St. Joseph's Hospital of Buckhannon, Inc. d/b/a St. Joseph's Hospital v. Stonewall Jackson Memorial Hospital Company and West Virginia Health Care Authority

CourtIntermediate Court of Appeals of West Virginia
DecidedMay 23, 2024
Docket23-ica-265
StatusPublished

This text of St. Joseph's Hospital of Buckhannon, Inc. d/b/a St. Joseph's Hospital v. Stonewall Jackson Memorial Hospital Company and West Virginia Health Care Authority (St. Joseph's Hospital of Buckhannon, Inc. d/b/a St. Joseph's Hospital v. Stonewall Jackson Memorial Hospital Company and West Virginia Health Care Authority) is published on Counsel Stack Legal Research, covering Intermediate Court of Appeals of West Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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St. Joseph's Hospital of Buckhannon, Inc. d/b/a St. Joseph's Hospital v. Stonewall Jackson Memorial Hospital Company and West Virginia Health Care Authority, (W. Va. Ct. App. 2024).

Opinion

IN THE INTERMEDIATE COURT OF APPEALS OF WEST VIRGINIA FILED Spring 2024 Term May 23, 2024 _____________________ released at 3:00 p.m. ASHLEY N. DEEM, DEPUTY CLERK INTERMEDIATE COURT OF APPEALS No. 23-ICA-265 OF WEST VIRGINIA _____________________

ST. JOSEPH’S HOSPITAL OF BUCKHANNON, INC. d/b/a ST. JOSEPH’S HOSPITAL, Respondent Below, Petitioner,

v.

STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY, Petitioner Below, Respondent, and WEST VIRGINIA HEALTH CARE AUTHORITY, Respondent.

___________________________________________________________

Appeal from the West Virginia Health Care Authority Certificate of Need File No. 23-7-12659-X

AFFIRMED _________________________________________________________

Submitted: March 19, 2024 Filed: May 23, 2024

Alaina N. Crislip, Esq. Thomas G. Casto, Esq. Neil C. Brown, Esq. Webster J. Arceneaux, Esq. Jackson Kelly PLLC Hannah Wright, Esq. Charleston, West Virginia Lewis Gianola PLLC Counsel for Petitioner Charleston, West Virginia Counsel for Respondent Stonewall Jackson Memorial Hospital Company Patrick Morrisey, Esq. Attorney General Heather Connolly, Esq. Assistant Attorney General Frankie Dame, Esq. Assistant Solicitor General Michael R. Williams, Esq. Principal Deputy Solicitor General Charleston, West Virginia Counsel for Respondent West Virginia Health Care Authority

CHIEF JUDGE SCARR delivered the Opinion of the Court. JUDGE LORENSEN dissents and reserves the right to file a separate opinion. SCARR, CHIEF JUDGE:

Petitioner St. Joseph’s Hospital of Buckhannon appeals the Amended

Decision on Request for Ruling on Reviewability issued by Respondent West Virginia

Health Care Authority on July 12, 2023, holding that a Certificate of Need is not required

for Respondent Stonewall Jackson Memorial Hospital’s proposed relocation. Petitioner

contends that the Authority’s decision misapplies the statute enumerating what types of

proposed health care projects require a Certificate of Need. Petitioner also contends that

the Health Care Authority lacks the power to amend their original decision in this matter,

and thus the amended decision is ultra vires, and thus invalid.

Having reviewed the parties’ arguments, the administrative record on appeal,

and the controlling law, we affirm the Health Care Authority’s July 12, 2023, Amended

Decision on Request for Ruling on Reviewability. We affirm for the reasons fully discussed

below, on the basis that the Health Care Authority’s decision is a reasonable and

permissible interpretation of a statute that is ambiguous when applied to the proposed

relocation project at issue here.

I. FACTUAL AND PROCEDURAL BACKGROUND

Stonewall Jackson Memorial Hospital (“Stonewall”) is a 70-bed acute care

hospital located on the western edge of Weston, located in Lewis County, West Virginia.

Stonewall’s current facility was built in 1972, over fifty years ago. Because of the facility’s

age, Stonewall sought to replace its current facility with a new, state of the art, 29-bed

1 facility to be located at the intersection of Interstate 79 and United States Highway 33 E.,

4.2 miles to the southeast of its current site.

St. Joseph’s Hospital of Buckhannon (“St. Joseph’s”) is a 25-bed critical

access hospital (“CAH”) located in Buckhannon, Upshur County, West Virginia, where it

is the sole community hospital. CAH is a designation by the United States Department of

Health and Human Services, Centers for Medicare & Medicaid Services, which enables a

qualified rural hospital to be reimbursed on a cost-basis for providing services to Medicare

and Medicaid patients, as opposed to being reimbursed on a prospective payment basis.

Essentially, rather than being paid a pre-determined fixed amount for hospital services, a

CAH is paid primarily on the basis of the costs it incurs. St. Joseph’s struggled financially

prior to its CAH designation in 2014, but its financial health has improved since its CAH

designation.1 To qualify for CAH status, St. Joseph’s must not be located closer than 15

mountainous terrain miles from another hospital. Although St. Joseph’s is currently more

than 15 miles from any hospital, allowing Stonewall to relocate to its proposed relocation

site would place it within 15 miles of St. Joseph’s, thereby eliminating St. Joseph’s

eligibility for CAH designation.

1 In 2015, St. Joseph’s became affiliated with United Hospital Center and West Virginia University Medicine. 2 The procedural history of this case is multilayered. On September 13, 2021,

Stonewall’s Certificate of Need (“CON”) application was received by the West Virginia

Health Care Authority (“the Authority”). The cost of the proposed relocation was

$55,950,000.00 To meet Stonewall’s current needs and accommodate future growth,

Stonewall considered alternatives to relocation, such as large-scale renovations of the

existing facility, maintaining the status quo, and construction of a new hospital. Stonewall

ultimately determined that construction of new hospital was the best solution. The reasons

put forth for moving the site of the hospital were the current site’s poor accessibility,

constraints to expansion, and space and layout deficiencies. On October 14, 2021, St.

Joseph’s filed its request for affected person status as well as a request for a public hearing.

St. Joseph’s asserted that it provided similar services to those proposed in the CON

application and that it would be significantly affected by the proposed relocation project.

On June 13, 2022, the Authority issued the first decision regarding

Stonewall’s CON, which was appealed to this Court. See Stonewall Jackson Mem'l Hosp.

Co. v. St. Joseph's Hosp. of Buckhannon, Inc., No. 22-ICA-147, 2023 WL 4197305 at *1

(W. Va. Ct. App. June 27, 2023) (memorandum decision). Relevant to that appeal, the

Authority held that although the proposed relocation may be the superior alternative in

terms of cost, efficiency, and appropriateness for Stonewall, the Authority must also

determine whether the proposed project is the superior alternative for an affected person

(like St. Joseph’s) and the citizens of West Virginia. The Authority found that Stonewall’s

proposed relocation would cause St. Joseph’s to lose its CAH status, which would have a

3 significant financial impact upon St. Joseph’s. Further, the Authority found that Stonewall

did not prove the impracticability of developing alternative site locations, noting that

Stonewall had not explored any other sites for the project other than the proposed location.

The Authority concluded that Stonewall’s application should be denied because Stonewall

failed to demonstrate that superior alternatives to the services proposed did not exist within

the state and that the development of alternatives was not practicable as required by West

Virginia Code §16-2D-12(b)(1) (2016). On June 27, 2023, this Court issued a

memorandum decision affirming the Authority’s order, holding, among other things, that

“[b]ased upon a review of the record and the deference given to the Authority because of

its institutional expertise, we find no error in the Authority’s determination that Stonewall

did not provide sufficient evidence to show that superior alternatives do not exist and that

the development of alternatives is not practicable.” Id. at *4.

However, between the time the CON application was decided by the

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St. Joseph's Hospital of Buckhannon, Inc. d/b/a St. Joseph's Hospital v. Stonewall Jackson Memorial Hospital Company and West Virginia Health Care Authority, Counsel Stack Legal Research, https://law.counselstack.com/opinion/st-josephs-hospital-of-buckhannon-inc-dba-st-josephs-hospital-v-wvactapp-2024.