Cobb Hospital, Inc. v. Emory-Adventist, Inc.

CourtCourt of Appeals of Georgia
DecidedNovember 17, 2020
DocketA20A1000
StatusPublished

This text of Cobb Hospital, Inc. v. Emory-Adventist, Inc. (Cobb Hospital, Inc. v. Emory-Adventist, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cobb Hospital, Inc. v. Emory-Adventist, Inc., (Ga. Ct. App. 2020).

Opinion

SECOND DIVISION MILLER, P. J., DOYLE, P. J., and MERCIER, J.

NOTICE: Motions for reconsideration must be physically received in our clerk’s office within ten days of the date of decision to be deemed timely filed. https://www.gaappeals.us/rules

DEADLINES ARE NO LONGER TOLLED IN THIS COURT. ALL FILINGS MUST BE SUBMITTED WITHIN THE TIMES SET BY OUR COURT RULES.

November 3, 2020

In the Court of Appeals of Georgia A20A1000. COBB HOSPITAL, INC. et al. v. DO-039 EMORY-ADVENTIST, INC. et al.

DOYLE, Presiding Judge.

The instant appeal arises from a declaratory judgment action filed in superior

court by Cobb Hospital, Inc., d/b/a WellStar Cobb Hospital, Kennestone Hospital,

Inc., d/b/a WellStar Kennestone Hospital, and WellStar Health System, Inc.,

(collectively, “WellStar”) seeking to have the acquisition of Emory-Adventist

Hospital by Emory Healthcare, Inc.,1 declared null and void for violation of the

Hospital Acquisition Act (“HAA”), OCGA § 31-7-400 et seq., and for an injunction

to prevent the operation of Emory’s hospital at the location of the former Emory-

Adventist Hospital. The parties filed cross-motions for summary judgment, and the

1 Wellstar also named as defendants Emory-Adventist, Inc., and Emory University, Inc., d/b/a Emory University Hospital Smyrna (collectively, “Emory”). trial court granted Emory’s motion, denying Wellstar’s requests for relief. Wellstar

appeals, arguing that the trial court erred by finding that Emory’s acquisition of

Emory-Adventist Hospital did not violate the HAA. For the reasons that follow, we

affirm.

As explained in an earlier opinion of this Court,

Smyrna Hospital, Inc., an 88-bed community hospital, opened on South Cobb Drive in Smyrna in 1974. Adventist Health System acquired the hospital in 1976. In 1995, Emory Healthcare entered a joint venture agreement with Adventist Health System and obtained a 35 percent share ownership in the hospital; thereafter, the hospital was renamed Emory-Adventist Hospital. Due to declining revenues, Emory-Adventist ceased operations on October 31, 2014. In April 2015, Emory University acquired sole ownership of the hospital, which was renamed Emory University Hospital Smyrna and reopened on October 20, 2015.2

When Emory-Adventist ceased operations on October 31, 2014, it surrendered

its permit to the Department of Community Health (“DCH”). Rather than complete

revocation of its permit, Emory-Adventist advised DCH that it would temporarily

close and requested that the permit be placed on “inactive” status. Prior to Emory-

2 Cobb Hosp., Inc. v. Dept. of Community Health, 349 Ga. App. 452, 453-454 (825 SE2d 886) (2019), reversed in part by Cobb Hosp. v. Dept. of Community Health, 307 Ga. 578 (837 SE2d 371) (2019).

2 Adventist’s closure, its representatives discussed acquisition of the hospital by

Emory, as well as whether Emory could reopen the facility within twelve months of

closure if Emory-Adventist placed the permit on inactive status.3 Emory also

discussed this issue with the director of DCH.

Thereafter, on January 14, 2015, Emory entered into a purchase and sale

agreement with Emory-Adventist for the hospital building and two medical office

buildings. On April 1, 2015, Emory representatives discussed the purchase with the

Attorney General’s office, and the Attorney General opined that review under the

HAA was not necessary. Based on the Attorney General’s representations to Emory,

no written disclosure under the HAA was filed.

In May 2015, after Emory closed on the transaction, it met with the Attorney

General’s office again, this time to discuss a proposed reopening of the old Emory-

Adventist facility and to confirm that the HAA was not implicated. In March 2016,

3 There is some evidence in the record that prior to closing, Emory-Adventist was in discussions for a buyout with Wellstar, which had dissolved by March 2014. At that point, discussions between Emory and Emory-Adventist had begun, which all occurred about a year before closing on the purchase and sale agreement at issue.

3 DCH granted Emory a new certificate of need for proposed improvements and

renovations at former Emory-Adventist to open an orthopedic surgery center.4

After contacting the Attorney General arguing that Emory’s acquisition of

Emory-Adventist violated the HAA, Wellstar filed this suit seeking declaratory and

injunctive relief. The trial court granted summary judgment, finding that Emory-

Adventist was not a hospital for purposes of the HAA. Wellstar now appeals.

When examining statutory provisions, we apply the fundamental rules of statutory construction that require us to construe the statute according to its terms, to give words their plain and ordinary meaning, and to avoid a construction that makes some language mere surplusage. Thus, a statute should be read according to its natural and most obvious import of the language without resorting to subtle and forced constructions for the purpose of either limiting or extending its operation. Similarly, in construing agency regulations, we employ the basic rules of statutory construction and look to the plain meaning of the regulation to determine its meaning. Accordingly, when an administrative agency decision is the subject of judicial review, judicial deference is to be afforded the agency’s interpretation of rules and regulations it has enacted to fulfill the function given it by the legislative branch. And in construing administrative rules, the ultimate criterion is

4 See generally Cobb Hosp., Inc., 349 Ga. App. at 452.

4 the administrative interpretation, which becomes of controlling weight unless it is plainly erroneous or inconsistent with the rule.5

1. Georgia’s HAA6 applies any time the sale, purchase, or lease, of 50 percent

or more of the assets of a hospital owned, controlled, or operated by a nonprofit entity

occurs. Under the Act, both the entity for sale and the acquiring entity are directed to

5 (Citations and punctuation omitted.) Cobb Hosp., Inc., 349 Ga. App. at 459- 460 (1) (c) (ii), quoting ASMC, LLC v. Northside Hosp., 344 Ga. App. 576, 582 (810 SE2d 663) (2018); Lakeview Behavioral Health System v. UHS Peachford, LP, 321 Ga. App. 820, 822 (1) (743 SE2d 492) (2013); Walker v. Dept. of Transp., 279 Ga. App. 287, 292 (2) (a) (630 SE2d 878) (2006). 6 Approximately 20 years ago, members of this Court commented on the opaque piece of Code that is the HAA. See Turpen v. Rabun County Bd. of Commrs., 245 Ga. App. 190, 197 (537 SE2d 435) (2000) (physical precedent only), Smith J. specially concurring (“I am concerned about the flaws, both ambiguities and omissions, in the [HAA.]”); Sparks v. Hosp. Auth. of the City of Bremen &c., 241 Ga. App. 485, 489-490 (526 SE2d 593) (1999) (physical precedent only), Smith J. specially concurring. The statute is among approximately 19 passed in the United States between 1996 and 1998 after a surge of for-profit takeovers of nonprofit hospitals across the country. See Sara Collins, Bradford Gray, & Jack Hadley, The For-Profit Conversion of Nonprofit Hospitals in the U.S. Health Care System: Eight Case Studies, The Commonwealth Fund, (May 2001), available at http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.499.3671&rep=rep1&ty pe=pdf.

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