Canonsburg General Hospital v. Commonwealth

413 A.2d 1185, 51 Pa. Commw. 156, 1980 Pa. Commw. LEXIS 1403
CourtCommonwealth Court of Pennsylvania
DecidedMay 6, 1980
DocketNo. 2335 C.D. 1979
StatusPublished
Cited by5 cases

This text of 413 A.2d 1185 (Canonsburg General Hospital v. Commonwealth) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Canonsburg General Hospital v. Commonwealth, 413 A.2d 1185, 51 Pa. Commw. 156, 1980 Pa. Commw. LEXIS 1403 (Pa. Ct. App. 1980).

Opinion

Opinion by

Judge Craig,

Canonsburg General Hospital (hospital) presented a petition for review in the nature of an action in mandamus against the Pennsylvania Department of Health (department) and its acting secretary, addressed to our original jurisdiction, seeking a peremptory judgment to mandate that the department certify to the United States Department of Health, Education and Welfare (HEW) that the hospital’s application for federal capital reimbursement for a hospital replacement project (project) is in conformity with standards of community need and other factors.

The hospital’s position has been based upon provisions of law, discussed below, which provide that an application shall be legally deemed to be in conformity if the department has failed to act upon it within 90 days after its submission in a completed status.

The department opposed the petition on the merits and also filed preliminary objections questioning the [159]*159propriety of the subject matter jurisdiction in mandamus. After a hearing before one judge of this court, in which only documentary evidence and affidavits were presented, the hearing judge issued a peremptory order in favor of the hospital. The department thereafter filed its petition to open the peremptory judgment, which is now before the court en banc for disposition.

Throughout the proceedings, the case has involved two major issues, which we state at the outset.

The Basic Issues Stated

1. Is an action in mandamus appropriate to compel a certification to the federal government, by the designated state agency, that a hospital’s application for capital project funding has been determined to be in conformity, under federal and state regulations which both provide that failure of the state agency to approve or disapprove within ninety days after receipt of the application “shall have the effect of a determination” of conformity?

2. Can the state agency seek to require “research efforts” of the hospital, in addition to existing information given by the hospital in answering the questions on the application, so that the starting date for the ninety-day consideration of the application is postponed until completion of the “research efforts ’ ’ ?

Concerning the above second question, it is significant that the department, in its statement of the questions involved, has itself straightforwardly used the characterization “research efforts” to describe what the state agency was demanding before the application could be approved or disapproved.

The Background oe The Case

We must first review the law which establishes the legal premise for our consideration.

[160]*160 The Governing Statutes and Regulations

Section 1122 of the Social Security Act, 42 U.S.C. §1320a-1, establishes a federal system to reimburse health care facilities for capital project costs by permitting such capital expenditures to be included within Medicare and Medicaid payments subsequently made to the health care facility. To avoid supporting unnecessary capital expenditures, the procedure is integrated with the comprehensive health planning structure created under the National Health Planning and Resources Development Act, 42 U.S.C. §300k et seq.f whereby health needs within a region are assessed by a health systems agency, such as the Health Systems Agency of Southwestern Pennsylvania, Inc. (HSA), which acted as agent for the department here.

The HSA makes the initial assessment of a hospital’s application for a capital project and then submits its recommendation to the department, which serves as the designated planning agency (DPA) for Pennsylvania by contract with HEW. Implementing Section 1122, 42 C.F.R. §100.107 (1979) requires both the HSA and the DPA to consider whether a proposed project is in conformity with community needs and standards with respect to adequate staffing, cost containment and economic feasibility.

The department’s certification of conformity or nonconformity is a recommendation to HEW, and the Secretary of HEW makes the final decision in accordance with 42 C.F.R. §100.108 (1979), as authorized by Section 1122.

The crucial implementing regulation here is 42 C.F.R. §100.106 (1979). Under 42 C.F.R. §100.106(a) (2) (1979) the proposal application must “be submitted in such form and manner and . . . contain such information” as the DPA requires to meet the needs of all agencies involved.

[161]*161Section 1122 of the statute clearly requires the state DPA to make its notification of conformity or nonconformity “within a reasonable period” after receiving the application. That time factor requirement is specifically implemented by 42 C.F.R. §100.106(a) (3) and (4) (1979),1 subsections which can be summarized as follows:

Subsection (3) refers to the application as a “notice”. It requires the DPA, if the notice is incomplete, to notify the applicant “within 15 days of its receipt of such incomplete notice,” advising as to the additional information required. “Where such timely noti[162]*162fication of incompleteness is provided,” the ninety-day time limitation governing the DPA under Subsection (4) “shall run from the date of receipt by the agency of a notice containing such additional information. ’ ’

Subsection (4) prescribes that the failure of the DPA to provide notification of conformity or nonconformity within “90 days after the receipt of such notice . . . shall have the effect of a determination” of conformity.

The parties do not differ with respect to the meaning and effect of those subsections, as summarized.

The parties also agree that the responsibilities of the department, as DPA, for thus reviewing the appli[163]*163cation notices have been delegated to the HSA, so that the actions of the HSA can be considered as actions of the department.

General History

On April 16, 1979, the HSA received from the hospital its application for capital reimbursement to replace its present 108-bed facility with a 100-bed facility, at a cost of approximately $17,000,000. By letter of April 30, 1979, the HSA advised the hospital that the application was incomplete. The hospital, under date of May 22, submitted additional information, which the HSA received May 30, 1979. Thereafter, commencing with an additional request from the HSA on June 6, there followed considerable correspondence, which will be analyzed in detail below, in considering the merits.

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Bluebook (online)
413 A.2d 1185, 51 Pa. Commw. 156, 1980 Pa. Commw. LEXIS 1403, Counsel Stack Legal Research, https://law.counselstack.com/opinion/canonsburg-general-hospital-v-commonwealth-pacommwct-1980.