Kirk v. Norton County Hospital

CourtDistrict Court, D. Kansas
DecidedFebruary 4, 2025
Docket2:24-cv-02405
StatusUnknown

This text of Kirk v. Norton County Hospital (Kirk v. Norton County Hospital) is published on Counsel Stack Legal Research, covering District Court, D. Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kirk v. Norton County Hospital, (D. Kan. 2025).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF KANSAS

BRIAN KIRK, ) ) Plaintiff, ) CIVIL ACTION ) v. ) No. 24-2405-KHV ) NORTON COUNTY HOSPITAL, ) ) Defendant. ) ____________________________________________)

MEMORANDUM AND ORDER

On September 6, 2024, plaintiff filed suit against his former employer, Norton County Hospital. Plaintiff asserts that in violation of the False Claims Act, 31 U.S.C. § 3729 et seq. (Count I), the Kansas False Claims Act, K.S.A. § 75-7501 et seq. (Count II) and Kansas common law (Count III), defendant terminated his employment in retaliation for reporting potential violations of federal and state law. See Complaint (Doc. #1). This matter is before the Court on Defendant’s Motion To Dismiss (Doc. #7) filed November 6, 2024. For reasons stated below, the Court sustains defendant’s motion in part and overrules it in part. Legal Standard In ruling on a motion to dismiss for failure to state a claim under Rule 12(b)(6), Fed. R. Civ. P., the Court assumes as true all well-pleaded factual allegations and determines whether they plausibly give rise to an entitlement to relief. Ashcroft v. Iqbal, 556 U.S. 662, 679 (2009). To survive a motion to dismiss, a complaint must contain sufficient factual matter to state a claim which is plausible—and not merely conceivable—on its face. Id. at 679–80; Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007). In determining whether a complaint states a plausible claim for relief, the Court draws on its judicial experience and common sense. Iqbal, 556 U.S. at 679. The Court need not accept as true those allegations which state only legal conclusions. See id. Plaintiff bears the burden of framing his claims with enough factual matter to suggest that he is entitled to relief; it is not enough to make threadbare recitals of a cause of action accompanied by conclusory statements. See Twombly, 550 U.S. at 556. Plaintiff makes a facially plausible claim by pleading factual content from which the Court can reasonably infer that defendant is

liable for the alleged misconduct. Iqbal, 556 U.S. at 678. Plaintiff must show more than a sheer possibility that defendant has acted unlawfully—it is not enough to plead facts that are “merely consistent” with defendant’s liability. Id. (quoting Twombly, 550 U.S. at 557). A pleading which offers labels and conclusions, a formulaic recitation of the elements of a cause of action or naked assertions devoid of further factual enhancement will not stand. Id. Similarly, where the well- pleaded facts do not permit the Court to infer more than the mere possibility of misconduct, the pleading has alleged—but has not “shown”—that the pleader is entitled to relief. Id. at 679. The degree of specificity necessary to establish plausibility and fair notice depends on context, because what constitutes fair notice under Rule 8(a)(2), Fed. R. Civ. P., depends on the type of case.

Robbins v. Oklahoma, 519 F.3d 1242, 1248 (10th Cir. 2008). In evaluating a motion to dismiss under Rule 12(b)(6), the Court can consider not only the complaint, but also exhibits and documents which the complaint attaches and incorporates by reference. Smith v. United States, 561 F.3d 1090, 1098 (10th Cir. 2009). Factual Background Highly summarized, plaintiff’s complaint alleges as follows: Defendant is a “Critical Access Hospital,” providing a full range of medical services to patients in Norton County, Kansas and surrounding northwest Kansas and southwest Nebraska communities.1 I. Defendant’s Financial Situation In September of 2021, defendant appointed plaintiff its Chief Executive Officer (“CEO”). When defendant hired plaintiff, it was in a dire financial situation. Defendant tasked plaintiff with significant responsibilities to curtail financial spending, including to stop the hemorrhage of

defendant’s cash. Plaintiff immediately implemented cost-reduction efforts, including changes to nursing staff ratios and eliminating non-essential positions. Between October of 2021 and April of 2022, plaintiff made substantial improvements to defendant’s financial situation. For those eight months, the Norton County Hospital Board of Trustees held plaintiff in high esteem and awarded him consistently high performance reviews.2 By April of 2022, plaintiff had discovered serious problems with defendant’s staffing and compensation agreements. First, defendant was extremely overstaffed for the number of patients.3 For example, by the end of June 30, 2022, defendant reported 10,381 medical clinic patients. Two doctors and one mid-level practitioner could have adequately treated this number of patients, but

defendant had five doctors and two mid-level practitioners doing so. Second, plaintiff identified three physicians—Dr. Joshua Gaede, Dr. Miranda McKellar and Dr. Theresia Neill—whom defendant was paying above fair market value, despite the low number of patients they saw.

1 “Critical Access Hospital” is a designation by the Centers for Medicare & Medicaid Services to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities.

2 The Board governs defendant’s staff, including its active medical staff, administrators, departmental supervisors and other employees.

3 As a Critical Access Hospital, defendant had to maintain certain staffing standards in three primary areas: the medical clinic, hospital inpatients and the emergency room. Plaintiff does not allege the exact number—or ratio—of doctors that it needed to be compliant with its designation. Defendant paid Dr. Gaede a salary of $513,000 for his first year of employment and then $415,000 per year. Defendant paid Dr. McKellar and Dr. Neill $415,000 per year. According to a 2022 physician compensation salary survey by the Kansas Hospital Association, Drs. Gaede, McKellar and Neill were the highest paid rural doctors in Kansas. Plaintiff was concerned that the overstaffing and overpayments to physicians contributed

to losses for the hospital, and that the three physicians were not fulfilling their obligation to meet the work relative value units set by their employment agreements.4 Plaintiff learned that these three doctors were not working full time and only saw eight to ten patients per day, working less than 1,000 hours a year. II. Plaintiff’s Reports Plaintiff’s licenses and duties as CEO required him to maintain hospital compliance with all federal and state rules and regulations. Because defendant provides services to Medicare beneficiaries, it must operate and furnish services in compliance with applicable laws, including the Physician Self-Referral statute (commonly referred to as the Stark Law, 42 U.S.C. § 1395nn).5

Plaintiff concluded that the compensation rates for the three physicians were not determined based on services performed and potentially violated the Stark Law, thus also implicating the False

4 A work relative value unit is a standard unit of measurement used to establish value for common health care procedures.

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Kirk v. Norton County Hospital, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kirk-v-norton-county-hospital-ksd-2025.