Lombardi Rest Home, Inc. v. Richter

778 A.2d 230, 63 Conn. App. 646, 2001 Conn. App. LEXIS 284
CourtConnecticut Appellate Court
DecidedJune 5, 2001
DocketAC 19650
StatusPublished
Cited by4 cases

This text of 778 A.2d 230 (Lombardi Rest Home, Inc. v. Richter) is published on Counsel Stack Legal Research, covering Connecticut Appellate Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lombardi Rest Home, Inc. v. Richter, 778 A.2d 230, 63 Conn. App. 646, 2001 Conn. App. LEXIS 284 (Colo. Ct. App. 2001).

Opinion

[648]*648 Opinion

LAVERY, C. J.

The plaintiffs, Lombardi Rest Home, Inc., and Rose Lombardi, appeal from the summary judgment rendered in favor of the defendants, Gary Richter and Maria Ludena. On appeal, the plaintiffs claim that the trial court improperly granted summary judgment on the basis of their failure to allege an injury and, thus, to state a cause of action. We disagree and affirm the judgment of the trial court.

The record discloses the following facts. Lombardi Rest Home, Inc., is licensed by the department of public health as a home for the aged pursuant to General Statutes § 17a-227. Rose Lombardi, is the owner of Lombardi Rest Home, Inc. The defendants are employees of the department of social services (department). Richter is the director of the certificate of need and rate setting unit, and Ludena is a cost analyst in that unit. The plaintiffs brought this action against the defendants in their individual capacities.

In the complaint, the plaintiffs alleged that they had a property right to receive monthly payments from the department of income maintenance1 for the care of certain patients. The method statutorily prescribed for determining a reimbursement rate is cost based. Those amounts are determined by the provisions of General Statutes (Rev. to 1993) § 17-314 (a), now 17b-340 (a), and in the regulations of the department. See Regs., Conn. State Agencies § 17-311-50 et seq.

The plaintiffs also alleged that they were denied their rights of access to the courts and to petition the government for redress of grievances in violation of the first amendment to the United States constitution when Ludena informed them that they would be paid some [649]*649of the money allegedly owed to them only if they waived in writing their appeal rights related to the methods applied in computing rates for the facility. The plaintiffs refused to waive those rights.

The defendants’ answer denied the material allegations of the complaint and raised several affirmative defenses, including that they were entitled to qualified immunity and therefore were immune from liability for civil damages. On April 16, 1999, the defendants filed a motion for summary judgment, claiming that there was no genuine issue of fact that the plaintiffs had failed to state a cause of action for denial of their right of access to the courts under the first amendment and that, in addition, the defendants were entitled to qualified immunity. The court granted the motion for summary judgment and, in response to the plaintiffs’ motion for articulation, issued a memorandum of decision on June 28, 1999. In its memorandum, the court held that the plaintiffs had failed to state a claim for violations of their first amendment rights. The court did not reach the defendants’ claim of qualified immunity. On appeal, the defendants reassert that claim.

Pursuant to § 17-314 (a), now 17b-340 (a), the department is required to establish per diem rates at which long-term care facilities are reimbursed for reasonable costs in providing room and board to their residents who qualify for assistance under a state supplementation program.2 Facilities must annually submit audited consolidated operating reports. Regs., Conn. State Agencies § 17-311-50. Those cost reports are received by department personnel who apply the provisions of [650]*650the statutes and regulations to determine each facility’s rate of reimbursement for qualified clients. See General Statutes (Rev. to 1993) § 17-314 (a), now 17b-340 (a). The rates are determined prospectively and are based on the allowable costs as contained in the facility’s cost report.3

The reimbursement system under § 17-311-55 of the regulations makes provisions for establishing “interim rates” when a facility changes ownership or has a significant change in licensed bed capacity. Regs., Conn. State Agencies § 17-311-55. An interim rate is a temporary, estimated rate that is replaced when the facility files its required annual cost report at the scheduled time. If a facility fails to file a timely cost report after interim rates have been issued, the department’s regulations also provide for a reduction in the facility’s reimbursement rate to the lowest rate issued to a comparable facility within the same level of care until a late cost report is filed. Regs., Conn. State Agencies, § 17-311-50. General Statutes (Rev. to 1993) § 17-311 (b), now 17b-238 (b), provides for an administrative hearing process if a facility is aggrieved by a department decision in the rate setting process. If a facility is still aggrieved after the hearing, the statute provides that the facility may submit the issues to a three member arbitration panel. Section 17-311 (b), now 17b-238 (b), requires that an aggrieved facility initiate the hearing process within ten days after written notice of the rates established by the commissioner of the department of social services.

On May 3,1993, the plaintiffs submitted to the defendants an application for the setting of the amount of the monthly payments. On the basis of that submission, the defendants determined that the plaintiffs would receive $65 per patient per day for the period of Febru[651]*651ary 11, 1993, through June 30, 1993, and $60 per patient per day for the period of July 1, 1993, through June 30, 1994. Pursuant to § 17-311-55 of the department’s regulations, the department could adjust those rates and issue a replacement rate when the facility filed a report showing actual costs.

The plaintiffs did not timely file a 1993 annual cost report showing actual costs. Consequently, the department did not issue a replacement rate for the period February 11, 1993, through June 30, 1994, until July 27, 1995. The replacement rate of $60 was replaced with a rate set at $55.65 per day in a rate letter issued August 7, 1995. The plaintiffs did not appeal to challenge the replacement rates issued on July 27, 1995, and August 7, 1995. The replacement rates were adjusted so that the department was reimbursed by the amount overpaid to Lombardi Rest Home, Inc., because of the interim rates.

The accountant for Lombardi Rest Home, Inc., Donald Siclari, arranged to meet with the department to discuss the replacement rates and amounts owed. Siclari, along with an attorney for Lombardi Rest Home, Inc., met with the defendants on September 19, 1995. The parties agreed on a rate of $58.71 per patient per day for the period of July 1, 1993, through June 30, 1994. On October 3, 1995, Ludena sent to the plaintiffs the department’s standard letter memorializing the agreed upon rates, which also contained a “waiver of appeal rights.” Specifically, the letter informed the plaintiffs that payment would be made if the plaintiffs would waive their appeal rights related to the methods applied in computing rates for the facility for rate periods preceding June 30, 1994. The plaintiffs did not return or respond to the letter.

The plaintiffs brought this action under 42 U.S.C. § 19834 against the defendants in June, 1996. The court [652]*652dismissed the plaintiffs’ action because of insufficient service of process. The plaintiffs then refiled the action.

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Cite This Page — Counsel Stack

Bluebook (online)
778 A.2d 230, 63 Conn. App. 646, 2001 Conn. App. LEXIS 284, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lombardi-rest-home-inc-v-richter-connappct-2001.