Spokane Valley General Hospital, Inc. v. United States

688 F.2d 771, 231 Ct. Cl. 550, 1982 U.S. Ct. Cl. LEXIS 470
CourtUnited States Court of Claims
DecidedSeptember 8, 1982
DocketNo. 445-80C
StatusPublished
Cited by20 cases

This text of 688 F.2d 771 (Spokane Valley General Hospital, Inc. v. United States) is published on Counsel Stack Legal Research, covering United States Court of Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Spokane Valley General Hospital, Inc. v. United States, 688 F.2d 771, 231 Ct. Cl. 550, 1982 U.S. Ct. Cl. LEXIS 470 (cc 1982).

Opinion

FRIEDMAN, Chief Judge,

delivered the opinion of the court:

Spokane Valley General Hospital, Inc. ("Spokane Valley”), a provider of Medicare services under Part A of the Medicare Act, 42 U.S.C. §§ 1395 et seq. (1976 & Supp. IV 1980), seeks for the years 1971 and 1972, as part of its reasonable costs of providing those services, a return on the $750,000 it paid for "goodwill.” The parties have filed cross-motions for summary judgment. We hold that under the statute and the regulations, the plaintiff is entitled to receive such a return. We therefore grant the plaintiffs motion for summary judgment and deny that of the defendant.

I.

A. In 1967, five physicians formed Valley Mission, Inc. ("Valley Mission”),1 in order to construct and own a for-profit hospital in Spokane, Washington. In February 1968, prior to the facility’s completion, the same physicians formed Spokane Valley (hereinafter occasionally referred to as "the original Spokane Valley”) to lease the property from Valley Mission and to operate the hospital.

Both before and after the formation of Valley Mission and Spokane Valley, these physicians expended a great deal [552]*552of time and effort to assure that the hospital would be successful as soon as it opened its doors. By the end of 1968, the physicians, among other things, (1) had arranged for a medical staff of 121 doctors, (2) had screened and interviewed numerous applicants for other positions, (3) had adopted the bylaws, rules and regulations for the hospital, (4) had acquired the requisite state and professional accreditation and licensing for the hospital, (5) had endeavored through various means to develop goodwill and recognition in the community for the hospital, and (6) had leased a substantial amount of the equipment the hospital would require.

Late in 1968, American Medicorp, Inc. ("Medicorp”),2 which operates a large number of general community hospitals in several states, formed S.V.G.H., Inc. (hereinafter, "the subsidiary”), for the purpose of purchasing Spokane Valley. On December 28, 1968, the purchase was consummated. The subsidiary exchanged 10,000 shares of Medicorp stock, having a fair market value of $750,000, for all of Spokane Valley’s capital stock. The 10,000 shares were approximately four-tenths of one percent of Medi-corp’s voting stock. Spokane Valley’s original stockholders retained no control over the hospital’s management after the sale was consummated. The purchase agreement obligated the physicians not to compete with the hospital for at least five years.

As a condition of the purchase, Valley Mission was to lease the hospital building and real estate to the subsidiary. On the same day the purchase agreement was signed, the subsidiary entered into a 50-year lease with Valley Mission for the land and hospital building at a rental of $15,000 per month, or a total of $9 million over the life of the lease.

In early January 1969, in accordance with the parties’ intentions at the time the purchase and lease were agreed to, Spokane Valley was merged into the subsidiary. The subsidiary, as the surviving corporation, took Spokane Valley’s corporate name. One month later, Spokane Valley opened its doors and began operations. Spokane Valley [553]*553ápparently had immediate success. In its first year, the hospital had a 59 percent occupancy rate.

Spokane Valley accounted for the transaction on its books by treating the $750,000 of Medicorp stock as having been exchanged solely for goodwill of that value. Spokane Valley’s independent auditors and the Securities and Exchange Commission approved this accounting treatment, as did two accountants employed by Spokane Valley’s "fiscal intermediary,” Blue Cross-Washington/Alaska ("Blue Cross”), which was responsible for making initial provider reimbursement determinations (see below).

B. Pursuant to a written agreement with the Secretary of Health, Education and Welfare, now of Health and Human Services ("the Secretary”) (see 42 U.S.C. § 1395cc (1976 & Supp. IV 1980)), Spokane Valley was entitled to be reimbursed from Medicare funds for the reasonable cost of providing Medicare services. See 42 U.S.C. § 1395x(v) (1976 & Supp. IV 1980). Spokane Valley filed cost reports with Blue Cross, and Blue Cross determined Spokane Valley’s entitlement to reimbursement. See 42 U.S.C. § 1395g (1976 & Supp. IV 1980); 42 C.F.R. § 405.453(f) (1980).3

Spokane Valley submitted cost reports seeking reimbursement for the years 1971 through 1975 of a return on the $750,000 paid for the original Spokane Valley. Section 405.429 of the Medicare regulations allows a proprietary provider to a return on its equity capital invested in Medicare-related assets (see below). Although Medicare reimbursed Spokane Valley for a return on the $750,000 for the years 1969 and 1970, Blue Cross refused to reimburse Spokane Valley for a return thereafter on the ground that the $750,000 was not properly includable in Spokane Valley’s equity capital.

Spokane Valley first appealed the determinations for 1973, 1974, and 1975. For claims arising after June 30, 1973, Congress has authorized a provider to appeal a fiscal intermediary’s determination to the Provider Reimbursement Review Board ("the Board”) if the amount in contro[554]*554versy is at least $10,000. 42 U.S.C. § 1395oo (1976 & Supp. IV 1980); 42 C.F.R. §§ 405.1835 et seq.

The Board affirmed Blue Cross’s denial of a return on the $750,000 for 1973 through 1975. The Board’s decision rested on three grounds. First, it ruled that as a result of the entire transaction, the subsidiary received nothing more from the original Spokane Valley than a "right to negotiate a lease” with Valley Mission, so that the $750,000 represented merely an opportunity for the subsidiary "internally” to generate goodwill in the future, and that internally generated goodwill cannot be included in equity capital. Second, the Board concluded that the goodwill was internally generated for the additional reason that Spokane Valley had not begun operations or earned income until after the transaction was completed. Finally, the transaction itself was deemed to be a "pooling of interests” rather than a "purchase of assets,” so that recognition of the $750,000 as goodwill was improper under generally accepted accounting principles.

One Board member dissented, stating that the $750,000 represented prepaid rent (over the 50-year lease). He apparently would have permitted the payment to be amortized and reimbursed over the life of the lease.

Pursuant to the statute providing judicial review of Board decisions, Spokane Valley filed suit in the United States District Court for the Eastern District of Washington.

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Bluebook (online)
688 F.2d 771, 231 Ct. Cl. 550, 1982 U.S. Ct. Cl. LEXIS 470, Counsel Stack Legal Research, https://law.counselstack.com/opinion/spokane-valley-general-hospital-inc-v-united-states-cc-1982.