Department of Social Services v. Peace of Mind Adult Day Care Center

377 S.W.3d 631, 2012 WL 4344163, 2012 Mo. App. LEXIS 1203
CourtMissouri Court of Appeals
DecidedSeptember 25, 2012
DocketNo. WD 74519
StatusPublished
Cited by14 cases

This text of 377 S.W.3d 631 (Department of Social Services v. Peace of Mind Adult Day Care Center) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Department of Social Services v. Peace of Mind Adult Day Care Center, 377 S.W.3d 631, 2012 WL 4344163, 2012 Mo. App. LEXIS 1203 (Mo. Ct. App. 2012).

Opinion

CYNTHIA L. MARTIN, Judge.

The Missouri Department of Social Services (“DSS”) and the Missouri Department of Health and Senior Services (“DHSS”) (collectively, “the Departments”) appeal from the Missouri Administrative Hearing Commission’s (“AHC”) decision holding that Peace of Mind Adult Day Care Center (“Peace of Mind”) is not subject to MO HealthNet sanctions, that Peace of Mind is entitled to a participation agreement with DHSS for home- and community-based care, and that Stephanie Patton (“Patton”) is entitled to a payment of $45,340 for adult day care services rendered from December 20, 2008, through February 20, 2009. The Departments contend that the AHC erred in five respects: (1) in finding that Patton properly raised and preserved allegations of constitutional violations against DHSS and in considering the merits of those constitutional violations; (2) in ruling against the Departments because its decision was not supported by substantial and competent evidence on the record; (3) in finding that there were two bases for DSS to sanction Patton and in rejecting three other bases for sanctions; (4) in refusing to impose DSS sanctions on Patton; and (5) in finding Patton is entitled to a DHSS participation agreement for home- and community-based services. We affirm in part [633]*633and reverse in part.1

Factual and Procedural History

Patton was the owner and operator of Peace of Mind, an adult day care facility in St. Louis devoted to serving African Americans. DHSS offers two types of licenses to adult day cares, depending on the services the facility provides. If an adult day care facility offers medical services and complies with 19 CSR 30-90.050(8)(D), then DHSS issues a medical model license to the adult day care. If no medical services are provided or the adult day care facility does not comply with 19 CSR 30-90.050(8)(D), then the adult day care will be licensed as a social model facility. Peace of Mind had a medical model license that was set to expire on December 20, 2008.

December 21, 2008 Issuance of a Provisional Social Model License by DHSS

Prior to the expiration of the license, two DHSS inspectors from the St. Louis regional office — Cassie Blum (“Blum”) and Sharon Davis Buckner (“Buckner”) — conducted an unannounced inspection of Peace of Mind on October 16, 2008. Patton was not at the facility at the time the inspection began. Once Patton arrived, she introduced herself to the inspectors and accompanied them throughout the building. The inspection was not completed, but the evidence presented at the hearing was not conclusive as to why Blum and Buckner did not complete the inspection. The programming manager for licensing and certification testified that the inspection was not completed because “[t]he relationship between the program director and [the inspectors] became very aggravated.” Patton testified that Blum and Buckner were rude and disruptive during the inspection and upset Peace of Mind’s clients. According to Patton’s testimony, Blum called Patton a racial epithet and accused Patton of being illiterate. The inspectors called the local police department, and officers responded to Peace of Mind. The police report indicated that Michael Carr (“Carr”) — one of Peace of Mind’s employees — told the police that “Blum appeared to have an agenda when she walked in to conduct her inspection.” Blum and Buckner, on the other hand, told the police that Patton said, “I’m gonna hurt her.”

Patton called DHSS’s St. Louis regional office to speak to the inspectors’ supervisor, Mary Collier (“Collier”). Patton asked to speak -with “Mary” and her call was transferred to Mary Cannon (“Cannon”). Patton told Cannon that Blum was “making [a] big scene” and being disrespectful. A few days later, Patton realized that she had spoken with the wrong “Mary” and wrote a letter to Collier that described the inspectors’ behavior on October 16, 2008. DHSS subsequently sent Patton a letter, reminding Patton of her obligation to cooperate fully with DHSS inspectors, as set forth in section 660.407.2

In response to the failed inspection, DHSS decided to send officials from Jefferson City to complete the inspection of Peace of Mind. DHSS selected Tracy Niekamp (“Niekamp”), the program manager for licensing and certification, and Shelly Williamson (“Williamson”), the operations manager for the section for long-term care regulation, to conduct an unannounced inspection of Peace of Mind on [634]*634December 5, 2008. During that inspection, Niekamp and Williamson claim to have observed that, despite having a medical model license, Peace of Mind did not have a nurse on duty. Niekamp and Williamson testified that in response to their question about Peace of Mind’s medical model license, Patton told them that she was not sure why she had a medical model license because she had not employed a nurse since late 1999 or early 2000. On cross-examination, Niekamp admitted that she did not ask Peace of Mind’s employees whether a nurse was present. Patton’s testimony was in sharp contrast to Niek-amp and Williamson’s testimony. Patton testified that there were two nurses on duty during the inspection.

As a result of Niekamp and Williamson’s reported finding that Peace of Mind’s failed to employ a nurse, Tracy Cleeton (“Cleeton”) — DHSS’s adult day care program manager — wrote Patton a letter that informed her Peace of Mind “was not in substantial compliance” with the requirements for adult day care licensure.3 The letter indicated that DHSS was issuing Peace of Mind a provisional social model license to be effective December 21, 2008, a day after the medical model license expired. The letter did not inform Patton of her right to appeal DHSS’s decision to the AHC.

December 20, 2008 Termination of Participation in MO HealthNet by DSS

DHSS also sent DSS a copy of Cleeton’s letter to Patton because Peace of Mind was enrolled as a Title XIX MO HealthNet adult day care provider and received reimbursement by MO HealthNet for adult day care services provided. DSS regulations require a participant in the MO HealthNet program to maintain a medical model license from DHSS. See 18 CSR 70-92.010(3)(A), (3)(F). As a result of Peace of Mind’s failure to maintain a medical model license, DSS terminated Peace of Mind’s participation in the MO HealthNet program effective on the close of business of December 20, 2008, and stopped making payments to Peace of Mind. DSS informed Patton of its decision in a letter dated February 2, 2009.

February 11, 2009 Reissuance of a Medical Model License by DHSS

Patton contacted DSS to ask why Peace of Mind’s participation in the MO Health-Net program was terminated. The DSS employee told Patton that Peace of Mind’s participation was terminated because it no longer had a medical model license and that Patton could call DHSS to speak about licensing. Patton contacted DHSS and asked about having Peace of Mind’s medical model license reinstated. DHSS informed Patton that she would have to hire a licensed nurse to be at Peace of Mind during its business hours. Patton provided proof that Peace of Mind employed a licensed nurse, and on February 11, 2009, DHSS issued Peace of Mind a medical model license following an inspection that revealed Peace of Mind “was in substantial compliance with the licensure law, rules and regulations.” DHSS informed DSS of the reissuance of Peace of Mind’s medical model license.

Denial of MO HealthNet Claims by DSS

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Cite This Page — Counsel Stack

Bluebook (online)
377 S.W.3d 631, 2012 WL 4344163, 2012 Mo. App. LEXIS 1203, Counsel Stack Legal Research, https://law.counselstack.com/opinion/department-of-social-services-v-peace-of-mind-adult-day-care-center-moctapp-2012.