State Ex Rel. Nebraska Health Care Ass'n v. Department of Health & Human Services Finance & Support

587 N.W.2d 100, 255 Neb. 784, 1998 Neb. LEXIS 244
CourtNebraska Supreme Court
DecidedDecember 18, 1998
DocketS-97-941
StatusPublished
Cited by101 cases

This text of 587 N.W.2d 100 (State Ex Rel. Nebraska Health Care Ass'n v. Department of Health & Human Services Finance & Support) 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
State Ex Rel. Nebraska Health Care Ass'n v. Department of Health & Human Services Finance & Support, 587 N.W.2d 100, 255 Neb. 784, 1998 Neb. LEXIS 244 (Neb. 1998).

Opinion

Gerrard, J.

NATURE OF CASE

The Nebraska Health Care Association (NHCA), the relator-appellant, sued the Nebraska Department of Health and Human Services Finance and Support and its director (collectively Department), seeking a writ of mandamus to compel the Department to release certain documents pursuant to the public records statutes, Neb. Rev. Stat. §§ 84-712 through 84-712.09 (Reissue 1994 & Cum. Supp. 1998). The documents sought were created by the Department as part of its supervision of medicaid payments to Nebraska nursing homes. The documents were requests for information sent by the Department to nursing homes as part of the Department’s audits of the claims for reim *786 bursement submitted annually by the nursing homes. The issue presented in this case is whether those documents are records produced in the course of an investigation, such that they are exempt from disclosure under the public records statutes.

PROCEDURAL BACKGROUND

The NHCA is a nonprofit corporation that represents nursing homes and intermediate care facilities in the State of Nebraska. The NHCA sued the Department after the Department refused part of the NHCA’s request to review documents relating to the Department’s administration of nursing home medicaid reimbursement.

On March 27, 1997, the NHCA had submitted a written request to the Department to review public records as authorized by the public records statutes. The requests generally dealt with records relating to the audit process used by the Department to verify the expenditure claims made by nursing homes seeking medicaid reimbursement. In a letter dated April 3, the Department indicated generally that access to the records would be provided and suggested that the parties meet to coordinate the inspection.

In a letter dated April 23, 1997, the NHCA memorialized the events of an April 22 meeting with the Department. The letter indicated the Department’s agreement to allow access to most of the documents but indicated reservations by the Department regarding two particular requests. The NHCA began copying documents on June 16. On July 1, a letter was sent to the NHCA by the Department, as required by § 84-712.04, officially denying access to the documents described by the two remaining requests at issue.

To obtain access to the documents, the NHCA sought a writ of mandamus in the district court, as authorized by § 84-712.03. A hearing was held at which witnesses from the Department and the NHCA testified about the audit process and the nature of the documents at issue. The documents themselves were not examined by the court, with the exception of one audit record that was mistakenly given to the NHCA by the Department.

After the hearing, the district court denied the NHCA’s request, finding, based on the evidence presented, that the doc *787 uments requested fell within the investigatory records exception to the public records statutes, as set forth in § 84-712.05(5). The NHCA appeals.

FACTUAL BACKGROUND

The contested requests seek documents relating specifically to the auditing process of the Department. Each year, every nursing home in Nebraska submits detailed cost reports that are used by the Department to calculate the rates at which each facility will receive medicaid reimbursement payments. Cost reports are forms issued by the Nebraska medicaid program in order to gather data and supporting information from nursing homes about the nursing homes’ expenses.

These reports are audited by the Department in order to verify that the costs reported are accurate. Moreover, certain expenses of nursing homes are not compensated by medicaid, and the audits are used to distinguish compensable from noncompensable expenses. Two types of audit are used by the Department to verify cost reports: desk audits and field audits.

A desk audit generally occurs every year for each of Nebraska’s 230 nursing homes. For a desk audit, an auditor reviews the cost report submitted by the facility and then sends written requests to the facility, seeking documentation for particular aspects of the cost report. The auditor may seek additional documentation for reported costs that seem unusual or are not described in sufficient detail for the Department to determine whether or not they are compensable. .

A field audit is more extensive and utilized less often. The Department conducts about 20 to 30 field audits per year, in which an auditor goes “on site” to the nursing home and reviews every aspect of that nursing home’s cost report by checking the report against the records that the nursing home maintains. While a field audit is in progress, or after the field work has been completed but before a final report is issued, the auditor may send written requests to the nursing home for additional information the auditor believes to be necessary.

The public records sought by the NHCA and retained by the Department are the written communications from the Department to the nursing homes that are sent out as a part of *788 the desk and field audit process. Essentially, the NHCA wants copies of the letters that the Department has sent to nursing homes when the Department needs more information from a nursing home to complete a desk or field audit.

ASSIGNMENTS OF ERROR

The NHCA claims that the district court erred (1) in finding the documents requested by the NHCA are exempt from disclosure as public records pursuant to § 84-712.05(5); (2) in failing to consider that once the Department makes a document public by mailing or faxing it to the entity being investigated, the document is no longer afforded any protection pursuant to § 84-712.05(5); (3) in failing to find the Department waived its right to claim an objection to producing the documents; (4) in failing to find the Department should be estopped from claiming the requested documents are exempt from production; (5) in failing to issue a writ of mandamus ordering the department to produce the public records.

BURDEN OF PROOF AND STANDARD OF REVIEW

Burden of Proof

The appropriate burden of proof in this case is established by statute. Section 84-712.03 provides, in relevant part:

Any person denied any rights granted by sections 84-712 to 84-712.03 may elect to ... file for speedy relief by a writ of mandamus in the district court within whose jurisdiction the state, county, or political subdivision officer who has custody of said public record can be served ..
In any suit filed under this section, the court has jurisdiction to enjoin the public body from withholding records, to order the disclosure, and to grant such other equitable relief as may be proper. The court shall determine the matter de novo and the burden is on the public body to sustain its action.

Pursuant to § 84-712.03, it is clear that the burden of proof in a case such as this is not on the party seeking the writ of mandamus, but on the party attempting to withhold records.

*789

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Cite This Page — Counsel Stack

Bluebook (online)
587 N.W.2d 100, 255 Neb. 784, 1998 Neb. LEXIS 244, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-ex-rel-nebraska-health-care-assn-v-department-of-health-human-neb-1998.