Glencoe Area Health Center v. Minnesota Department of Human Services

441 N.W.2d 549, 1989 Minn. App. LEXIS 697, 1989 WL 61468
CourtCourt of Appeals of Minnesota
DecidedJune 13, 1989
DocketNo. C2-88-2446
StatusPublished

This text of 441 N.W.2d 549 (Glencoe Area Health Center v. Minnesota Department of Human Services) is published on Counsel Stack Legal Research, covering Court of Appeals of Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Glencoe Area Health Center v. Minnesota Department of Human Services, 441 N.W.2d 549, 1989 Minn. App. LEXIS 697, 1989 WL 61468 (Mich. Ct. App. 1989).

Opinion

[550]*550OPINION

FOLEY, Judge.

This matter is before this court on the petition for writ of certiorari of relator Glencoe Area Health Center. Glencoe, a new facility receiving its first residents on May 1, 1984, challenges the action of the Commissioner of Human Services in sustaining Glencoe’s property-related payment rates and particularly the offset of interest income against interest expense for the following periods: May 1, 1984 to September 30, 1985; October 1, 1985 to June 80, 1986; and July 1, 1986 to June 30, 1987.

The parties have stipulated to certain facts and those facts, together with documents and exhibits on file, the evidence and statutes and rules relevant thereto, sustain the action of the Commissioner. We affirm.

FACTS

The parties’ stipulation, which is incorporated by reference, presents the following factual situation. Glencoe is a non-proprietary, hospital-attached nursing home located in Glencoe, Minnesota, certified to participate in Minnesota’s Medical Assistance Program. Its medical assistance reimbursement rates are set by the Department of Human Services pursuant to Minn.Stat. §§ 256B.41-256B.48 (1988) and Minn.R. 9549.0010-0080 (1987). The Medical Assistance Program is a jointly funded federal-state program that provides medical care assistance for eligible persons and is administered in Minnesota by the Department of Human Services. See Minn.Stat. § 256.01, subd. 1 (1988).

From 1972 until July 1, 1983, nursing homes were reimbursed under a rate system found in Minn.R. 9510.0010-0480 (1987), which is commonly referred to as “Rule 49.” In 1983, the legislature implemented a new reimbursement system that would use a “rental value” approach for reimbursing the nursing homes’ property costs. Minn. Laws 1983, ch. 199, § 12, codified at Minn.Stat. § 256B.431 (1988). Since the new system would not become effective until July 1985, the legislature directed the Department of Human Services to adopt a temporary method of reimbursement which would be effective from July 1, 1983 through June 30, 1985. Accordingly, the Department of Human Services implemented Temporary Rule 50 (also known as 12 MCAR §§ 2.05001-2.05016) until ultimately, Permanent Rule 50 became effective on June 17, 1985. (Minn.R. 9549.0010-0080 (1987)).

Under Permanent Rule 50, medical assistance reimbursement rates for a rate year beginning on July 1 are set based on cost reports which are submitted by providers for the one-year period ending September 30 of the preceding year. Minn.R. 9549.0020, subp. 41 (1987).

The system to set rates for a newly constructed nursing home, however, is not the same. Initially, for a new facility to establish medical assistance reimbursement rates under Permanent Rule 50, it must submit a report of its estimated actual costs for a start-up period which is commonly referred to as the “interim period.” Minn.R. 9549.0060, subp. 14. A. (1987). This interim period begins on the first day a resident is admitted to the facility and continues until September 30, not to exceed 17 months. At the end of the interim period, the facility submits a settle-up cost report which contains the actual costs incurred during this initial period. From the information contained in that report, a new rate, a settle-up rate, is then established for the interim period (or settle-up period). The Department of Human Services then retroactively adjusts the rates for the settle-up period, substituting the historical cost-based settle-up rates for the projected interim rates.

This settle-up cost report is then used to establish rates for three separate periods;

1. Settle-up rates for the interim period;
2. Rates for the nine-month period between the date of the settle-up cost report (September 30) and the beginning of the next rate year July 1; and
3. Rates for the next rate year commencing on July 1 following the interim period.

[551]*551Glencoe’s interim period began on May 1, 1984 which was the first day it admitted residents. Glencoe received interim medical assistance payment rates based on its estimated costs until September 30, 1985. Glencoe then submitted its settle-up cost report which reflected its actual costs incurred during the interim period. This' September 30, 1985 settle-up cost report was used by the Department of Human Services to calculate

1. The settle-up rates for the period from May 1, 1984 through September 30, 1985;
2. The rates for the nine month period from October 1, 1985 through June 30, 1986; and
3. The rates for the rate year from July 1, 1986 through June 30, 1987.

In calculating these rates, the Department of Human Services relied on Permanent Rule 50, Temporary Rule 50, Rule 49, and Minn. Laws 1985, 1st Sp.Sess., ch. 3, § 31.

According to the Department of Human Services, a nursing home’s rate is determined based largely on its allowable costs, and if costs are higher, the nursing home’s rates will also be higher. Therefore, the Department of Human Service’s offset of Glencoe’s interest income against its interest expense, resulted in a reduction of the total allowable costs used to calculate Glen-coe’s medical assistance rates for periods beginning May 1, 1984 and continuing through June 30, 1987.

The matter was heard as a contested case under the Administrative Procedure Act. Minn.Stat. §§ 14.01-14.69 (1986). The referee sustained the offset of interest income against interest expense, and the matter was appealed to the Commissioner, who sustained the action of the department. Glencoe appeals.

ISSUE

Did the Department of Human Services correctly offset Glencoe’s interest income against its interest expense in determining Glencoe’s property-related payment rates for various rate periods?

ANALYSIS

Standard of Review

Our standard of review of an agency’s decision has been set out in Minn.Stat. § 14.69 (1986) which provides:

In a judicial review under sections 14.-63 to 14.68, the court may affirm the decision of the agency or remand the caSe for further proceedings; or it may reverse or modify the decision if the substantial rights of the petitioners may have been prejudiced because the administrative finding, inferences, conclusion, or decisions are:
(a) In violation of constitutional provisions; or
(b) In excess of the statutory authority or jurisdiction of the agency; or
(c) Made upon unlawful procedure; or
(d) Affected by other error or law; or
(e) Unsupported by substantial evidence in view of the entire record as submitted; or
(f) Arbitrary or capricious.

Further, an agency’s decision enjoys a “presumption of correctness.” Reserve Mining Co. v. Herbst, 256 N.W.2d 808, 824 (Minn.1977). Courts should show deference to the agency’s expertise and special knowledge in the field of its training, education, and experience. Id.

Glencoe relies heavily on St. Otto’s Home v. Dept. of Human Services,

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Related

Udall v. Tallman
380 U.S. 1 (Supreme Court, 1965)
Reserve Mining Co. v. Herbst
256 N.W.2d 808 (Supreme Court of Minnesota, 1977)
Krumm v. R. A. Nadeau Co.
276 N.W.2d 641 (Supreme Court of Minnesota, 1979)
Goodman v. State, Department of Public Safety
282 N.W.2d 559 (Supreme Court of Minnesota, 1979)
In Re the Proposed Activation of the Minnesota Joint Underwriting Ass'n
408 N.W.2d 599 (Court of Appeals of Minnesota, 1987)

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Bluebook (online)
441 N.W.2d 549, 1989 Minn. App. LEXIS 697, 1989 WL 61468, Counsel Stack Legal Research, https://law.counselstack.com/opinion/glencoe-area-health-center-v-minnesota-department-of-human-services-minnctapp-1989.