TALLAHASSEE (CBSMiami/NSF) – An administrative law judge has ruled that the Florida Department of Health improperly allowed a Miami-Dade hospital operate an upgraded trauma center amid a legal challenge from competing hospitals.

But in her 15-page decision, Administrative Law Judge Cathy Sellers said she does not have the legal authority to require the department to reverse a decision that allowed Kendall Regional Medical Center to begin operating what is known as a “provisional Level 1” trauma center.

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Sellers wrote that Nicklaus Children’s Hospital, which challenged the department’s go-ahead for Kendall Regional, could take the issue to circuit court.

Florida’s trauma system, which has been the subject of years of legal battles in the hospital industry, includes Level 1, Level 2 and pediatric trauma centers.

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Level 1 facilities are required by law to meet pediatric-trauma center standards and also have formal research and education programs.

The Department of Health this year gave “provisional” approval for Kendall Regional to upgrade from a Level 2 to a Level 1 trauma facility, but the decision quickly drew administrative legal challenges from Nicklaus Children’s Hospital and the Public Health Trust of Miami-Dade County, which includes the Jackson hospital system. The department allowed Kendall to begin operating as a Level 1 trauma center while the challenges are pending, spurring Nicklaus Children’s Hospital to seek a ruling by Sellers.

“In sum, DOH (the Department of Health) is not authorized to permit Kendall to operate as a provisional Level I trauma center while this proceeding is pending, and DOH should require Kendall to cease such operation until this administrative proceeding has concluded,” Sellers wrote. ‘Further, this administrative proceeding does not provide an available, adequate administrative remedy to NCH (Nicklaus Children’s Hospital) for the ongoing economic harm NCH claims it will suffer as a result of DOH allowing Kendall to operate. Accordingly, if DOH allows Kendall to operate as a provisional Level I trauma center while this proceeding is pending, NCH should not be required to exhaust administrative remedies before seeking recourse in the appropriate judicial forum.”

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The News Service of Florida contributed to this report.