Methodist Homes for the Aging v. Stewart
Methodist Homes for the Aging v. Stewart
Opinion
This is an appeal involving competing applications for a Certificate of Need (CON) to operate additional hospital beds in Lee County. The issuance of a CON is a prerequisite to the offering or operation of any new institutional health service in this state by any individual or entity. §
In July 1989 Methodist Homes for the Aging (Methodist) filed an application with SHPA, seeking approval for the operation of 20 new skilled nursing facility (SNF) beds in the Wesley Terrace nursing home in Lee County. In August 1989 East Alabama Health Care Authority (East Alabama) filed a separate application, seeking approval for the operation of 20 new SNF *Page 163 beds in the East Alabama Medical Center in Lee County. Because the two applicants were considered to be competing for all SNF beds then available in Lee County under the State Health Plan, their applications were subjected to "comparative review."
Both applications were considered at a public hearing held before SHPA's quasi-judicial CON Review Board (Board) on October 10, 1989. On that same date the Board denied Methodist's application and approved East Alabama's application. Methodist then filed a Request for Reconsideration of both the denial of its application and the approval of East Alabama's application. Finding no showing of "good cause," the Board denied the Request for Reconsideration on December 12, 1989. At that point Methodist orally requested that SHPA provide an administrative Fair Hearing, as allowed under §
The cases were consolidated and heard in the Lee County Circuit Court in November 1990. On January 4, 1991, the circuit court entered an order affirming the Board's denial of Methodist's CON application and approval of East Alabama's application. Pursuant to Rule 59, Alabama Rules of Civil Procedure, Methodist then filed a postjudgment motion, wherein it asked for, inter alia, a declaration from the circuit court ordering SHPA to provide a Fair Hearing with respect to the CON applications of both parties. Methodist based its motion on this court's per curiam opinion in the case of Auburn MedicalCenter, Inc. v. East Alabama Health Care Authority,
Methodist now appeals to this court, contending that the circuit court erred in refusing to declare that SHPA was required to provide a comparative Fair Hearing with respect to the applications of both Methodist and East Alabama. We reverse and remand.
This court has held in prior cases, Auburn Medical Center,
A review of the administrative record in this case reveals that in 1989 Methodist and East Alabama were competing, through their respective CON applications, for the same finite, numerically limited health care resources: 20 SNF beds that were needed in Lee County according to the State Health Plan then in effect. Therefore, the Board's approval of East Alabama's application by necessity resulted in the denial of Methodist's application. In adopting the position that the Fair Hearing process was available only with respect to Methodist's *Page 164
denied application, SHPA, which filed an appellee's brief in this appeal, relied on language in §
SHPA's CON Review Board considered the CON applications of Methodist and East Alabama together in a consolidated hearing that was held on October 10, 1989. The record of the proceedings clearly states that the two applications were "competing," and the Board indicated by its actions that the applications were treated as competing. East Alabama, which also filed an appellee's brief in this appeal, has argued that its application proposes the operation of a hospital based SNF, as opposed to the nursing home based facility proposed by Methodist, and that the services provided by a hospital based SNF cannot be considered as an alternative to those proposed by Methodist. However, the State Health Plan does not differentiate between hospital based SNFs and those located in nursing homes. It also remains undisputed that the two applications were, in fact, competing for the same 20 SNF beds.
This court has previously recognized the special circumstances created where two CON applicants are competing for the same limited resources and where the grant of one application effectively precludes the other. See, e.g., AuburnMedical Center,
East Alabama asserts that even if Methodist were entitled to a comparative Fair Hearing with respect to both applications, Methodist never filed a proper request with SHPA. East Alabama points to the language in §
The record on appeal contains the affidavit of Charlie Stewart, SHPA's acting executive director on December 12, 1989, the date on which Methodist's Request for Reconsideration was denied by the Board. In his affidavit, which was filed simultaneously with an affidavit from Methodist's counsel, Stewart attests to a telephone conversation with Methodist's counsel wherein Methodist's counsel requested that SHPA provide a Fair Hearing on the merits of the two applications; Stewart, however, informed Methodist's counsel that it was SHPA's position that a Fair Hearing could be held only with respect to Methodist's denied application, but would have no effect upon East Alabama's approved application. Relying on Stewart's representation, Methodist concluded that a hearing on the merits of its application alone would be futile and therefore sought review of the respective applications in the circuit courts.
As support for its argument that Methodist's request for a Fair Hearing should not be entertained, East Alabama points to this court's holding in Auburn *Page 165 Medical Center,
Although neither the SHPA regulation providing for a Fair Hearing nor the statutory authority for this regulation contains an explicit requirement that an applicant's request for a Fair Hearing be in writing, we recognize that the system of review in CON cases operates according to specific, defined time guidelines. See §
Nevertheless, under the facts in the instant case, it would be manifestly unfair to permit SHPA to rely on its own misrepresentation to Methodist in order to deny Methodist an opportunity to exhaust its administrative remedies. Methodist's actions under the circumstances in this case were justifiable. It could not reasonably be expected to file a written request for a Fair Hearing once it was informed by SHPA that a comparative Fair Hearing was not available and that any hearing would have no effect upon the approval of East Alabama's CON application. To hold that Methodist is now disqualified from receiving the Fair Hearing it had originally requested would obviously work a serious injustice. See Ex parte StateDepartment of Human Resources,
East Alabama has also argued that Methodist lacks standing to seek further review of the merits of East Alabama's application due to its failure to formally intervene in the proceedings on East Alabama's application. East Alabama maintains that agency regulations required Methodist to intervene in its case prior to filing a Request for Reconsideration of both applications. If East Alabama's argument is accepted, and Methodist's Request for Reconsideration was invalid insofar as it relates to East Alabama's application, all subsequent review of East Alabama's application would be flawed, and Methodist's appeals relating to the application would be rendered untimely.
Section
In view of the above, we hold that the circuit court erred by refusing to declare that SHPA was required to provide a comparative Fair Hearing with respect to the *Page 166 CON applications of both Methodist and East Alabama. Accordingly, we reverse the judgment of the circuit court and remand the cause with instructions that the court enter an order consistent with this opinion.
REVERSED AND REMANDED WITH INSTRUCTIONS.
ROBERTSON, P.J., and THIGPEN, J., concur.
Reference
- Full Case Name
- Methodist Homes for the Aging Corp. D/B/A Wesley Terrace v. Charlie Stewart
- Cited By
- 9 cases
- Status
- Published