Miss. State Dep't of Health v. Baptist Mem'l Hosp.-Desoto
| Docket Number: | 2007-SA-00035-SCT Linked Case(s): 2007-sa-00035-sct |
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| Supreme Court: | Opinion Link Opinion Date: 06-19-2008 Opinion Author: RANDOLPH, J. Holding: Reversed and Rendered |
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| Additional Case Information: |
Topic: Certificate of need - Substantial evidence - Section 41-7-197 - Substitution of new route - Due process Judge(s) Concurring: SMITH, C.J., WALLER AND DIAZ, P.JJ., EASLEY, CARLSON, DICKINSON AND LAMAR, JJ. Dissenting Author : GRAVES, J., without separate written opinion. Procedural History: Bench Trial Nature of the Case: CIVIL - STATE BOARDS AND CIVIL - STATE BOARDS AND AGENCIES |
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| Trial Court: |
Date of Trial Judgment: 12-29-2006 Appealed from: Hinds County Chancery Court Judge: Patricia D. Wise Disposition: The trial court found that DeSoto's application complied with the Fiscal Year 2006 Mississippi State Health Plan’s (State Health Plan) General Certificate of Need Policies, the State Health Plan’s CON Criteria and Standards for the Offering of MRI Services, and the CON Review Manual’s General Considerations, and recommended approval of DeSoto’s application. Case Number: G2006-1611 W/4 |
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| Party Name: | Attorney Name: | Brief(s) Available: | ||
| Appellant: | MISSISSIPPI STATE DEPARTMENT OF HEALTH
AND DESOTO IMAGING & DIAGNOSTICS, LLC |
DONALD E. EICHER, III,
THOMAS L. KIRKLAND, JR.,
ANDY LOWRY,
ALLISON C. SIMPSON |
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| Appellee: | BAPTIST MEMORIAL HOSPITAL-DESOTO, INC. d/b/a BAPTIST MEMORIAL HOSPITAL-DESOTO AND DESOTO DIAGNOSTIC IMAGING, LLC d/b/a CARVEL IMAGING | BARRY K. COCKRELL, KATHRYN RUSSELL GILCHRIST, DAVID WELDON DONNELL | ||
| Appellee #2: | ||||
Synopsis provided by:  If you are interested in subscribing to the weekly synopses of all Mississippi Supreme Court and Court of Appeals hand downs please contact Tammy Upton in the MLI Press office. |
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| Topic: | Certificate of need - Substantial evidence - Section 41-7-197 - Substitution of new route - Due process |
| Summary of the Facts: | DeSoto Imaging and Diagnostics, LLC entered into an agreement with Alliance Imaging for the provision of mobile magnetic resonance imaging services, contingent upon DeSoto procuring a Certificate of Need from the Mississippi State Department of Health. DeSoto’s subsequently filed CON application was opposed by Baptist Memorial Hospital-DeSoto, Inc. and DeSoto Diagnostic Imaging, LLC. The hearing officer recommended approval of DeSoto’s application. Soon thereafter, Gilmore Memorial Hospital, a hospital on the proposed mobile route which DeSoto was to join, terminated its MRI Service Agreement with Alliance. Baptist and Carvel then filed a “Joint Motion to Reopen and Supplement Record and for Reconsideration of Hearing Officer’s Findings of Fact and Conclusions of Law,” alleging that because of this development, the mobile route proposed would not meet requirements of the State Health Plan. Alliance subsequently attested that alteration of routes was common and a modified route would satisfy the State Health Plan’s requirements. The hearing officer denied the motion and reaffirmed the recommendation to grant DeSoto’s application. The State Health Officer subsequently issued a final order adopting the findings and recommendation of the hearing officer. Baptist and Carvel appealed to chancery court which reversed the MSDH’s approval of DeSoto’s application and remanded to the MSDH “with the mandate that, if [DeSoto] wishes to propose a new MRI route, that new route be subjected to a hearing during the course of review at which interested parties may oppose or support the new route.” DeSoto and the MSDH appeal. |
| Summary of Opinion Analysis: | Issue 1: Substantial evidence The final order of the State Health Officer regarding a CON application shall not be vacated or set aside, either in whole or in part, except for errors of law, unless the court finds that the order of the MSDH is not supported by substantial evidence, is contrary to the manifest weight of the evidence, is in excess of the statutory authority or jurisdiction of the MSDH, or violates any vested constitutional rights of any party involved in the appeal. DeSoto presented evidence that Alliance’s 1.5 Tesla MRI unit would perform more than 1,700 procedures annually among Gilmore, Mission, and DeSoto, based on the procedures performed at Gilmore and Mission in the most recent twelve-month period in conjunction with projections for DeSoto. Additionally, DeSoto presented physician affidavits, in compliance with the State Health Plan, accounting for 372 additional projected MRI referrals. An expert in healthcare planning and systems analysis conceded that DeSoto can show that the route of the magnet has 1,700 or more procedures per year and meet that definition. Thus, substantial evidence is present in the record to support the finding that the number of procedures exceeded the requirements of the State Health Plan. DeSoto presented evidence that DeSoto County was the fastest-growing county in Mississippi and the thirty-fifth fastest-growing county in the United States. Additionally, numerous qualified individuals testified at the hearing as to the impact of population growth on healthcare provision. This evidence supports the finding that the population growth in DeSoto County has created a need for additional MRI services toward the end of improving the health of Mississippi residents. Of additional import, expert testimony indicated that DeSoto’s proposed provision of MRI services could meet that need in a manner which would not infringe upon the financial viability of existing providers, while simultaneously increasing accessibility of MRI services in DeSoto County. Issue 2: Substitution of new route A new and unforeseen problem arose in the case in that the proposed route which DeSoto was to join was rendered prospectively insufficient to produce the minimum number of annual procedures required by the State Health Plan by Gilmore’s termination of its MRI Service Agreement with Alliance, after the hearing officer’s recommendation to grant DeSoto’s application, but before the State Health Officer ruled thereon. Baptist argues that the hearing officer’s denial of its motion to reopen and supplement the record and accompanying recommendation to grant DeSoto’s application, adopted by the State Health Officer, contravened section 41-7-197(2) in that “any person affected by the proposal being reviewed” was not given the opportunity to “conduct reasonable questioning of persons who make relevant factual allegations concerning the proposal.” In the administrative setting, minimum procedural due process is notice and opportunity to be heard. The great deference extended to the MSDH reaches to the new and unforeseen problems it encounters over time. There can be no legitimate dispute that the procedures outlined in section 41-7-197(1) were satisfied with respect to DeSoto’s application. Following a route change, which was not a substantial change in scope and which would have required a new CON application had CON Review Manual § 100.01 been applicable, a hearing was held to consider Baptist and Carvel’s “Joint Motion to Reopen and Supplement Record and for Reconsideration of Hearing Officer’s Findings of Fact and Conclusions of Law.” Significantly, no parties to the proceeding, no health care facilities in the same health care service area, and no others originally noticed, appeared to request a new hearing. Also, the administrative procedural due process requirements were satisfied. Baptist and Carvel were on notice of the new route. A motion hearing on their joint motion accorded them due process. Therefore, the chancery court erred in remanding to the MSDH. |
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