In re Certificate of Need Granted to the Harborage

693 A.2d 133, 300 N.J. Super. 363, 1997 N.J. Super. LEXIS 208
CourtNew Jersey Superior Court Appellate Division
DecidedMay 2, 1997
StatusPublished
Cited by16 cases

This text of 693 A.2d 133 (In re Certificate of Need Granted to the Harborage) 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
In re Certificate of Need Granted to the Harborage, 693 A.2d 133, 300 N.J. Super. 363, 1997 N.J. Super. LEXIS 208 (N.J. Ct. App. 1997).

Opinion

The opinion of the Court was delivered by

MICHELS, P.J.A.D.

Appellant Bergen Pines County Hospital (Bergen Pines) appeals from a final administrative action of respondent Deputy Commissioner of the Department of Health and Senior Services of the State of New Jersey1 that awarded a Certificate of Need (CON) to respondent The Harborage for the establishment of a thirteen long-term ventilator care bed unit at its facility in North Bergen, Hudson County, New Jersey, and denied Bergen Pines’ CON application for a similar thirteen-bed unit at its facility in Paramus, New Jersey.

I.

REGULATORY BACKGROUND

Pursuant to the Health Care Facilities Planning Act, N.J.S.A. 26.-2H-1 et seq. (the Act), and specifically N.J.S.A. 26:2H-7, no health care facility, including a hospital, may construct new facilities or expand an existing one or initiate a new health care service, unless a CON has been applied for by the facility and been granted by the State Commissioner of Health (Commissioner). See also N.J.A.C. 8:33-3.1.2 The award of the CON is governed by N.J.S.A. 26:2H-8, which, in pertinent part, provides:

[368]*368No certificate of need shall he issued unless the action proposed in the application for such certificate is necessary to provide required health care in the area to be served, can be economically accomplished and maintained, will not have an adverse economic or financial impact on the delivery of health care services in the region or Statewide, and will contribute to the orderly development of adequate and effective health care services. In making such determinations there shall be taken into consideration (a) the availability of facilities or services which may serve as alternatives or substitutes, (b) the need for special equipment and services in the area, (c) the possible economies and improvement in services to be anticipated from the operation of joint central services, (d) the adequacy of financial resources and sources of present and future revenues, (e) the availability of sufficient manpower in the several professional disciplines, and (f) such other factors as may be established by regulation. The State Health Plan may also be considered in determining whether to approve a certificate of need application.

CON applications are submitted to the State Department of Health and Senior Services (Department) for its consideration. N.J.S.A. 26:2H-10. However, an application to provide a particular health care service cannot be submitted until the Department issues a “call,” in the New Jersey Register, inviting the submission of CON applications for that specific service. N.J.A.C. 8:33-4.1(a) and (b). Once a call is issued and a CON application received, the Department determines if the application is complete and meets specific criteria. N.JAC. 8:33-4.5; N.J.A.C. 8:33-4.9; N.J.A.C. 8:33-4.10. Once deemed complete, the application is forwarded for review to the Local Advisory Board (LAB) with jurisdiction over the geographic area in which the applicant is located. N.J.S.A. 26:2H-5.9b; N.J.S.A. 26:2H-10; N.J.A.C. 8:33-4.1; N.J.A.C. 8:33-4.12. The LAB is authorized to review, in light of applicable health planning regulations, CON applications for any proposed project in its geographic region and to make recommendations regarding those applications to the Commissioner. N.J.S.A. 26:2H-5.9b; N.J.A.C. 8:33-4.12(b).

Health planning regulations pertinent to this appeal, which involves the provision for adult ventilator beds, a specialized form of long-term care service, N.J.A.C. 8:33H-1.7(a)l, are codified at N.J.A.C. 8:33H-1.1 to N.J.A.C. 8.-33H-1.20 of the New Jersey [369]*369Administrative Code. If twenty-five percent or more of the quorum of voting members of a LAB vote to approve an application, regardless of whether the LAB’s overall recommendation is to approve or deny the application, it is forwarded to the State Health Planning Board (SHPB), which was established within the Department by N.J.S.A 26:2H-5.7, for review. N.J.S.A. 26:2H-10.1a(l); N.J.A.C. 8:33-4.1; N.J.A.C. 8:33-4.14(a). If twenty-five percent of a quorum of voting members at the SHPB vote to approve the application, the application is forwarded to the Commissioner for consideration, regardless of whether the SHPB’s overall recommendation is to deny or approve the application. If less than twenty-five percent approve the application, it is not submitted to the Commissioner. N.J.S.A. 26:2H-10.1a(2); N.J.A.C. 8:33-4.14(b).

An applicant whose application is denied by the SHPB may seek a hearing conducted by the Office of Administrative Law (OAL). N.J.S.A. 26:2H-10.1b; N.J.A.C. 8:33-4.14(c). If the Administrative Law Judge (ALJ) decides that the application was wrongly denied by the SHPB, the application proceeds to the Commissioner for final review. N.JAC. 8:33-4.14(c). The ALJ’s decision in this respect is deemed a final agency decision, subject to appeal directly to this court. N.JAC. 8:33-4.14(c)3; R. 2:2-3(a)(2). The Commissioner reviews the application, whether forwarded by the SHPB or as directed by an ALJ, based on relevant statutory and regulatory criteria and determines whether or not to approve it. N.J.S.A. 26:2H-9; N.J.A.C. 8:33-4.15.

Finally, an applicant whose application is ultimately denied by the Commissioner may file an appeal with the Health Care Administration Board, created pursuant to N.J.S.A. 26:211-4. This appeal will be heard by the OAL. N.J.SA 26:2H-9; N.J.A.C. 8:33-4.15(b). The Health Care Administration Board’s decision to deny a CON is a final agency decision, subject to direct appeal to this court, R. 2:2 — 3(a)(2); N.J.A.C. 8:33-4.15(e), as is the Commissioner’s decision to grant a CON to a competing applicant.

[370]*370II.

THE DEPARTMENT’S CALL AND THE COMPETING APPLICATIONS

On December 6, 1993, the Department issued a call inviting the submission of CON applications for ventilator beds for adult patients. 25 N.J.R. 5704(b) (December 6, 1993). The call specifically noted that thirteen additional ventilator beds were needed in the region administered by LAB II, covering Hudson and Bergen Counties, the relevant geographic area involved in this appeal. In response to the call, Bergen Pines, a county-owned, 1185-bed teaching hospital located in Paramus, New Jersey, submitted an application to convert thirteen of its long-term care beds to thirteen ventilator beds. Bergen Pines proposed to locate the ventilator beds in its long-term care facility next to twelve ventilator beds for which Bergen Pines had applied and received a CON in 1989. At the time of the submission of the application, the previously approved CON for the twelve-bed ventilator unit had not been implemented due to incomplete negotiations with Medicaid. However, we were advised at oral argument that while this appeal was pending, the CON awarded to Bergen Pines for the twelve-bed unit was implemented. Bergen Pines envisioned the proposed twenty-five-bed unit as a subsection of the existing long-term care unit, serving ventilator-dependent patients who require a mechanical respiratory device in order to sustain their lives.

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Bluebook (online)
693 A.2d 133, 300 N.J. Super. 363, 1997 N.J. Super. LEXIS 208, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-certificate-of-need-granted-to-the-harborage-njsuperctappdiv-1997.