State v. Carmel Healthcare Management, Inc.

660 N.E.2d 1379, 1996 Ind. App. LEXIS 43, 1996 WL 34055
CourtIndiana Court of Appeals
DecidedJanuary 31, 1996
Docket29A04-9308-CV-284
StatusPublished
Cited by19 cases

This text of 660 N.E.2d 1379 (State v. Carmel Healthcare Management, Inc.) is published on Counsel Stack Legal Research, covering Indiana Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State v. Carmel Healthcare Management, Inc., 660 N.E.2d 1379, 1996 Ind. App. LEXIS 43, 1996 WL 34055 (Ind. Ct. App. 1996).

Opinion

*1381 OPINION

RILEY, Judge.

STATEMENT OF THE CASE

Petitioners-Appellants State of Indiana, Family and Social Services Administration, Division of Family and Children of the Family and Social Services Administration Offices of Medicaid Policy and Planning, and Indiana State Board of Public Welfare (collectively referred to as "the Department") appeal the trial court's determination in favor of Respondent-Appellee Carmel Healthcare Management, Inc. (CHM). *

We affirm in part and reverse in part. ;

ISSUES

The Department raises the following issues for our review:

1. Whether the trial court erred in finding that the Department waived any challenge to the issues presented at the administrative hearing.
2, Whether the trial court used the proper standard in reviewing the Department's finding that notice was sent to the correct address.
3. Whether the trial court erred in concluding that CHM was entitled to a hearing prior to imposition of the penalty.
4. Whether the trial court erred in con-eluding that CHM was entitled to recoup the penalty imposed by the Department.

FACTS AND PROCEDURAL HISTORY

In September of 1989, CHM became the new provider for the Carmel Care Center ("the Center"), a long-term care facility. Pursuant to 470 LA.C. 5-4.2-5, the "provider" is to file an historical financial report with the Department within sixty days following the end of the first nine months of operation. CHM failed to submit the historical financial report within the period mandated by the regulation.

On July 10, 1990, the rate setting contractor, an agent of the Department, sent a certified letter to the Center, warning that CHM had to provide the historical report within ten days or the initial interim rate would be reduced by ten percent. CHM did not submit the report within the ten day period. On August 7, 1990, the Department sent notice to the Center that, pursuant to 470 LA.C. 5-4.1-5(g), the Center's "per diem rates are reduced ten percent effective May 1, 1990, and shall continue until the first day of the month after receipt of this report by our Department." (R. 174).

CHM appealed the Department's imposition of the penalty. Following the administrative hearing, the Administrative Law Judge entered findings of fact and conclusions of law. Upon request of the parties, the findings were amended to read:

1. That the provider, Carmel Healthcare Management, Inc., failed to submit an historical report for the first nine months of operation as required by 470 LA.C. 5-4.1-5(f).
2. That the department sent the provider a ten day notice letter on July 10, 1990, and that the provider received that letter at their address at 118 Medical Drive, Carmel, Indiana, 46082.
3. That this notice letter complied with the regulations and that the Administrative Law Judge finds that the provider did receive said notice and was notified according to the requirements of 470 LA.C. 5-41-5.
4. However, the department did not satisfy all of the requirements prior to the imposition of a ten percent penalty.
5. That the Administrative Law Judge finds that the department imposed the ten percent penalty prematurely without properly notifying the provider and giving the provider a right to a hearing, prior to the imposition of said penalty.
6. That the Administrative Law Judge further finds that prior to the imposition of any ten percent penalty, a hearing is required in order to allow the provider an opportunity to recoup any penalty. Hathaway v. Mathews (7th Cir.1976), 546 F.2d 227.
7. That the ten percent penalty which has previously been withheld without opportunity for a hearing, should be immediately reimbursed to Carmel Healthcare *1382 Management, Inc., and the department, if it wishes to impose such penalty, must notify the provider in writing of its intention to do the same and give the provider thirty (80) days within which to appeal that decision and/or recoup any loss which the department intends to impose upon the provider.
8. That it is apparent that the department did not suffer any financial harm due to the late filing of the historical report except for the administrative inconvenience of the late filing of the provider; and that an equitable penalty for said late filing would be from one to five percent of the total penalty depending on the cireum-stances of the late filing; and in this case the Administrative Law Judge finds that an appropriate penalty would be two percent (2%) of the 10% penalty or approximately $2,000.00 and recommends that said penalty be imposed for this provider and the remainder of the 10% penalty be returned to the provider.

(R. 485-437; 441-442).

The Department appealed the Administrative Law Judge's determination to the Indiana Board of Public Welfare. The Board sustained the Department's imposition of the ten percent penalty. In so doing, it determined that the only issue was whether the notice letter was timely sent to CHM. (R. 470-472).

CHM filed a petition for judicial review. After the filing of briefs and oral argument, the trial court issued findings of fact and conclusions of law. The court determined that the Department erred in imposing the ten percent penalty without providing a hearing beforehand. In doing so, the court determined that: (1) CHM did not receive proper notice of the penalty; (2) the Department had not satisfied all of the requirements pri- or to imposing the penalty; and (3) the penalty could be recouped by CHM. (R. 131-132). Accordingly, the trial court ordered that the Department calculate the penalty withheld and reimburse the full amount to CHM.

The Department appealed to this court. In a memorandum decision, State of Indiana, et al. v. Carmel Health Care Management, Inc., 641 N.E.2d 1299 (Ind.App.1994), a panel of this court, by 2-1 vote, held that CHM failed to timely file the agency record. The panel further held that this failure deprived the trial court of jurisdiction over the case. Accordingly, the trial court's judgment was reversed and the cause was remanded to the trial court with directions to vacate its judgment and dismiss the petition for lack of jurisdiction. Memo. decision at 7. In an order dated April 17, 1995, our supreme court granted transfer, vacated the memorandum decision, and remanded to this court for a decision on the merits.

We now review the merits. 1

DISCUSSION AND DECISION

I. WAIVER OF THE JURISDICTIONAL CHALLENGE

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Cite This Page — Counsel Stack

Bluebook (online)
660 N.E.2d 1379, 1996 Ind. App. LEXIS 43, 1996 WL 34055, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-v-carmel-healthcare-management-inc-indctapp-1996.