Appeal of Clipper Home

579 A.2d 808, 133 N.H. 593, 1990 N.H. LEXIS 102
CourtSupreme Court of New Hampshire
DecidedAugust 29, 1990
DocketNo. 89-383
StatusPublished
Cited by1 cases

This text of 579 A.2d 808 (Appeal of Clipper Home) is published on Counsel Stack Legal Research, covering Supreme Court of New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Appeal of Clipper Home, 579 A.2d 808, 133 N.H. 593, 1990 N.H. LEXIS 102 (N.H. 1990).

Opinion

Batchelder, J.

This is an appeal by the petitioner, Clipper Home of North Conway (Clipper Home), from the State Health Services Planning and Review Board’s (board) decision of August 4, 1989, denying relief sought by Clipper Home from conditions imposed by the board in a certificate of need (CON) issued in 1986 to Clipper Home, authorizing construction of a 72-bed health care facility in North Conway. Clipper Home asserts, and we agree, that the following three questions are before us:

1. Whether the board’s decision was unreasonable or illegal in failing to find that the 1987 Medicaid regulations of the New Hampshire Department of Human Services, Bureau of Provider Audits, were legally controlling over the board’s certificate of need (CON) order of June 2,1986, wherein the board sought to establish Medicaid rates for petitioner for a five-year period.
[595]*5952. Whether the board’s decision was unreasonable in refusing to amend the conditions contained in the June 2, 1986 CON, increasing the amount of the Medicaid rates contained therein to account for unforeseen and uncontrollable costs incurred after the issuance of the CON.
3. Whether the board’s decision was illegal or unreasonable by virtue of the board’s refusal to find that the 15%-plus-inflation rule of RSA 151-C:12, IV-a was applicable to operating costs controlled by RSA 151-C:12, V rather than to just capital costs.

For the reasons which follow, we answer the foregoing questions in the negative and affirm the decision of the board.

Clipper Home (then referred to as Gilmore-Holloway) was one of three applicants before the board in 1982 seeking a CON that would enable it to build a health care facility in North Conway. Clipper Home was unsuccessful in that proceeding, and the board rejected its motion for reconsideration as well. An appeal to this court was pursued, and on August 5, 1985, in Appeal of Lemire-Courville Associates, 127 N.H. 21, 499 A.2d 1328 (1985), we vacated and remanded the board’s decision. After subsequent review by the board, the CON originally awarded to Country Village Health Care, Inc., another competing applicant, was vacated and a CON with certain conditions was issued to Clipper Home.

The CON awarded to Clipper Home on June 2,1986, included these conditions: 1) Medicaid patients shall, for the first five years, comprise the total number of patients in the facility; 2) Medicaid reimbursements, adjusted for inflation, shall not exceed the following amounts in each of the corresponding years:

1987 $52.35
1988 $54.97
1989 $54.52
1990 $54.03
1991 $56.73

Notwithstanding the petitioner’s arguments to the contrary, we recognize that the board has ample authority to impose conditions on any CON which it issues. RSA 151-C:9 (Supp. 1989) provides in part that “the decision shall be in the form of an approval, denial, or an approval with conditions . . .” (emphasis added). It is important to note at the outset that Clipper Home did not take an appeal in a timely fashion from the board’s issuance of the CON containing the above conditions from which relief is now sought, but rather mounted a collateral attack seeking relief from the conditions rather than challenging the lawfulness of their insertion in the first place.

[596]*596Since there was no appeal taken from the board’s insertion of the conditions in its CON relating to projected operating costs, the board and the petitioner found themselves in 1989 looking upon the 1986 CON language with hindsight vision. Clipper Home makes much of two post-1986 factors: (1) a substantial diminution of the labor market in the North Conway area, resulting in significantly higher wage rates than were contemplated in Clipper Home’s application; and (2) an amendment to the State’s Medicaid regulations by the division of human services, bureau of provider audits, which authorized the bureau as the appropriate department of State government to set Medicaid rates. The amendment also identified the role of the CON in the rate-setting process for new nursing homes by providing that CON-approved capital costs would control the fixed operating cost component of the rate, while the average cost of comparable facilities would control the variable operating costs component of the rate.

On this issue, Clipper Home takes some comfort from the contents of a letter to it, dated January 9,1989, from the legal counsel to the department of health and human services, stating in part:

“I can verify that I advised my client and the Attorney General that in my opinion the Division has no authority to set a rate established by the CON Board, and must establish and pay the rate according to our federally-approved state program of reimbursement. Thus, with respect to the above facility, the Division will establish a rate according to its rules and not as established by the CON Board.”

Because the Medicaid rates authorized by the bureau of provider audit are higher than the projections resulting in the CON conditions applicable to Clipper Home, this litigation arose.

In reviewing the board’s action, we are guided by RSA 151-C:10, III (Supp. 1989), which provides:

“Appeals to the Supreme Court.
I. Any person submitting an application for a certificate of need, if aggrieved or dissatisfied with the decision of the board, shall have the right, upon a petition which provides a detailed statement of the grounds upon which the decision of the board is claimed to be erroneous and contrary to the facts and the law, to appeal from the decision to the supreme court pursuant to RSA 541.
II. The provisions of RSA 541 shall govern all appeals under this section.
[597]*597III. The court shall affirm the decision of the board unless it finds it to be arbitrary or capricious or not made in compliance with applicable law.”

Clipper Home bears the burden of convincing this court that the board’s decision of April 8, 1989, denying relief was arbitrary, capricious or not made in compliance with applicable law. RSA 151-C:10 (Supp. 1989). Because a review of the record reveals that this burden has not been met, we might end the matter here. However, a brief summary of the deficiencies in the record which lead us to conclude as we do may be helpful to the board and other applicants in the future. A proper starting point for our discussion is the language of the certificate itself.

“A CERTIFICATE OF NEED
The Certificate of Need Review Board, acting as the State Agency, in accordance with RSA 151-C, in conformity with the Public Health Service Act, as amended, relative to Certificate of Need and review of new institutional health services, hereby issues this Certificate of Need.
DATE OF ISSUE: June 2, 1986
APPLICANT: William Gilmore, Douglas Stockbridge and Paul Holloway d/b/a THE CLIPPER HOME OF NORTH CONWAY[,] North Conway, New Hampshire

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Bluebook (online)
579 A.2d 808, 133 N.H. 593, 1990 N.H. LEXIS 102, Counsel Stack Legal Research, https://law.counselstack.com/opinion/appeal-of-clipper-home-nh-1990.