Slack Nursing Home, Inc. v. Department of Social Services

528 N.W.2d 285, 247 Neb. 452, 1995 Neb. LEXIS 49
CourtNebraska Supreme Court
DecidedMarch 3, 1995
DocketS-93-643
StatusPublished
Cited by52 cases

This text of 528 N.W.2d 285 (Slack Nursing Home, Inc. v. Department of Social Services) is published on Counsel Stack Legal Research, covering Nebraska Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Slack Nursing Home, Inc. v. Department of Social Services, 528 N.W.2d 285, 247 Neb. 452, 1995 Neb. LEXIS 49 (Neb. 1995).

Opinion

Lanphier, J.

The Department of Social Services (Department) appeals a finding and order of the district court for Lancaster County, dated June 22, 1993. Slack Nursing Home, Inc., appealed to the district court from the finding and order of the director of the Department dated May 29, 1992. The district court conducted its review de novo on the record of the Department. The Department contends that the district court should have limited its review to a determination of whether the Department’s order was supported by substantial evidence, whether the Department acted within the scope of its authority, and whether the Department’s decision was arbitrary, capricious, or unreasonable. The Department asserts that the district court’s broader review violated Nebraska’s separation of powers doctrine. See Neb. Const, art. II, § 1. We hold that the legislatively mandated de novo standard of review in contested case proceedings under the Administrative Procedure Act (APA) does not violate the separation of powers doctrine. However, in this case the district court erred in rejecting the Department’s interpretation of its own regulation absent a showing that the Department’s interpretation was plainly erroneous or *455 inconsistent. We, therefore, reverse the decision of the district court and reinstate the finding and order made by the Department dated May 29, 1992.

STATEMENT OF FACTS

Slack Nursing Home is a long-term-care facility owned by Richard D. Slack and is located in Gothenburg, Nebraska. Slack Nursing Home is certified by the Department as a provider of medicaid long-term-care services. As a long-term-care provider, Slack Nursing Home is subject to the rules and regulations of the Department and the federal medicaid rules and regulations. See, 471 Neb. Admin. Code, ch. 12, § Oil (1990); Bethesda Found, v. Nebraska Dept. of Soc. Servs., 243 Neb. 130, 498 N.W.2d 86 (1993).

In 1965, the State of Nebraska became a participant in the medicaid program pursuant to Neb. Rev. Stat. § 68-1018 (Reissue 1990). The Department administers the program in Nebraska. As a certified provider of medicaid long-term-care services, Slack Nursing Home may apply for reimbursement of direct care expenses subject to the provisions of the Nebraska state plan. To obtain reimbursement under the program, Slack Nursing Home is required to submit its costs by filing a “Long Term Care Cost Report.” According to § 011.10, the Long Term Care Cost Report is subject to a desk audit by the Department. If the Department determines that the reimbursement calculated by the facility is incorrect or not allowed by the rules and regulations, the Department is empowered to adjust the Long Term Care Cost Report. § 011.11.

On September 27, 1991, Slack Nursing Home submitted its Long Term Care .Cost Report for the fiscal year ending June 30, 1991. The desk audit determined that some of the nursing home’s cost claims were incorrect, and the Department completed the necessary adjustments reducing the claims. Slack Nursing Home was notified of these adjustments by a letter dated December 20, 1991.

Slack Nursing Home appealed the adjustments at an administrative hearing held on April 28, 1992. The specific adjustments appealed were claims regarding the nursing home’s administrator’s salary and for an interest expense on delinquent *456 property taxes. Only the claim regarding the administrator’s salary is before us on appeal.

From the agency hearing, the Department issued a finding and order on May 29, 1992, which found that the Department had applied the methodology provided by state and federal regulations in determining a reasonable rate of compensation for Slack Nursing Home’s administrator. Slack Nursing Home timely filed for a review of the agency decision in the district court pursuant to Neb. Rev. Stat. § 84-917 (Reissue 1994).

The district court stated its review of the agency determination under § 84-917 was to be conducted de novo on the record of the Department. In so doing, the district court rejected the Department’s argument that the separation of powers doctrine limited the scope of its review to a determination of whether the Department’s decision was supported by substantial evidence; whether the Department acted within the scope of its authority; or whether the Department’s decision was arbitrary, capricious, or unreasonable.

The district court overturned the Department’s interpretation of § 011.06K. This regulation states:

Compensation received by an administrator, owner, or directly-related parties is limited to a reasonable amount for the services provided. Medicare regulations and administrator salary surveys for the Kansas City Region, adjusted for inflation by the Department of Health and Human Services, are used in determining reasonable salaries for administrators. All compensation received by an Administrator is included in the Administration Cost Category, unless an allocation has prior approval from the Department. The regulations and surveys are used as a guideline in determining reasonable salaries for owners or related parties holding other positions at the facility.

The district court interpreted this regulation as providing that the salary surveys for the Kansas City region were to be used only as a guideline in determining reasonable salaries. The Department argues that § 011.06K, when taken in its entirety and with due note of the key words “are used,” dictates that salary surveys for the Kansas City region must be used to *457 determine the maximum amount of reimbursement a facility can receive for an administrator’s salary. The maximum reimbursement allowed by the Kansas City salary surveys was less than the amount claimed by Slack Nursing Home. Therefore, the Department adjusted Slack’s claim downward.

In accordance with its interpretation of § Oil .06K, the district court held that the Kansas City salary surveys were merely a guideline. The court held that the salary claimed by Slack Nursing Home was reasonable and that the Department should not have adjusted Slack Nursing Home’s claim for its administrator’s salary downward.

SCOPE OF REVIEW

We have stated that a statute is presumed to be constitutional, and all reasonable doubts will be resolved in favor of its constitutionality. The burden is upon the party claiming a statute is unconstitutional to establish its unconstitutionality. State v. Philipps, 246 Neb. 610, 521 N.W.2d 913 (1994); Jaksha v. State, 241 Neb. 106, 486 N.W.2d 858 (1992); State ex rel. Spire v. Strawberries, Inc., 239 Neb. 1, 473 N.W.2d 428 (1991). Moreover, the unconstitutionality of a statute must be clearly established before a court may declare it void. State v. Philipps, supra.

ANALYSIS

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Bluebook (online)
528 N.W.2d 285, 247 Neb. 452, 1995 Neb. LEXIS 49, Counsel Stack Legal Research, https://law.counselstack.com/opinion/slack-nursing-home-inc-v-department-of-social-services-neb-1995.