Crawford County v. Heckler

629 F. Supp. 328, 1986 U.S. Dist. LEXIS 29307
CourtDistrict Court, W.D. Arkansas
DecidedFebruary 18, 1986
DocketCiv. No. 85-2092
StatusPublished
Cited by1 cases

This text of 629 F. Supp. 328 (Crawford County v. Heckler) is published on Counsel Stack Legal Research, covering District Court, W.D. Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Crawford County v. Heckler, 629 F. Supp. 328, 1986 U.S. Dist. LEXIS 29307 (W.D. Ark. 1986).

Opinion

MEMORANDUM OPINION

H. FRANKLIN WATERS, Chief Judge.

This is an action arising under the Hill-Burton Act, 42 U.S.C. § 291i, to determine the propriety of the prospective recovery of grant assistance received by the Crawford County Hospital under Title VI of the Public Health Service Act and the Accelerated Public Works Act. The case was tried to the court on December 18, 1985.

The evidence indicates that on February 15, 1950, Crawford County, Arkansas, (Crawford County) was awarded a grant pursuant to Title VI of the Hill-Burton Act for the construction of a 52-bed general hospital. The total cost of this project was $577,924.93, of which $321,214.85 was the total federal grant share. The hospital opened on July 18, 1951.

On December 12, 1963, Crawford County was awarded a supplemental funding grant pursuant to the Accelerated Public Works Act of 1962, 42 U.S.C. §§ 2641 et seq., for further construction at the hospital. The total cost of this project was $16,024.60, of which the total federal contribution was $11,012.30. This construction was completed on April 1, 1964.

On March 5, 1968, Crawford County was awarded a three-part grant for additions to and renovations of the hospital. The total cost of these projects was $1,897,919.15, of which $999,608.75 was the federal share. The expanded and renovated facilities opened on May 1, 1970.

Prior to the lease which “triggered” the asserted right of recovery of the funds, the hospital was leased to and operated by the Sisters of the St. Scholastica Convent of Fort Smith, a benevolent association and non-profit corporation. Early in 1981, St. Scholastica reported financial difficulties with the hospital operation.

It was ascertained by Crawford County that the hospital was in severe financial difficulty and that the buildings and equipment were in poor condition. Because of these problems, only limited medical care could be provided. The Crawford County Quorum Court decided that Humana Medical Centers, Inc., (Humana) could provide the best health care at the hospital. Humana is a for-profit corporation and it is agreed that it is an ineligible entity under the Hill-Burton Act (see § 609 of the Public Health Service Act).

On December 16, 1981, a lease agreement was executed between Crawford County and Humana, effective February 2, 1982. The United States Department of Health and Human Services (HHS) was informed of the lease by the Arkansas Department of Health pursuant to 42 C.F.R. § 53.134. Crawford County Judge George Willmuth was notified of the pending recovery claim on September 27, 1983, July 18, 1984, and January 9, 1985.

On April 30,1984, the lease was assigned to Republic Health Corporation and HHS was so notified by letter dated January 23, 1985, from Humana.

The pertinent provisions of the Hill-Burton Act which authorize recovery actions, 42 U.S.C. § 291i, state that if

any facility with respect to which funds have been paid under section 606 [42 U.S.C. 291fJ shall, at any time within 20 years after the completion of construction or modernization—
(1) be sold or transferred to any entity (A) which is not qualified to file an application under section 605 [42 U.S.C. § 291eJ or (B) which is not approved as a transferee by the State agency designated pursuant to section 604 [42 U.S.C. § 291d], or its successor, or
(2) cease to be a public health center or a public or other nonprofit hospital, outpa[330]*330tient facility, facility for long-term care, or rehabilitation facility,
the United States shall be entitled to recover, whether from the transferor or the transferee (or, in the case of a facility which has ceased to be public or nonprofit, from the owners thereof) an amount determined under subsection (c) .
(d) (1) The Secretary may waive the recovery rights of the United States under subsection (a)(1) with respect to a facility in any State if the Secretary determines, in accordance with regulations, that the entity to which the facility was sold or transferred—
(A) has established an irrevocable trust —(i) in an amount equal to the greater of twice the cost of the remaining obligation of the facility under clause (2) of section 603(e) [)2 U.S.C. £ 291c(e)(2)], or the amount, determined under subsection (c), that the United States is entitled to recover, and
(ii) which will only be used by the entity to provide the care required by clause (2) of section 603(e); and
(B) will meet the obligation of the facility under clause (1) of section 603(e) [42 U.S.C. § 291c(e)(l)].
(2) The Secretary may waive the recovery rights of the United States under subsection (a)(2) with respect to a facility in any state if the Secretary determines, in accordance with regulations, that there is good cause for waiving such rights with respect to such facility. (Emphasis supplied).

Thus, because it is undisputed that Crawford County was paid funds under section 291f for construction projects and that within 20 years of completion of the projects it leased the hospital to a for-profit corporation, i.e., Humana, the only issue remaining with regard to the right of recovery is whether the lease to Humana constitutes a “transfer” within the meaning of the Hill-Burton Act.

Consideration for the lease included an initial payment of $2,500,000 to Crawford County, a payment of $775,000 due on the sixth anniversary of the lease, and sums necessary to retire certain revenue bonds in the amount of $213,000 during the second through fifth years of the lease. Humana was to be responsible for all repairs to the hospital. Humana was to be similarly responsible for real and personal property taxes and insurance. Humana could cancel the lease only during the 30-day period beginning on the fifth anniversary of the lease and ending 30 days thereafter. The lease granted Humana an absolute and irrevocable right of first refusal to purchase the hospital. Humana was obligated to expend at least $2,800,000 on the hospital during the first three years of the lease.

It was agreed that Humana would provide 24-hour emergency room service and treatment for all life-threatening emergencies regardless of ability to pay for the services. Indigent care was to be provided only to residents of Crawford County, and only so long as there were funds in the Indigent Care Fund.

All medical affairs of the hospital were to be administered by a Board of Trustees in accordance with Board by-laws.

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Cite This Page — Counsel Stack

Bluebook (online)
629 F. Supp. 328, 1986 U.S. Dist. LEXIS 29307, Counsel Stack Legal Research, https://law.counselstack.com/opinion/crawford-county-v-heckler-arwd-1986.