Helene Fuld Medical Center v. New Jersey Department of Health & Senior Services

739 A.2d 962, 325 N.J. Super. 423, 1999 N.J. Super. LEXIS 355
CourtNew Jersey Superior Court Appellate Division
DecidedNovember 8, 1999
StatusPublished

This text of 739 A.2d 962 (Helene Fuld Medical Center v. New Jersey Department of Health & Senior Services) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Helene Fuld Medical Center v. New Jersey Department of Health & Senior Services, 739 A.2d 962, 325 N.J. Super. 423, 1999 N.J. Super. LEXIS 355 (N.J. Ct. App. 1999).

Opinion

The opinion was of the court was delivered by

LANDAU, J.AD.

In these consolidated appeals, Helene Fuld Medical Center (Fuld) challenges a final determination by the Department of Health and Senior Services (Department), to the extent that it granted a Certificate of Need (CN) authorizing conversion of five open psychiatric beds1 at respondent St. Francis Hospital (St. Francis), Trenton, to closed psychiatric beds servicing Mercer County, while allowing Fuld to convert only six of the eleven open beds it sought to be converted to closed status for Mercer County2.

The Factual and Regulatory Background

Pursuant to N.J.A.C. 8:33-4.1(a), the Department issued a call on May 2, 1994, published at 26 N.J.R. 1887, inviting proposals from acute care hospitals for a CN to convert underutilized beds to a category that would result in “bed increases” within the same hospital facility. The call was limited to several categories, including “acute psychiatric,” and required that hospitals making a proposal must be currently licensed for the category and that the total number of beds for which the hospital was licensed may not be increased by reason of the proposed conversion. Underlying this call were statistical studies issued October 1 and November 9, 1993, (later revised September 8, 1994 and November 10, 1994) in which, as relevant to these appeals, the Department identified a surplus of open psychiatric beds totaling 74 in Mercer County, six in Hunterdon County and nine in Somerset County, while listing as unmet, the need for eleven closed beds in Mercer, one in Hunterdon, and five in Somerset.

[426]*426At the time the parties responded to the 1994 call, Fuld had 24 open psychiatric beds, with a 73 percent occupancy rate and four closed psychiatric beds. St. Francis had twenty-four open psychiatric beds operating at 41.77 percent occupancy, and no closed beds. N.J.AC. 8:33A-1.9 establishes 70 percent as the appropriate minimum occupancy rate for hospital psychiatric services.

Fuld applied to convert enough open beds to satisfy the entire unmet eleven closed bed need for Mercer County. It also applied to convert a bed to meet the one closed bed need in Hunterdon. St. Francis sought five of the closed Mercer County beds, and also asked to convert five beds in Somerset County to closed status, and for an additional bed to serve as a “back-up” in Hunterdon County.

Consistent with N.J.AC. 8:33, the requests were submitted to the respective Mental Health Boards of the affected counties, and thereafter to the Local Advisory Board for Region IV (LAB IV).

On January 5, 1995, the Hunterdon County Mental Health Board considered the applications of St. Francis and Fuld with regard to the conversion of one bed. It decided to recommend the Fuld application.

On March 16, 1995, the applications of St. Francis and Fuld were considered by the Mercer County Health Board. The Mercer Board responded with a qualified endorsement of the Fuld request and an endorsement of the St. Francis request. It said, “[s]ince both proposals are in competition over a five(5) bed portion of a total requested conversion of eleven (11) such beds, these endorsements include the Board’s explicit recommendation to [Helene Fuld] that it reduce its request for conversion of eleven (11) beds to six (6) to remain within the planned bed need____”

On March 22, 1995, after reviewing the St. Francis application, the Somerset County Board recommended that St. Francis be permitted to convert to closed use, the five beds it sought in Somerset County.

[427]*427Local Advisory Board IV voted unanimously to recommend the approval for conversion by St. Francis of live open beds to closed beds in Mercer County, as well as for a similar conversion of five beds to serve Somerset County. It also voted to recommend converting six open beds to closed beds at Fuld for Mercer County plus an additional bed for Hunterdon County. It cited as reasons: (1) opportunity for patient choice; (2) conversion of open beds to closed beds in St. Francis will raise the low occupancy rates of open beds at St. Francis; (3) the rate of admissions to State hospitals such as Trenton State Psychiatric Hospital will decrease as a result of additional closed beds (this is especially important with the proposed closing of Marlboro Hospital); (4) the closing of open beds at Fuld will raise the occupancy rates at St. Francis; (5) the recommendation of the Mercer County Mental Health Board, Somerset County Health Board and Hunterdon County Mental Health Board; and (6) St. Francis and Fuld both satisfied the criteria of N.J. AC. 8:33 and 8:33R.

These actions were concurred in by the Department of Human Services, which also appears to have recognized that granting Fuld’s request to convert eleven beds to closed bed status would, based upon then current utilization rates at that facility, exhaust or exceed its open acute capacity.

The State Health Planning Board further provided, consistent with N.J.S.A. 26:2H-10.1(a)(l) (repealed 1998) and N.J AC. 8:33-4.14, independent consideration to the Fuld and St. Francis CN requests. After appropriate review, the recommendations made by Local Advisory Board IV were adopted and the CN application forwarded to Commissioner Fishman for Departmental action.

By letter dated August 3,1995, the Commissioner granted a CN to St. Francis to convert five adult open beds to closed acute psychiatric beds for Mercer County and five adult open beds to closed acute psychiatric beds for Somerset County needs. Simultaneously, the Commissioner granted leave to Fuld to convert six [428]*428Mercer adult open psychiatric beds to adult closed beds, and to convert one bed to closed status for Hunterdon.

The Commissioner observed that:

permitting Helene Fuld to convert the entire need capacity of Mercer County, eleven (11) beds from open psychiatric beds to closed beds, would result in an occupancy rate in excess of one hundred (100%) percent for its remaining adult open bed capacity; the excess capacity will “creat[e] a potential unavailability of needed adult open acute psychiatric services in Helene Fuld’s service area”; permitting St. Francis to convert five (5) beds from open psychiatric to closed psychiatric beds will result in the laudable goal of “improved patient choice in Mercer County”; and that the CN granted would increase St. Francis’ open bed psychiatric services occupancy to more than ninety (90%) percent, thus “promoting a more efficient and effective delivery of the full range of adult acute psychiatric services at St. Francis.”

As noted here in fn. 2, supra, Fuld appealed the St. Francis grant directly to this court and appealed through the Office of Administrative Law the denial of part of its Mercer County request. The Administrative Law Judge’s initial decision recommended affirmance of the Commissioner’s ruling. That decision was in turn affirmed, following argument, by the then-authorized final decision maker, the Health Care Administrative Board. Its decision was appealed to this court, where the two related matters were consolidated.

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739 A.2d 962, 325 N.J. Super. 423, 1999 N.J. Super. LEXIS 355, Counsel Stack Legal Research, https://law.counselstack.com/opinion/helene-fuld-medical-center-v-new-jersey-department-of-health-senior-njsuperctappdiv-1999.