Sunrise Manor Nursing Home v. Axelrod

135 A.D.2d 293, 525 N.Y.S.2d 367, 1988 N.Y. App. Div. LEXIS 1940
CourtAppellate Division of the Supreme Court of the State of New York
DecidedFebruary 25, 1988
StatusPublished
Cited by14 cases

This text of 135 A.D.2d 293 (Sunrise Manor Nursing Home v. Axelrod) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sunrise Manor Nursing Home v. Axelrod, 135 A.D.2d 293, 525 N.Y.S.2d 367, 1988 N.Y. App. Div. LEXIS 1940 (N.Y. Ct. App. 1988).

Opinion

OPINION OF THE COURT

Kane, J. P.

Petitioner, a duly licensed skilled nursing facility, participated in the Medicaid program (42 USC § 1396 et seq.) and as such was entitled to have a portion of the services it rendered to its medically indigent elderly patients reimbursed at a rate computed by respondents pursuant to Public Health Law § 2807 (3). The instant proceeding concerns the amount of reimbursement that the State Department of Health (hereinafter DOH) calculated petitioner as being entitled to for the years 1981 through 1984.

Subsequent to the determination of its reimbursement rate [295]*295for each of the years in question, petitioner filed four separate appeals, one for each year. The appeals requested readjustment of the rates due to increased labor costs for additional wages and fringe benefits arising from collective bargaining agreements with its unionized employees. A readjustment was also sought due to wage and fringe benefit increases to its nonunion employees. Among the newly granted benefits for both union and nonunion employees were pension benefits, commencing in 1981.

The rate appeals were reviewed together by DOH pursuant to the first-stage appeal process set forth in 10 NYCRR 86-2.14 (b). DOH issued a determination agreeing to revise petitioner’s reimbursement rates to reflect the increased labor costs attributable to some, but not all, of the items submitted by petitioner. The value of the adjustments due petitioner was calculated to be approximately $230,000. The adjustments that DOH denied, and which are the subject of the instant proceeding, were those items concerning pension contributions for nonunion employees and newly unionized registered nurses and cooks. The denial was based on DOH’s determination that these items represented "new benefits” which, according to DOH "policy”, were "parity” items and as such would not be considered for reimbursement until such time as they became part of a base year cost calculation used to set a prospective rate.

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Bluebook (online)
135 A.D.2d 293, 525 N.Y.S.2d 367, 1988 N.Y. App. Div. LEXIS 1940, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sunrise-manor-nursing-home-v-axelrod-nyappdiv-1988.