the negative, finding that nursing homes do not fall within the definition of "health care facility" or "health care provider" in article X, section 25.
The Fourth District described the unfortunate facts underlying this case:
Jodi Benjamin, as personal representative of the estate of Marlene Gagnon, sued Tandem [Healthcare, Inc., a nursing home,] for negligence resulting in the death of Gagnon, a patient at the home. Gagnon suffered cardiac failure and brain damage when food became lodged in her airway [due to Tandem's alleged failure to serve her food in compliance with her treatment plan]. Benjamin requested that Tandem produce "all reports or records of any `Adverse Medical Incident'" involving Gagnon, as provided by Article X, section 25, of the Florida Constitution. [Benjamin] also requested peer review documents and quality assurance records.
Tandem Healthcare, 969 So. 2d at 520. The trial court granted Benjamin's discovery request, and Tandem Healthcare appealed to the Fourth District. The Fourth District noted that the requested materials would normally be privileged as peer review and quality assurance records under Florida law. Id. Benjamin argued, however, that those peer review and quality assurance privileges had been abrogated when Florida's voters approved article X, section 25 of the Florida Constitution.
- 2 -
Article X, section 25 of the Florida Constitution was adopted in 2004.1 This provision, also referred to as Amendment 7 because of its numbering seventh on
1. The provision states in full:
Section 25. Patients' right to know about adverse medical
incidents.--
(a) In addition to any other similar rights provided herein or by general law, patients have a right to have access to any records made or received in the course of business by a health care facility or provider relating to any adverse medical incident.
(b) In providing such access, the identity of patients involved in the incidents shall not be disclosed, and any privacy restrictions imposed by federal law shall be maintained.
(c) For purposes of this section, the following terms have the following meanings:
(1) The phrases "health care facility" and "health care provider" have the meaning given in general law related to a patient's rights and responsibilities.
(2) The term "patient" means an individual who has sought, is seeking, is undergoing, or has undergone care or treatment in a health care facility or by a health care provider.
(3) The phrase "adverse medical incident" means medical negligence, intentional misconduct, and any other act, neglect, or default of a health care facility or health care provider that caused or could have caused injury to or death of a patient, including, but not limited to, those incidents that are required by state or federal law to be reported to any governmental agency or body, and incidents that are reported to or reviewed by any health care facility peer review, risk management, quality assurance, credentials, or similar committee, or any representative of any such committees.
(4) The phrase "have access to any records" means, in addition to any other procedure for producing such records provided by general law, making the records available for inspection and copying upon formal or informal request by the patient or a representative of the patient, provided that current records which have been made publicly available by publication or on the Internet may be "provided" by reference to the location at which the records are publicly available.
- 3 -
the November 2004 ballot, gave patients "a right to have access to any records made or received in the course of business by a health care facility or provider relating to any adverse medical incident." Art. X, § 25(a), Fla. Const. It defines "health care facility" and "health care provider" as "hav[ing] the meaning given in general law related to a patient's rights and responsibilities." Id. § 25(c)(1).
Petitioner contends that nursing homes fall under this definition.
The Fourth District concluded that article X, section 25, does not encompass nursing homes because section 25(c)(1) of that provision defines the terms as having the meaning given in "general law related to a patient's rights and responsibilities." Tandem Healthcare, 969 So. 2d at 522. The Fourth District read the term "patient's rights and responsibilities" as a specific reference to section
381.026, Florida Statutes, titled "Florida Patient's Bill of Rights and Responsibilities." In reaching this conclusion, the Fourth District agreed with and relied upon the First District's opinion in Avante Villa at Jacksonville Beach, Inc.
v. Breidert, 958 So. 2d 1031 (Fla. 1st DCA 2007), stating:
The petitioner in Avante Villa was a nursing home, and the order on review, as in this case, compelled discovery of documents which the nursing home claimed were privileged. The [First D]istrict . . . concluded that the nursing home was not subject to the amendment. Id. at 1032.
The district court focused on the following language of Article X, section 25: "The phrases `health care facility' and `health care
Art. X, § 25, Fla. Const.
- 4 -
provider' have the meaning given in general law related to a patient's rights and responsibilities." Art. X, § 25(c)(1), Fla. Const. (emphasis added). It noted that while there are provisions of general law that include nursing homes within the meaning of "health care facility" or "health care provider," only one statute deals with "a patient's rights and responsibilities," and that statute was section 381.026, enacted in
1991. That was the only statute using that language at the time Amendment 7 was adopted. The court, therefore, concluded that "the specific language in Amendment 7 requiring that the definition be `related to a patient's rights and responsibilities' can be reasonably interpreted as adopting the definitions used in the Florida Patient's Bill of Rights and Responsibilities." Id. at 1033.
Tandem Healthcare, 969 So. 2d at 521. Accordingly, the Fourth District concluded that nursing homes were not encompassed by article X, section 25.2
ANALYSIS
2. Neither the parties nor amici have argued in this case that nursing homes fall under the definitions of section 381.026. Section 381.026 states:
(b) "Health care facility" means a facility licensed under chapter 395.
(c) "Health care provider" means a physician licensed under chapter 458, an osteopathic physician licensed under chapter 459, or a podiatric physician licensed under chapter 461.
§§ 381.026(2)(b)-(c), Fla. Stat. (2004). Chapter 395 addresses licensing of hospitals, ambulatory surgical centers, and mobile surgical facilities. See, e.g., §
395.022, Fla. Stat. (2004) (defining terms under chapter 395); § 395.001, Fla. Stat. (2004) (describing the intent of the Legislature in chapter 395). Chapters 458, 459, and 461 address licensing of physicians, osteopathic physicians, and podiatric physicians, respectively. See, e.g., § 458.301, Fla. Stat. (2004) (stating Legislative intent as to chapter 458); § 458.305, Fla. Stat. (2004) (defining terms); § 459.001, Fla. Stat. (2004) (stating Legislative intent as to chapter 459); § 459.003, Fla. Stat. (2004) (defining terms); § 461.001, Fla. Stat. (2004) (stating Legislative intent as to chapter 461); § 461.003, Fla. Stat. (2004) (defining terms).