Cupey Bajo Nursing Home, Inc. v. United States

40 Cont. Cas. Fed. 76,952, 36 Fed. Cl. 122, 1996 U.S. Claims LEXIS 121, 1996 WL 343069
CourtUnited States Court of Federal Claims
DecidedJune 24, 1996
DocketNo. 685-89C
StatusPublished
Cited by14 cases

This text of 40 Cont. Cas. Fed. 76,952 (Cupey Bajo Nursing Home, Inc. v. United States) is published on Counsel Stack Legal Research, covering United States Court of Federal Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cupey Bajo Nursing Home, Inc. v. United States, 40 Cont. Cas. Fed. 76,952, 36 Fed. Cl. 122, 1996 U.S. Claims LEXIS 121, 1996 WL 343069 (uscfc 1996).

Opinion

OPINION

REGINALD W. GIBSON, Senior Judge.

I. INTRODUCTION

Cupey Bajo Nursing Home, Inc., d/b/a Hospital Nuestra Señora de Los Angeles (Cupey Bajo or plaintiff), brings a government contract action against the United States (the government or defendant) pursuant to the Contract Disputes Act of 1978 (CDA), 41 U.S.C. §§ 601-613 (1988 & Supp. V 1993). In its complaint, as amended,1 Cu-pey Bajo claims that defendant wrongfully disallowed $35,000 in costs that plaintiff allegedly incurred performing its cost-reimbursement type contract for the Veterans Administration (VA)2 during the period January 1,1983 through November 22,1983. PL Ex. 11 A; Tr. 15.3

In response to Cupey Bajo’s claim, defendant filed an answer, affirmative defenses, and a counterclaim on May 18,1993, seeking recovery of $239,730, which it asserts the government overpaid Cupey Bajo under the contract during the calendar year 1983. In short, therefore, the dispute before this court is whether, based on the terms of the contract and the applicable regulatory provisions, plaintiff was underpaid or overpaid under its cost reimbursement type contract with the VA during 1983. This court held a five-day trial to resolve the parties’ dispute, commencing May 17, 1995 and concluding May 23, 1995, in San Juan, Puerto Rico.

II. FACTS

A. Background

1. The Contract

On April 1,1982, defendant awarded a cost reimbursement type contract, Contract No. V455P-1531, to Cupey Bajo for the performance of hospital services, including psychiatric care, to veteran patients at its inpatient facility in Rio Pedras, Puerto Rico (the contract). The life of the contract at issue was initially scheduled for a one-year period commencing on April 1,1982.4 Through mutually executed contract modifications, the parties extended contract performance through to October 31, 1983.5 Predating the Federal Acquisition Regulations, the contract terms require application of the Federal Procurement Regulations (FPR) and Medicare Manual HIM-15.

[126]*1262. Reimbursable Costs According To A Per Diem Rate

The payment terms of the contract directed the government to reimburse plaintiff for costs incurred in providing inpatient hospital services to YA beneficiaries based upon an “all-inclusive inpatient day cost basis”, or “per diem rate.” Jt.Ex. 1, 112; Pl.Ex. 1, II 4(a). Cupey Bajo would receive such “per diem” reimbursement each day a veteran received inpatient care at the hospital, otherwise referred to as a ‘YA inpatient service day.” Pl.Ex. 1,114(b).

For the payment of contract performance costs invoiced during 1983, the contract established a provisional, or “interim”, per diem rate of $65.93.6 This interim per diem rate was subject to adjustment by the government based on a final determination of Cupey Bajo’s actual cost of performance through audit. The contract defines plaintiffs 1983 actual, or “final,” per diem rate payable for each ‘YA inpatient service day” performed as: (i) “the total allowable costs for hospital services” plaintiff incurred during the year, divided by (ii) the total number of inpatient service days plaintiff provided during the same year. PLEx. 1, 114(a); Tr. 558, 560 (Davey). Total allowable expenses for purposes of calculating the “final per diem rate” exclude outpatient costs. See Pl.Ex. 1, U 4(a); Tr. 421-22 (Davey). This “final per diem rate” multiplied by the actual number of ‘YA inpatient service days” serviced in the particular year comprised the total reimbursable cost for that year. PLEx. 1,H 4(a).

Approximately one year after the contract’s expiration on October 31,1983, Cupey Bajo, on October 23, 1984, reported the foregoing figures on Form JHF-001, captioned “Hospital Statement of Reimbursable Cost.”7 PLEx. 2; Tr. 235 (Oyóla). At that latter time, supra, Cupey Bajo’s Hospital Administrator, Mr. Luis M. Oyóla, completed the form and reported the sum of $3,188,443 as plaintiffs total inpatient costs incurred in performing the contract during 1983. Based on this sum of total inpatient costs for 1983, plaintiff claimed a “final” per diem rate of $72.95 as follows:

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This “final” per diem rate of $72.95, calculated by Cupey Bajo, for reimbursable costs during 1983 exceeded the contract estimate, or “provisional,” per diem rate of $65.93 by $7.02. In other words, based on plaintiffs final per diem rate calculation, defendant allegedly underpaid plaintiff $7.02 for each of the 24,203 ‘YA inpatient service days” allegedly serviced during 1983. Accordingly, Cu-pey Bajo multiplied $7.02 by the 24,203 ‘YA inpatient service days” as follows:

[127]*127[[Image here]]

Def.Ex. 2 at 072; Pl.Ex. 11. Therefore, Cu-pey Bajo averred that the VA owed it $169,-905 in costs not invoiced by Cupey Bajo or paid by the government for services performed in 1983.

After Cupey Bajo provided this statement of proposed actual costs dated October 23,1984, to the VA, neither the VA nor Cupey Bajo acted on this matter until the spring of 1987. At that time, Mr. Oyóla sent a letter to the CO on June 8, 1987, asserting that Cupey Bajo was due additional compensation of $169,905 under the contract based on the alleged difference between (i) the contract’s provisional interim rate paid to the hospital; and (ii) the alleged final per diem cost rate incurred by the hospital.3 ****8 Mr. Oyóla attached a copy of his calculations made in arriving at the “final per diem rate” of $72.95, supra, but failed to furnish any documentation evidencing his claim that the hospital provided a total of 24,203 VA inpatient service days under the contract.

3. The Audit

In July 1987, the VA attempted to verify Cupey Bajo’s claim and requested the DCAA to perform an audit of plaintiffs 1983 records as anticipated by the terms of the contract. In August and September, 1987, Ms. Maria Melendez Davey, a senior auditor for DCAA at the time, audited plaintiffs costs allegedly incurred during contract performance in 1983. The audit report states that it was “performed in accordance with generally accepted Government auditing standards ... [and] the cost principles contained in Subpart 1-15.2 of the [FPR] and Medicare Manual HIM-15.” Def.Ex. 2 at 1. The results of her audit were reviewed and approved by her supervisor, Mr. Ted Traylor. The DCAA audit results reported a number of alleged deficiencies in Cupey Bajo’s cost calculations. Plaintiff now challenges several of these alleged deficiencies before this court.

B. The Parties’ Dispute

Essentially, the parties’ dispute requires this court to determine the final per diem rate reflecting the total allowable inpatient costs incurred by plaintiff in 1983 under its contract with the VA Only then may this court find whether plaintiff was underpaid or overpaid by defendant for inpatient care at the hospital under the terms of their cost reimbursement type contract and, if either, by what amount.

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Bluebook (online)
40 Cont. Cas. Fed. 76,952, 36 Fed. Cl. 122, 1996 U.S. Claims LEXIS 121, 1996 WL 343069, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cupey-bajo-nursing-home-inc-v-united-states-uscfc-1996.