Sacred Heart Medical Center v. Nez Perce County

35 P.3d 265, 136 Idaho 448, 2001 Ida. LEXIS 137
CourtIdaho Supreme Court
DecidedOctober 24, 2001
Docket26011
StatusPublished
Cited by6 cases

This text of 35 P.3d 265 (Sacred Heart Medical Center v. Nez Perce County) is published on Counsel Stack Legal Research, covering Idaho Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sacred Heart Medical Center v. Nez Perce County, 35 P.3d 265, 136 Idaho 448, 2001 Ida. LEXIS 137 (Idaho 2001).

Opinion

WALTERS, Justice.

This is an appeal from the district court’s order granting summary judgment to Sacred Heart Medical Center (SHMC) on its claim to recover payment for services rendered pursuant to Idaho’s medical indigency statutes, chapters 34 and 35, title 31, Idaho Code. Because we hold the district court’s interpretation of I.C. § 31-3511(4) authorizing approval of the application by default to be error as a matter of law, we vacate the summary judgment and remand this case for further proceedings before the district court.

HISTORICAL AND PROCEDURAL FACTS

Mary J., an Idaho resident, applied for medical indigency benefits after her hospitalization as a coronary care patient at SHMC in Spokane between April 18 and April 29, 1997. The application submitted by Mary J. was incomplete, but Maiy J. signed as the applicant in the required spaces on the form. On the page entitled Medical Providers List, the patient is identified as Mary J., and in the space provided for “if a third party application,” is the name of Lisa Stark, patient sponsor, as the “contact person” at Sacred Heart Medical Center, the “facility.” Stark printed her name on the form but never affixed her signature on behalf of the hospital.

*449 In order to determine whether Mary J. met the indigency requirements, Nez Perce County sent a representative to interview Mary J., but Mary J. refused to cooperate and shortly thereafter verbally withdrew her application for benefits. On June 6, 1997, the Board of County Commissioners issued a certificate of denial for county aid citing the following reasons: “(1) no indigency exists— undocumented; (2) not the last resource— undocumented; (3) application is incomplete as per Idaho Code § 31-3511(2), (3); and (4) other reasons — applicant called and verbally withdrew her application for county assistance on May 30, 1997. Applicant refuses to cooperate or allow an interview.” SHMC timely filed a notice of appeal from the denial with the Board, pursuant to I.C. § 31-3505D. 1

The Board noticed a hearing on SHMC’s appeal from the denial. However, before the date scheduled for the hearing, the Board received a written request from Mary J., seeking to withdraw her application for benefits. The Board notified SHMC that it was withdrawing Mary J.’s application and vacated the October 1, 1997, healing date. Despite numerous requests by SHMC, the Board did not reinstate the original healing date, and no hearing on the hospital’s appeal was ever held.

On December 7, 1998, SHMC filed a complaint in the district court seeking to compel the County to declare the application of SHMC approved pursuant to I.C. § 31-3511(4) 2 and to order the County to pay the sum owing to the hospital for services rendered to Mary J. SHMC then filed a motion for summary judgment; the County filed a cross-motion for summary judgment and/or a motion to dismiss. After a hearing on the motions, the district court denied the County’s motions and granted the hospital’s motion for summary judgment. In a separate order, the district court denied SHMC’s request for an award of attorney fees.

The County appealed from the district court’s decision, asserting that a question of fact as to whether the hospital was a third-party applicant still needed to be resolved, making summary judgment inappropriate. The County also contested SHMC’s filing of a civil complaint in the district court to obtain redress from the Board’s refusal to conduct the appeal hearing after Mary J. was allowed to withdraw her indigency application. SHMC cross-appealed, challenging the district court’s order denying the hospital’s request for attorney fees.

STANDARD OF REVIEW

In reviewing a lower court’s decision on summary judgment, the standard of review is whether there are any genuine issues of material fact, and, if not, whether the prevailing party was entitled to judgment as a matter of law. Brown v. Caldwell School District No. 132, 127 Idaho 112, 898 P.2d 43 (1995); I.R.C.P. 56(c). If the evidence shows no disputed issues of material fact, what remains is a question of law, over which the appellate court exercises free review. Friel v. Boise City Hous. Auth., 126 Idaho 484, 887 P.2d 29 (1994).

DISCUSSION

We begin by noting the unusual posture of this ease. Typically, applications and requests for necessary medical services are filed with the clerk of the board of county commissioners within ten days prior to receiving nonemergeney necessary medical services, and within thirty days following emergency medical services. I.C. § 31-3505. The clerk interviews the applicant and investigates the information provided with the application within specified time limits, and files findings with the board. I.C. § 31-3505A. The board is required to make an initial determination on the application for medical services rendered within fifteen *450 days, and within five days for applications for services yet to be provided, and then — within five days of the initial determination — to mail a copy to the applicant, to the third party making an application on behalf of the applicant (as the case may be) and to each provider listed on the application. I.C. § 31-3505C. An applicant or provider may appeal from an adverse determination by filing a written notice of appeal with the board within twenty-eight days of the date of the initial determination. I.C. § 31-3505D. If no appeal is filed within the time allowed, the determination of the board becomes final. Id. The board shall hold a hearing on the appeal within seventy-five days (unless continued for not more than forty-five days) and shall make a final determination within thirty days of the conclusion of the hearing. I.C. § 31-3505E. If, after a hearing as provided in section 31-3505E, the final determination of the board is to deny an application for financial assistance with necessary medical services, the applicant, or a third party making an application on an applicant’s behalf, may seek judicial review of the final determination of the board. I.C. § 31-3505G.

In this ease, however, the board refused to hold a hearing on the appeal from its initial denial of Mary J.’s application, taking the position that the application no longer existed because it had been withdrawn subsequent to the notice of appeal filed by SHMC. As a result, there has not been a final determination by the board that would be subject to the judicial review process permitted by I.C. § 31-3505G, and SHMC pm-sued a civil action in the district court to compel the Board to pay the sum owed to the hospital for sendees rendered to Mary J. There was no other avenue for the hospital to obtain review of the Board’s decision vacating the appeal from the denial of the application. Because the district court granted summary judgment to SHMC and the Board has appealed from the district court’s judgment declaring the indigency application approved by operation of law, we are limited to a review only of the propriety of the summary judgment decision.

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Cite This Page — Counsel Stack

Bluebook (online)
35 P.3d 265, 136 Idaho 448, 2001 Ida. LEXIS 137, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sacred-heart-medical-center-v-nez-perce-county-idaho-2001.