Presbyterian-Orthopaedic Hospital v. North Carolina Department of Human Resources

470 S.E.2d 831, 122 N.C. App. 529, 1996 N.C. App. LEXIS 460
CourtCourt of Appeals of North Carolina
DecidedJune 4, 1996
DocketCOA94-1358
StatusPublished
Cited by11 cases

This text of 470 S.E.2d 831 (Presbyterian-Orthopaedic Hospital v. North Carolina Department of Human Resources) is published on Counsel Stack Legal Research, covering Court of Appeals of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Presbyterian-Orthopaedic Hospital v. North Carolina Department of Human Resources, 470 S.E.2d 831, 122 N.C. App. 529, 1996 N.C. App. LEXIS 460 (N.C. Ct. App. 1996).

Opinion

*533 EAGLES, Judge.

I.

Our review of final agency decisions is governed by G.S. 150B-51(b). Pursuant to G.S. 150B-51(b):

[T]he court reviewing a final decision [of an administrative agency] may affirm the decision of the agency or remand the case for further proceedings. It may also reverse or modify the agency’s decision if the substantial rights of the petitioners may have been prejudiced because the agency’s findings, inferences, conclusions, or decisions are:
(1) In violation of constitutional provisions;
(2) In excess of the statutory authority or jurisdiction of the agency;
(3) Made upon unlawful procedure;
(4) Affected by other error of law;
(5) Unsupported by substantial evidence admissible under G.S.150(b)-29(a), 150B-30, or 150B-31 in view of the entire record as submitted; or
(6) Arbitrary or capricious.

Here, Presbyterian argues that the AU in his recommended decision and the Director of the Division of Facility Services in his final agency decision erred in determining that Presbyterian should be denied a certificate of need. Presbyterian argues that there are genuine issues of material fact regarding: (1) the utility of Presbyterian’s proposal for new. construction versus conversion of underutilized existing space and (2) the adequacy of staffing proposed for Presbyterian’s project. We first address the construction issue.

In its recommended decision, the AU found that Presbyterian’s application failed to demonstrate why its proposal for new construction was more cost-efficient than conversion of existing underutilized space. At the time of Presbyterian’s application, the State Medical Facilities Plan provided that “[Conversion of underutilized hospital space to other needed purposes shall be considered to be more cost-efficient than new construction, unless shown otherwise.” N.C. Admin. Code. tit. 10, r. 3R.3050(a)(2) (Jan. 1993). Based on this language, the AU determined that if a hospital had underutilized space, *534 yet it proposed new construction, the hospital was required to justify the new construction. Based on the utilization targets in place at the time of Presbyterian’s application, the AU determined that the target occupancy rate for Presbyterian was 75% but that Presbyterian’s “occupancy was no more than 18% in the 12 months preceding the review and no more than 31% since 1989.” Having concluded from its statistics that Presbyterian had underutilized space, the AU determined that Presbyterian was required to show that its new construction was more cost-efficient than conversion of existing space and that Presbyterian had failed to justify its proposal for new construction in its application.

An application for a certificate of need for a proposed project must comply with “applicable policies and need determinations in the State Medical Facilities Plan.” G.S. 131E-183(a)(l). The application also must comply with the review criteria set out in G.S. 131E-183(a). G.S. 131E-183(a)(12) provides in part that “[applications involving construction shall demonstrate that the cost, design, and means of construction proposed represent the most reasonable alternative.” The AU granted summary judgment, concluding that Presbyterian had also failed to present any evidence that would create a genuine issue of material fact as to Presbyterian’s conformity with these criteria.

Summary judgment is only appropriate when no genuine issues of material fact exist. G.S. 1A-1, Rule 56(c). Here, Presbyterian presented the deposition testimony of Richard E. Salerno, Administrator and CEO of Presbyterian. Mr. Salerno testified that Presbyterian was not able to structure the rehabilitation unit within existing space without new construction because all of the space in the hospital was dedicated to other health care purposes and moving weight-bearing walls prohibited construction in existing space. Mr. Salerno also testified that the new construction would better meet patient needs. This deposition testimony creates a genuine issue of material fact as to whether Presbyterian showed that its proposal for new construction was the most reasonable alternative for developing its rehabilitation unit.

We note, however, that an application must comply with all review criteria. Accordingly, we must now determine whether a genuine issue of material fact exists regarding the adequacy of staffing for Presbyterian’s proposed project. In its recommended decision, the AU found that Presbyterian’s application failed to show that its pro *535 posed staffing for the rehabilitation unit conformed to applicable criteria. To operate a rehabilitation facility in North Carolina and to satisfy the review criteria of G.S. 131E-183(a), including G.S. 131E-183(a)(5) and G.S. 131E-183(a)(7), Presbyterian had to show that it would dedicate sufficient staff to provide three hours of therapy per patient per day in the rehabilitation unit. The AU found that Presbyterian’s application only showed that there would be sufficient staff to provide 1.27 hours of therapy per patient per day. Presbyterian argues that it presented a forecast of evidence which demonstrated that its proposed staff would be able to provide 3.2 hours of therapy per patient per day. However, several witnesses for Presbyterian testified conceding that Presbyterian’s application did not demonstrate on its face that it could provide three hours per patient per day. Presbyterian’s completed and filed application failed to show that Presbyterian intended to combine therapists from its acute care unit and the proposed rehabilitation unit to reach the required hours of therapy, in effect “pooling” resources. After careful review of the record, we agree with the AU and the final agency decision that Presbyterian’s application fails to show that it satisfies the mandatory staffing criteria. Accordingly, we conclude that the AU did not err in recommending summary judgment against Presbyterian and that the Director of the Division of Facility Services did not err in the final agency decision by concluding as a matter of law that Presbyterian should be denied a certificate of need.

II.

Presbyterian argues that the Director of Facility Services erred by granting summary judgment in favor of Mercy and Stanly after the AU had recommended summary judgment against Mercy and Stanly. Presbyterian contends there were genuine issues of material fact regarding Mercy’s and Stanly’s applications and that there should have been a contested case hearing where the parties could present evidence and cross-examine witnesses regarding these genuine issues of material fact. Here, the parties merely presented a forecast of evidence through deposition testimony and affidavits.

A “contested case hearing” is a full adjudicatory hearing. Charlotte-Mecklenburg Hosp. Authority v. N.C. Dept. of Human Resources, 83 N.C. App. 122, 125, 349 S.E.2d 291, 292-93 (1986). During a contested case hearing, parties have “an opportunity to present arguments on issues of law and policy and ...

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Bluebook (online)
470 S.E.2d 831, 122 N.C. App. 529, 1996 N.C. App. LEXIS 460, Counsel Stack Legal Research, https://law.counselstack.com/opinion/presbyterian-orthopaedic-hospital-v-north-carolina-department-of-human-ncctapp-1996.