A SAMUEL'S CHRISTIAN HOME CARE v. CENTER FOR MEDICARE AND MEDICAID SERVICES

CourtDistrict Court, W.D. Pennsylvania
DecidedMarch 29, 2024
Docket2:21-cv-01143
StatusUnknown

This text of A SAMUEL'S CHRISTIAN HOME CARE v. CENTER FOR MEDICARE AND MEDICAID SERVICES (A SAMUEL'S CHRISTIAN HOME CARE v. CENTER FOR MEDICARE AND MEDICAID SERVICES) is published on Counsel Stack Legal Research, covering District Court, W.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
A SAMUEL'S CHRISTIAN HOME CARE v. CENTER FOR MEDICARE AND MEDICAID SERVICES, (W.D. Pa. 2024).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA

A SAMUEL’S CHRISTIAN ) HOME CARE, ) ) Plaintiff, ) ) v. ) Civil Action No. 21-cv-1143 ) CENTER FOR MEDICARE AND ) MEDICAID SERVICES, MICHELE CLINTON, ) LAUREN REINERTSEN, WARREN ALBERT, ) LINN DAWN, and LINDA CHAMBERLAIN, ) ) Defendants. )

MEMORANDUM ORDER Presently before the Court are Defendants’ respective motions to dismiss Plaintiff’s Complaint. (Docket Nos. 7 (Commonwealth Defendants’ Motion), 12 (Federal Defendants’ Motion)). The Court has considered these motions and supporting briefs (Docket Nos. 8, 13, 18, 21), along with Plaintiff’s Opposition thereto. (Docket Nos. 17, 20). For the reasons explained herein, Defendants’ motions shall be granted, and the claims in Plaintiff’s Complaint shall be dismissed without prejudice. Plaintiff, A. Samuel’s Christian Home Care (“Plaintiff” or “ASCHC”),1 participated in the Medicare program as a home health agency (“HHA”) subject to state and federal regulation. (Docket No. 13-1, pg. 7). ASCHC initiated the present action on or about August 30, 2021, by filing a form Non-Prisoner Pro Se “Complaint for Violation of Civil Rights” that Plaintiff entitled

1 In the Complaint, Ebenezer Singha is described as a pro se plaintiff doing business as ASCHC. (Docket No. 1, pg. 9). On March 13, 2024, this Court entered an order acknowledging the apparent death of Ebenezer Singha. (Docket No. 28). At that time, the Court ordered that Defendants and any successor in interest or representative of Ebenezer Singha provide the Court with a Status Report within fourteen days. (Id.). Defendants complied with the Court’s Order. (Docket Nos. 29, 30). But the Court has yet to receive a Plaintiff’s-side status report. “Petition for Judicial Review of the Departmental Appeals Boards Decision.” (Docket No. 1). Therein, Plaintiff attempts to assert several putative claims pertaining to its regulation by Centers for Medicare and Medicaid Services (“CMS”) and the Pennsylvania Department of Health (“PA DOH”).2 In essence, Plaintiff contends that CMS and certain federal and state employees violated

its “constitutional,” “civil,” and “accommodation” rights, including its “due process” right to an evidentiary hearing, and otherwise acted improperly, when they surveyed Plaintiff’s operations in 2017 and found numerous “deficiencies”; recommended termination of Plaintiff’s Medicare participation agreement based on those “deficiencies”; and sought to uphold that recommendation during subsequent administrative proceedings. (Docket No. 1). Plaintiff seeks millions of dollars in damages for a variety of alleged physical, emotional, and reputational injuries, as well as reversal of the July 1, 2021, administrative decision3 that upheld CMS’s termination of ASCHC’s Medicare participation agreement. (Id. at pgs. 6, 20-21). These claims appear to be derived from regulatory surveys conducted by PA DOH in August and September 2017 which resulted in the issuance of a notice of deficiencies (dated

October 17, 2017) wherein CMS informed ASCHC that it was out of compliance with Medicare Conditions of Participation and its Medicare agreement would be terminated effective November 14, 2017. (Docket No. 13-1, pg. 9). CMS later reopened and revised its determination to add to its determination that ASCHC no longer met the statutory definition of a Medicare HHA. (Id. at pg.

2 CMS is a defendant here. Lauren Reinertsen and Michele Clinton, with CMS, are collectively the “Federal Defendants.” (Docket No. 13). Defendants Warren Albert, Linn Dawn, and Linda Chamberlain are PA DOH employees who are collectively referred to as the “Commonwealth Defendants.” (Docket No. 8).

3 This decision and the underlying administrative record are found at Docket Nos. 13-1 through 13- 4. These materials are properly considered by the Court. Wiggs v. Foley, No. 5:20-CV-02267, 2021 WL 3164373, at *2 (E.D. Pa. July 27, 2021) (explaining courts may consider exhibits attached to a complaint “as well as undisputedly authentic documents if the complainant’s claims are based upon these documents.” (quoting Mayer v. Belichick, 605 F.3d 223, 230 (3d Cir. 2010))). 10). ASCHC sought an administrative hearing before an Administrative Law Judge (ALJ), and before the ALJ CMS moved for summary judgment and argued there was no genuine dispute of material fact that ASCHC “was not primarily engaged in providing skilled nursing services and other therapeutic services and therefore … failed substantially to meet a part of the legal definition

of a Medicare ‘home health agency.’” (Id.). The ALJ agreed that ASCHC could not be considered an HHA. (Id. at pg. 12). The Department of Health and Human Services Departmental Appeals Board, Appellate Division, ultimately affirmed the ALJ’s determination and rejected certain arguments raised by ASCHC (e.g., denial of due process before the ALJ and allegations of CMS wrongdoing and ALJ bias). (Id. at pgs. 11-26). After receiving that administrative decision, ASCHC sought further review of it and asserted various claims against the Federal and Commonwealth Defendants in this Court. The Defendants now move to dismiss. In support of their Motion to Dismiss, the Commonwealth Defendants argue that to the extent they have been sued in their official capacities as Commonwealth employees, they are immune from suit pursuant to the Eleventh Amendment of

the U.S. Constitution. To the extent that ASCHC appears to have sued Commonwealth Defendant Dawn in both an individual and official capacity (see Docket No. 1), the Commonwealth has argued that ASCHC has failed to allege any personal involvement by Dawn in events that took place within the two years preceding filing of the Complaint in this matter; therefore, any claim against Dawn (or the other Commonwealth Defendants in their individual capacities) would be barred by the applicable statute of limitations on claims asserted pursuant to 42 U.S.C. § 1983. In support of their Motion to Dismiss, the Federal Defendants argue that to the extent Plaintiff seeks to pursue a Bivens4 claim, it cannot do so as a corporate entity, nor may the Federal Defendants be

4 Bivens v. Six Unknown Named Agents of Fed. Bureau of Narcotics, 403 U.S. 388 (1971). subject to a Bivens claim in their official capacities. To the extent that ASCHC seeks review of the administrative decision upholding CMS’s termination of ASCHC’s Medicare provider agreement, the Federal Defendants argue that decision is legally correct and supported by substantial evidence. The Court has considered the Defendants’ arguments for dismissal of the Complaint and

ASCHC’s responses thereto, and makes the following determinations. The Court will dismiss ASCHC’s claims against the Commonwealth Defendants in their official capacities pursuant to Fed. R. Civ. P. 12(b)(1) because such claims are indistinguishable from claims against the Commonwealth itself, and the “Constitution does not provide for federal jurisdiction over suits against nonconsenting States.” Diamond v. Pennsylvania State Educ. Ass’n, 399 F. Supp. 3d 361, 378 (W.D. Pa. 2019), aff’d, 972 F.3d 262 (3d Cir. 2020) (quoting Kimel v. Fla. Bd. of Regents, 528 U.S. 62, 73 (2000)). Further, no exceptions to immunity are applicable in this case. See id. (discussing exceptions to Eleventh Amendment sovereign immunity).

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Bluebook (online)
A SAMUEL'S CHRISTIAN HOME CARE v. CENTER FOR MEDICARE AND MEDICAID SERVICES, Counsel Stack Legal Research, https://law.counselstack.com/opinion/a-samuels-christian-home-care-v-center-for-medicare-and-medicaid-services-pawd-2024.