COBB HOSPITAL, INC. d/b/a WELLSTAR COBB HOSPITAL et al. v. GEORGIA DEPARTMENT OF COMMUNITY HEALTH et al.
A18A2009
In the Court of Appeals of Georgia
March 13, 2019
HODGES, Judge.
THIRD DIVISION, GOBEIL, J., COOMER and HODGES, JJ.
In the Court of Appeals of Georgia
HODGES, Judge.
In March 2016, Emory University d/b/a Emory University Hospital Smyrna (“EUHS”) filed an application with the Georgia Department of Community Health (“DCH”) for a new certificate of need (“CON”) to undertake improvements and renovations totaling approximately $33.8 million at the former Emory-Adventist Hospital. Cobb Hospital, Inc. d/b/a Wellstar Cobb Hospital and Kennestone Hospital, Inc., d/b/a Wellstar Kennestone Hospital (collectively, “Wellstar”) objected to EUHS’ application, arguing that the application “seeks to develop a new hospital” rather than reopening and renovating the former Emory-Adventist Hospital. The DCH granted EUHS’ application and awarded it a new CON for the proposed improvements and
In this appeal, we are asked to decide whether the CON Appeal Panel, in an appeal from a decision by the DCH on a health care facility’s application for a new certificate of need, has the authority to independently review the status of the facility’s existing certificate of need.1 We conclude that the plain language of
The record reveals that Smyrna Hospital, Inc., an 88-bed community hospital, opened on South Cobb Drive in Smyrna in 1974. Adventist Health System acquired the hospital in 1976. In 1995, Emory Healthcare entered a joint venture agreement with Adventist Health System and obtained a 35% share ownership in the hospital; thereafter, the hospital was renamed Emory-Adventist Hospital. Due to declining revenues, Emory-Adventist ceased operations on October 31, 2014. In April 2015, Emory University acquired sole ownership of the hospital, which was renamed Emory University Hospital Smyrna and reopened on October 20, 2015.2
Since it first opened as Smyrna Hospital in 1974, the hospital had never had a major improvement, renovation, or upgrade. As a result, EUHS applied for a certificate of need in March 2016 in order to proceed with improvements and
In its evaluation of EUHS’ application, the DCH noted that EUHS filed its application “to renovate and upgrade its current hospital facility.” In addition, the DCH determined that
EUHS, formerly known as Emory Adventist Hospital (EAH), closed on October 31, 2014 and re-opened October 20, 2015, according to Department records. In April 2015, Emory University acquired full title to EAH, and renamed it EUHS. As such, EUHS maintains an active CON status.5
Following its review, the DCH granted EUHS’ application and issued EUHS a CON for the proposed improvements and renovations.
Wellstar appealed the DCH’s award to the CON Appeal Panel. In a motion for summary adjudication, Wellstar argued, in part, that the DCH erred in awarding a CON to EUHS “to ‘renovate and upgrade’ the former Emory-Adventist Hospital . . . facility despite the fact that [EUHS] has no CON authorization to operate a hospital there.” As a result, Wellstar asserted that EUHS “must obtain new CON authority to operate a hospital[,]” which applies more extensive and rigorous guidelines.6 EUHS replied that the DCH has the sole authority to determine whether an applicant maintained a proper CON and, as a result, EUHS filed its own motion for summary
The panel hearing officer first noted that Wellstar raised “[its] arguments in the wrong forum.” In fact, the panel hearing officer found that “[i]t is not the function of the CON Appeal Panel to consider questions of CON and licensure status. . . .” The panel hearing officer observed that the Attorney General’s Office had the sole authority to oversee Emory Healthcare’s purchase of Emory-Adventist under the Hospital Acquisition Act (
Following an evidentiary hearing, the panel hearing officer affirmed the DCH’s decision granting EUHS’ application and issuing the CON.8 Wellstar objected to the
Wellstar then petitioned for judicial review of the commissioner’s decision in the Superior Court of Cobb County. The superior court denied judicial review of the Commissioner’s decision,10 and we granted Wellstar’s application for discretionary appeal. This appeal followed.
1. First, Wellstar contends that the CON Appeal Panel hearing officer erroneously concluded that he “lacked authority to independently decide if [EUHS] is a CON-authorized hospital.” For the following reasons, we find no error.
Under Georgia law, “any new institutional health service [is] required to obtain a certificate of need. . . .”
The legislature cedes this authority to the [DCH] because the public is better served by having experts in the complexities of health care planning make these decisions. The issues are complicated, and the applicable laws, rules, regulations, and precedents require much study, especially for a decision-maker who is not already familiar with them.
Dept. of Community Health v. Gwinnett County Hosp. Sys., 262 Ga. App. 879, 881-882 (586 SE2d 762) (2003). Pursuant to
Pertinent to this case, a certificate of need is required for: “(1) [t]he construction, development, or other establishment of a new health care facility; [and] (2) [a]ny expenditure by or on behalf of a health care facility in excess of $2.5 million which, under generally accepted accounting principles consistently applied, is a capital expenditure. . . .”
(b) Scope of Review of the DCH’s Certificate of Need Decision.
Following the DCH’s initial decision granting or denying an application for a new CON,
[a]ny applicant for a project [or] any competing health care facility that has notified the [DCH] prior to its decision that such facility is opposed to the application before the [DCH] . . . who is aggrieved by a decision of the [DCH] shall have the right to an initial administrative appeal hearing before an appeal panel hearing officer or to intervene in such hearing. . . .
The issue for the decision by the hearing officer shall be whether, and the hearing officer shall order the issuance of a certificate of need if, in the hearing officer’s judgment, the application is consistent with the considerations as set forth in Code Section 31-6-42 and the [DCH]’s
See also Dept. of Community Health v. Satilla Health Servs., Inc., 266 Ga. App. 880, 884 (1) (c) (598 SE2d 514) (2004).
Moreover, the DCH also mandated that certain issues “shall not be considered at an initial administrative appeal hearing and are immaterial to the hearing[,]” including “the correctness . . . of the considerations, rules, or standards by which the proposed project was reviewed by the [DCH]” and “the determination of whether a proposed project is subject to review under
Thereafter, an aggrieved party may petition the DCH commissioner for review of the panel hearing officer’s decision. See
(c) Review of EUHS’ Application for a Certificate of Need.
Here, the DCH found that EUHS applied for a CON “to renovate and upgrade its current hospital facility.” As a result, the DCH reviewed EUHS’ application “according to the relevant Certificate of Need rules outlined in the General Review Considerations.” See
(i) Generally, our standard of review requires that we determine “whether ‘substantial evidence’ supports the [DCH]’s findings of fact, and whether the
(ii) Nevertheless, in what it describes as an “outcome determinative” issue of its appeal from the DCH commissioner’s order affirming the panel hearing officer’s determination of the scope of review, Wellstar contends that the DCH’s initial determination of EUHS’ existing CON status was erroneous and should have been reviewed by the panel hearing officer. However, Wellstar’s argument is not proper within the limited framework of the CON Appeal Panel. Accordingly, this provides no basis for reversal and Wellstar must avail itself of other remedies.
To resolve this issue, we turn first to the governing statutes and agency rules and regulations. When examining statutory provisions,
(Citations and punctuation omitted.) Lakeview Behavioral Health Sys. v. UHS Peachford, LP, 321 Ga. App. 820, 822 (1) (743 SE2d 492) (2013). Similarly, “[i]n construing agency regulations, we employ the basic rules of statutory construction and look to the plain meaning of the regulation to determine its meaning.” (Citation omitted.) Walker v. Dept. of Transp., 279 Ga. App. 287, 292 (2) (a) (630 SE2d 878) (2006). Accordingly,
[w]hen an administrative agency decision is the subject of judicial review, judicial deference is to be afforded the agency’s interpretation of rules and regulations it has enacted to fulfill the function given it by the legislative branch. And in construing administrative rules, the ultimate criterion is the administrative interpretation, which becomes of controlling weight unless it is plainly erroneous or inconsistent with the rule.
(Citation and punctuation omitted.) ASMC, supra, 344 Ga. App. at 582.
[a]gencies provide a high level of expertise and an opportunity for specialization unavailable in the judicial or legislative branches. They are able to use these skills, along with the policy mandate and discretion entrusted to them by the legislature, to make rules and enforce them in fashioning solutions to very complex problems. Thus, their decisions are not to be taken lightly or minimized by the judiciary. Review overbroad in scope would have the effect of substituting the judgment of a judge or jury for that of the agency, thereby nullifying the benefits of legislative delegation to a specialized body.
Bentley v. Chastain, 242 Ga. 348, 350-351 (1) (249 SE2d 38) (1978). In the context of the DCH,
Further administrative review is also highly specialized. The hearing officer who reviews the initial DCH staff decision is one of five members of the CON Panel, all of whom are appointed by the Governor and are attorneys “who are familiar with the health care industry but who do not have a financial interest in or represent or have any compensation arrangement with any health care facility.”
Palmyra Park Hosp., Inc., supra, 310 Ga. App. at 491-492 (1). Ultimately, “our duty is not to review whether the record supports the superior court’s decision but whether the record supports the final decision of the administrative agency.” (Citation and punctuation omitted.) Satilla Health Servs., supra, 266 Ga. App. at 885 (1) (c).
(A) Plain Language of
On appeal from the DCH’s decision on a CON application, the scope of the panel hearing officer’s review is limited to “whether, . . . in the hearing officer’s judgment, the application is consistent with the considerations as set forth in Code Section 31-6-42 and the [DCH]’s rules, as the hearing officer deems such considerations and rules applicable to the review of the project.”
In that regard, none of the considerations under either
Wellstar relies principally on Floyd County Bd. of Commrs v. Floyd County Merit Sys. Bd. for the proposition that “incidental powers reasonably necessary to carry out . . . express powers are included by implication.” 246 Ga. 44, 45 (1) (268 SE2d 651) (1980). In Floyd County, our Supreme Court noted that an act creating the Merit System Board placed “broad responsibilities on that body in regard to the hiring, firing, promotion, etc., of county employees coming under its provisions.” Id. at 45 (2). As a result, the Court observed that “[i]t would strain the mind to think that such a body could function without personnel.” Id. Accordingly, the Court concluded that the Merit System Board, rather than the county board of commissioners, “had implied powers to hire and discharge employees in keeping with its annual budget, the same being reasonably necessary to execute the powers conferred.” Id. In this case, there is no such need to search for incidental powers because the CON Appeal Panel’s express powers, as described above, fully define its limited authority. See
In this regard, Wellstar’s reliance upon Longleaf Energy Assocs., LLC v. Friends of the Chattahoochee, Inc. for an expansive definition of “de novo” is misplaced. 298 Ga. App. 753, 768 (7) (681 SE2d 203) (2009). In Longleaf, we quoted an administrative rule of the Environmental Protection Division of the Department of Natural Resources providing that an administrative review hearing “‘shall be de
(B) Companion Statutes to
Our conclusion is buttressed by other statutes which must be read in pari materia with
The General Assembly granted the DCH exclusive authority to administer the CON program. See
Similarly, Article 3 of Title 31, Chapter 6 provides the DCH with authority to “to revoke a certificate of need, in whole or in part” for a varitety of reasons (
In sum, we conclude that Wellstar’s argument — that the CON Appeal Panel hearing officer may independently review the existing CON status of a health care facility in an appeal from a DCH decision on the facility’s application for a new CON — is foreclosed by the plain language of
In conclusion, neither
Judgment affirmed. Gobeil and Coomer, JJ., concur.