Harston Hall Nursing & Convalescent Home, Inc. v. Commonwealth

513 A.2d 1097, 99 Pa. Commw. 475, 1986 Pa. Commw. LEXIS 2430
CourtCommonwealth Court of Pennsylvania
DecidedAugust 7, 1986
DocketAppeal, No. 703 C.D. 1985
StatusPublished
Cited by37 cases

This text of 513 A.2d 1097 (Harston Hall Nursing & Convalescent Home, Inc. v. Commonwealth) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Harston Hall Nursing & Convalescent Home, Inc. v. Commonwealth, 513 A.2d 1097, 99 Pa. Commw. 475, 1986 Pa. Commw. LEXIS 2430 (Pa. Ct. App. 1986).

Opinion

Opinion by

Judge Palladino,

Harston Hall Nursing and Convalescent Home, Inc. (Petitioner), a privately owned, skilled nursing and in[477]*477termediate care facility, has appealed from an order of the Director, Office of Hearings and Appeals (Director) of the Pennsylvania Department of Public Welfare (DPW) denying Petitioners exceptions to DPW audit findings disallowing certain Medical Assistance reimbursements. In particular, Petitioner objects to DPWs refusal to allow Medical Assistance reimbursement for ground rent and DPWs imputation of interest to an interest-free loan made by Petitioner to its President, which imputed interest was used to reduce reimbursement for capital interest.1 For the reasons which follow, we affirm.

During 1976, Nelson R. Hartranft (Mr. Hartranft), President and sole stockholder of Petitioner, and his wife Thelma (Mrs. Hartranft) were in the process of obtaining a divorce. In order to provide future support for Mrs. Hartranft, the real estate upon which Petitioners facility is situated, jointly owned by Mr. and Mrs. Hartranft, was placed in trust pursuant to a Trust Agreement, dated March 19, 1976, which required Petitioner to pay ground rent to the Trust. In turn, the Trust paid a monthly income to Mrs. Hartranft. Because DPW determined that this was a transaction among related parties, it disallowed the ground rent expense claimed by Petitioner for fiscal years 1979, 1980, and 1981.

[478]*478In its 1977, 1979, 1980 and 1981 audits, DPW found record of an interest-free loan in Petitioners balance sheets. This loan was made in 1968 or 1969 to Mr. Hartranft. The amount due on January 1, 1977 was $108,807.00 and as of December 31, 1982 was $76,630.00. DPW imputed interest on this loan and then offset the imputed interest against Petitioners expense claim for interest on capital indebtedness. This action reduced Petitioners reimbursement for interest from the Medical Assistance Program. No documentation in Petitioners accounting records exists, dating back to 1968, as to whether the loan was in cash or in kind.

Title XIX of the Federal Social Security Act, 42 U.S.C. §§1396-1396q, establishes the Medical Assistance Program (Program). By statute,2 Pennsylvania participates in this jointly financed program which provides reimbursement for nursing care services to individuals qualifying for Medical Assistance. Under the auspices of DPW, Pennsylvania has developed a State Plan for Medical Assistance as required by federal law.3 The Program provides cost-related reimbursement on behalf of eligible individuals whose institutional care for skilled nursing home or intermediate care in a licensed non-public facility is prescribed by a physician.4 The guidelines and procedures for reimbursement are detailed in the Manual for Allowable Cost Reimbursement For Skilled Nursing And Intermediate Care Facilities (MACR).5

[479]*479In order to be eligible for cost reimbursement, each nursing facility must file a “cost report” with DPW within ninety days of the close of each fiscal year. 55 Pa. Code §§1181.45(a)(3) and 1181.71. DPW then audits the cost report, 55 Pa. Code §1181.74 and, based upon the results, computes any adjustments to the reimbursement due the facility. The facility has the right to appeal any adjustment with which it is dissatisfied. See 55 Pa. Code §§1101.84 and 1181.101.

Our scope of review in a DPW decision is limited to determining whether the adjudication is supported by substantial evidence, is in accordance with the law and whether any constitutional rights were violated. The Jewish Home of Eastern Pennsylvania v. Department of Public Welfare, Office of Hearings and Appeals, 84 Pa. Commonwealth Ct. 637, 480 A.2d 1316 (1984).

Ground Rent

Petitioner appeals a DPW audit finding disallowing Petitioners reimbursement claim for rent paid to a trust which holds title to the land upon which its facility is situated.

Our review of the trust agreement leads us to the inescapable conclusion that the trust was an elaborate mechanism to provide support for Mrs. Hartranft upon divorce without cost to Mr. Hartranft and without relinquishing control over the property for which Petitioner claims rental reimbursement.

The express purpose of the trust, as declared on its face page, is to provide support for Mrs. Hartranft subsequent to their divorce. This was accomplished by having Mr. and Mrs. Hartranft create a trust and deed the ground upon which Petitioner is situated to that trust. The terms of the trust provide that Petitioner must lease this ground from the trust. In turn, the trust pays a monthly stipend to Mrs. Hartranft, provides a [480]*480place for her to live and provides for all of her medical expenses. The trust contains an elaborate formula, linked to the rise and fall of the Consumer Price Index, to determine the monthly stipend.

Further, Mr. Hartranft is attempting, via the trust, to gain reimbursement for support payments to his wife without relinquishing control over this ground. Clause ten of the trust allows Petitioner to direct the trustees to sell or mortgage the ground in question and amend the lease to conform thereto. As sole owner of all of Petitioners common stock, the actions of Mr. Hartranft are the actions of Petitioner.

The ground rent expenses claimed were $56,084 for 1980 and $13,000 each for 1979 and 1981. Petitioner does not assert that it rented the ground upon which it stands at any time prior to the Hartranfts divorce.

All costs must be necessary and reasonable to the proper care of Medical Assistance patients in order to be allowable. MACR III, 8 Pa.B. 2833. In an arms-length transaction, ground rent might well be considered a “necessary and reasonable” cost. However, the instant payments are merely a method to provide support for Mrs. Hartranft and to gain reimbursement for this cost of his divorce from DPW. Petitioner cannot seriously contend that these payments are the same as an arms-length transaction between an unrelated lessor and lessee. The Medical Assistance Program does not exist to fund creative divorce settlements. Mead Nursing Home v. Department of Public Welfare, 59 Pa. Commonwealth Ct. 539, 430 A.2d 379 (1981). (Cost of resolving dispute among owners is not related to patient care and is not allowable.) See also Pennsylvania Pharmaceutical Association v. Department of Public Welfare, 542 F. Supp 1349 (W.D. Pa. 1982). (Program to benefit recipients not providers.) Accordingly, DPWs disallowance of the ground rental expense is supported [481]*481by substantial evidence in the record and is in accordance with the law.6

Imputation of Interest to an Interest-Free Loan

As its second ground for appeal, Petitioner contends that its reimbursement for capital interest expense should not be reduced by investment income derived from imputing interest to an interest-free loan in the absence of a specific regulation so requiring.

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Bluebook (online)
513 A.2d 1097, 99 Pa. Commw. 475, 1986 Pa. Commw. LEXIS 2430, Counsel Stack Legal Research, https://law.counselstack.com/opinion/harston-hall-nursing-convalescent-home-inc-v-commonwealth-pacommwct-1986.