Huntsville Senior Services, LLC v. Alabama Department of Public Health

CourtDistrict Court, N.D. Alabama
DecidedDecember 13, 2022
Docket3:22-cv-01347
StatusUnknown

This text of Huntsville Senior Services, LLC v. Alabama Department of Public Health (Huntsville Senior Services, LLC v. Alabama Department of Public Health) is published on Counsel Stack Legal Research, covering District Court, N.D. Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Huntsville Senior Services, LLC v. Alabama Department of Public Health, (N.D. Ala. 2022).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ALABAMA NORTHWESTERN DIVISION

HUNTSVILLE SENIOR § SERVICES d/b/a REGENCY § RETIREMENT VILLAGE OF § HUNTSVILLE, § § Case No.: 3:22-cv-1347-LCB Plaintiff, § § v. § § ALABAMA DEPARTMENT OF § PUBLIC HEALTH and SCOTT § HARRIS, § § Defendants. §

OPINION & ORDER Regency Retirement Village of Huntsville filed this action on October 20, 2022, naming as defendants the Alabama Department of Public Health and State Health Officer Scott Harris, M.D., in his official capacity. In its Original Complaint (Doc. 1), Regency sought declaratory relief (Count I) and a preliminary injunction (Count II). After a hearing on the injunction request, Defendants filed a Rule 12(b)(1) motion to dismiss (Doc. 17), contending that Regency’s Original Complaint, even construed in the light most favorable to Regency, failed to state a claim upon which this Court could find grounds for exercising jurisdiction pursuant to 28 U.S.C. § 1331. Regency subsequently filed its Amended Complaint (Doc. 19) and, for the first time, added a § 1983 claim (Count III) for violation of the Fourteenth Amendment’s Due Process Clause.

Incorporating by reference the arguments set forth in their 12(b)(1) motion to dismiss (Doc. 17), Defendants filed an Amended Motion (Doc. 22) in response to the Amended Complaint. They maintain that Counts I and II are due to be dismissed

for want of jurisdiction and additionally contend that Count III fails to state a claim upon which relief can be plausibly granted, likewise necessitating dismissal under the Rule 12(b)(6) standard.1 For the reasons set forth in greater detail below, the Court DISMISSES

Counts I and II without prejudice and DISMISSES Count III with prejudice. I. BACKGROUND In light of this case’s present posture, the Court accepts as true all well-

pleaded facts in Regency’s Amended Complaint (Doc. 19) and construes any genuine factual disputes in Regency’s favor. The forthcoming overview thus derives its contents solely from Regency’s recitation of the facts underlying this dispute. Regency leases and operates a facility offering senior citizens “a continuum

of care” ranging from “independent living” (“IL”) to various forms of “assisted living.” (Doc. 19 at 1–2.) Assisted living facilities (“ALFs”) and ILs are different in

1 The Court has given due consideration to Plaintiff’s Response (Doc. 23). an important way: Under Alabama law, an ALF is a “hospital”; an IL is not.2 And that distinction is, naturally, more than merely nominal. Of the two types, only ALFs

require licensure.3 Regency’s ALF and IL units are also distinct in that Regency neither provides nor otherwise offers any hospice care or assistance with daily living activities

(“ADL”) to its IL tenants, who instead contract with third-party providers to which Regency has no legal connection. (Doc. 19 at 2, 8–9.) In fact, this entire dispute revolves around the separation (or lack thereof) between Regency and the provision of those services. To summarize, Regency claims that its IL facility is “functionally

and legally the same as any other privately-owned multifamily residential apartment community,”4 while the Department contends that Regency IL is but a thinly veiled ALF for which Regency is without the requisite licensure and at which the provision

of licensed hospice services is accordingly unlawful under § 22-21-33 of the Alabama Code. Section 22-21-33 both prohibits the provision of licensed care at any unlicensed “hospital” and provides for the Department’s enforcement in Alabama

circuit court. The statute reads, in relevant part, as follows:

2 See ALA. CODE § 22-21-20. To be clear, though the statutory definition of “hospital” expressly includes ALFs but not ILs, the list of facilities is non-exhaustive and does not expressly exclude ILs from its scope. Id. But even assuming (without deciding) that Regency IL is not a hospital, dismissal of this suit remains the Court’s only option for the reasons discussed infra Section III. 3 ALA. CODE § 22-21-33; see also note 2, supra. 4 (Doc. 19 at 7.) Any . . . entity who operates or causes to be operated a hospital of any kind as defined in [§ 22-21-20] . . . without having been granted a license by the State Board of Health shall be guilty of a Class B misdemeanor upon conviction . . . . The State Board of Health, upon determination that a facility or business is operating as a hospital, within the meaning of this article or any rules promulgated hereunder, and that the facility or business does not have a current and valid license granted by the State Board of Health, may apply to the circuit court of the county in which the unlicensed facility or business is located for declaratory and injunctive relief. The proceedings shall be expedited. The sole evidentiary questions before the court in a proceeding shall be whether the facility or business that is the subject of the action meets the definition of a hospital, within the meaning of this article and any rules promulgated hereunder, and whether the facility or business has been granted a current and valid license to operate by the State Board of Health. If the State Board of Health prevails on these questions, then the court, upon request of the State Board of Health, shall grant declaratory and injunctive relief requiring the operator or operators to close the facility or business and requiring the operator or operators to move all residents or patients to appropriate placements. Any individual failing to obey an injunction to close a hospital shall be guilty of a Class A misdemeanor. . . . A licensed hospice or certified home health agency acting through an authorized agent of the licensed hospice or certified home health agency shall not knowingly provide treatment or services in an unlicensed hospital to a person who is in need of care rendered by a licensed hospital.

ALA. CODE § 22-21-33(a)(1)–(2), (b)(1). In sum, enforcement proceedings under § 22-21-33 are expedited, and they present for the circuit court’s resolution one evidentiary question: whether the facility at issue is a “hospital” (and, if so, whether the hospital possesses the requisite state licensure). Id. The Department’s enforcement of that statute is what Regency seeks to proactively enjoin by way of this federal court’s entry of declaratory and injunctive relief—at bottom, the reason Regency has appeared before this Court is to prevent state-court enforcement proceedings under § 22-21-33.

In factual terms, the parties’ dispute was born when the Department issued a “Statement of Deficiencies and Plan of Correction” to a pair of its licensed hospices (“the Hospice Providers”), in which “the Department declared that the licensed

Hospice Providers’ contracts for services with [Regency IL] residents constitute unlawful delivery of licensed services in an ‘unlicensed facility’” in violation of Alabama Code § 22-21-33. (Doc. 19 at 9.) As mentioned previously, Regency takes issue with that declaration, alleging that because it provides no healthcare services

to its IL residents, the IL facility is not a “hospital” under Alabama Code § 22-21- 20 and thus is not subject to enforcement of § 22-21-33’s licensure requirement. The Department has initiated licensure actions against the Hospice Providers

(Doc. 19 at 12) as a result of its determination that Regency is operating in violation of § 22-21-33, and the Hospice Providers have “notified [IL] residents of the providers’ intent to cease delivery of hospice services to those residents because of the actions of the Department,” (Doc. 19 at 18–19). Regency also alleges that “the

Department’s deci[sion] to label Regency an ‘unlicensed facility’ . . .

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