Daniel Senior Living of Inverness I, LLC, d/b/a Danberry at Inverness v. STV One Nineteen Senior Living, LLC, d/b/a Somerby at St. Vincent's One Nineteen; State Health Planning and Development Agency; and Certificate of Need Review Board
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11/18/11
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s h e e t s o f Southern R e p o r t e r . R e a d e r s a r e r e q u e s t e d t o n o t i f y t h e R e p o r t e r o f D e c i s i o n s ,
A l a b a m a A p p e l l a t e C o u r t s , 300 D e x t e r A v e n u e , M o n t g o m e r y , A l a b a m a 3 6 1 0 4 - 3 7 4 1
((334)
2 2 9 - 0 6 4 9 ) , o f a n y t y p o g r a p h i c a l o r o t h e r e r r o r s , i n o r d e r t h a t c o r r e c t i o n s may b e made
b e f o r e t h e o p i n i o n i s p r i n t e d i n Southern R e p o r t e r .
ALABAMA COURT OF CIVIL
APPEALS
OCTOBER TERM, 2011-2012
2100476
D a n i e l S e n i o r L i v i n g o f Inverness I, LLC, d/b/a Danberry a t
Inverness
v.
STV One Nineteen Senior L i v i n g , LLC, d/b/a Somerby a t S t .
V i n c e n t ' s One N i n e t e e n ; S t a t e H e a l t h P l a n n i n g and
Development Agency; and C e r t i f i c a t e o f Need Review Board
Appeal from Montgomery C i r c u i t Court
(CV-10-901242)
BRYAN, J u d g e .
D a n i e l S e n i o r L i v i n g o f I n v e r n e s s I , L L C , d/b/a D a n b e r r y
at
Inverness
("Danberry"),
appeals
from
a judgment o f
the
2100476
Montgomery
Circuit
Court
emergency c e r t i f i c a t e
Senior
Living,
Nineteen
LLC,
On
March
Council
25,
("the
of
need
d/b/a
("Somerby").
Procedural
affirming
We
Somerby
reverse
the
issuance
("CON") t o
H i s t o r y and
2010,
the
at
and
STV
St.
One
of
an
Nineteen
Vincent's
One
remand.
F a c t u a l Background
Statewide
C o u n c i l " ) , i n response
Health
to
Coordinating
Somerby's
request,
v o t e d t o a d j u s t the S t a t e H e a l t h P l a n to i n d i c a t e the need f o r
164
specialty-care assisted-living-facility
Shelby County.
1
On
March 31,
2010,
("SCALF") b e d s i n
t h e n G o v e r n o r Bob
approved the adjustment to the S t a t e H e a l t h P l a n .
on a p p e a l
i n d i c a t e s t h a t SCALF s e r v i c e s a r e
that a i d patients with dementia-related
the C o u n c i l a d j u s t e d
a n e e d f o r 96
submitted
it,
the
The
SCALF b e d s i n S h e l b y C o u n t y .
record
special services
impairments.
State Health
Riley
P l a n had
Before
indicated
However, e v i d e n c e
t o t h e C o u n c i l r e v e a l e d t h a t t h e r e were a c t u a l l y
128
The
State Health Plan i s a comprehensive p l a n t h a t
" p r o v i d e [ s ] f o r the
development of h e a l t h programs
and
resources to assure that q u a l i t y h e a l t h s e r v i c e s w i l l
be
a v a i l a b l e and a c c e s s i b l e i n a manner w h i c h a s s u r e s c o n t i n u i t y
of care, at reasonable c o s t s , f o r a l l r e s i d e n t s of the s t a t e . "
§
2 2 - 2 1 - 2 6 0 ( 1 3 ) , A l a . Code 1975.
The
Council
prepares,
reviews,
r e v i s e s , and a p p r o v e s t h e S t a t e H e a l t h P l a n .
§
2 2 - 4 - 8 ( b ) ( 2 ) , A l a . Code 1975.
1
2
2100476
SCALF b e d s i n s e r v i c e i n t h a t c o u n t y .
Thus, t h e a d j u s t m e n t t o
the
S t a t e H e a l t h P l a n t o i n d i c a t e t h e n e e d f o r 164 SCALF beds
in
Shelby
County
essentially
reflected
a
need
for
an
a d d i t i o n a l 36 SCALF b e d s above t h e 128 SCALF beds a l r e a d y i n
service.
After
the
adjustment to
the
State
Health
Plan,
both
Somerby a n d D a n b e r r y a p p l i e d f o r a CON t o c o n v e r t 24 o f t h e i r
existing
assisted-living-facility
C o u n t y t o SCALF b e d s .
t h a t Somerby f i l e d
convert
SCALF
in
Shelby
i t s s t a n d a r d CON a p p l i c a t i o n , Somerby
That i s ,
also
see § 22-21-268, A l a . Code 1975,
24 o f i t s e x i s t i n g
beds.
beds
However, on May 28, 2010, t h e same day
a p p l i e d f o r an e m e r g e n c y CON,
to
("ALF")
ALF b e d s
Somerby
applied
i n Shelby County t o
f o r both
a
standard,
nonemergency CON a n d an e m e r g e n c y CON i n an a t t e m p t t o c o n v e r t
24 o f i t s ALF b e d s t o SCALF b e d s .
a
standard,
e m e r g e n c y CON
parties,
and
nonemergency
an
applicant
does n o t n e e d t o p r o v i d e n o t i c e
the process
considerably expedited.
Code
CON,
U n l i k e an a p p l i c a n t
for granting
an
seeking
seeking
an
to
interested
emergency
CON
is
See R u l e 4 1 0 - 1 - 1 0 - . 0 1 ( 1 ) , A l a . Admin.
( S t a t e H e a l t h P l a n n i n g and Development A g e n c y ) .
As
we
w i l l d i s c u s s b e l o w , an e m e r g e n c y CON may be i s s u e d as a r e s u l t
3
2100476
of " u n f o r s e e n e v e n t s " t h a t "endanger t h e h e a l t h and s a f e t y o f
the p a t i e n t s . "
§ 22-21-268.
D a n b e r r y o p p o s e d Somerby's e m e r g e n c y CON a p p l i c a t i o n .
On
June 16, 2010, t h e C e r t i f i c a t e o f Need R e v i e w B o a r d ("CONRB")
of the State Health
considered
supporting
Planning
Somerby's
evidence
from Danberry.
application
and Development Agency
emergency
f r o m Somerby
CON
application,
and e v i d e n c e
("SHPDA")
receiving
i n opposition
T h a t same day, t h e CONRB a p p r o v e d Somerby's
f o r an e m e r g e n c y CON.
The CONRB i s s u e d a
final,
w r i t t e n d e c i s i o n g r a n t i n g Somerby t h e e m e r g e n c y CON on J u l y 1,
2010, s l i g h t l y
application.
to
more t h a n a month a f t e r Somerby h a d f i l e d i t s
After exhausting i t s administrative
t h e CONRB's d e c i s i o n ,
court,
Danberry appealed
to the
p u r s u a n t t o § 40-22-20, A l a . Code 1975.
court
entered
issue
Somerby
challenges
The
circuit
circuit
a j u d g m e n t a f f i r m i n g t h e CONRB's d e c i s i o n
an
emergency
CON
for
the
24
SCALF
to
beds.
D a n b e r r y f i l e d a t i m e l y n o t i c e o f a p p e a l t o t h i s c o u r t , a n d we
h e a r d o r a l argument on S e p t e m b e r 20, 2011.
Standard of Review
In
court's
reviewing
an a d m i n i s t r a t i v e
agency's d e c i s i o n ,
this
s t a n d a r d o f r e v i e w i s t h e same as t h a t o f t h e c i r c u i t
4
2100476
court.
Alabama
Assistance
2007).
review
in this
Dep't
Found., I n c . ,
Section
of
Envtl.
v.
Legal
Envtl.
973 So. 2d 369, 375 ( A l a . C i v . App.
41-22-20(k),
A l a . Code
and t h e c i r c u i t c o u r t ' s review
case.
Mgmt.
1975, g o v e r n s o u r
o f t h e CONRB's d e c i s i o n
In pertinent part, i t provides:
" ( k ) E x c e p t where j u d i c i a l r e v i e w i s b y t r i a l de
novo, t h e a g e n c y o r d e r s h a l l be t a k e n as p r i m a f a c i e
just
and reasonable
and t h e c o u r t
s h a l l not
s u b s t i t u t e i t s j u d g m e n t f o r t h a t o f t h e a g e n c y as t o
t h e w e i g h t o f t h e e v i d e n c e on q u e s t i o n s o f f a c t ,
e x c e p t where o t h e r w i s e a u t h o r i z e d b y s t a t u t e . ...
The c o u r t may r e v e r s e o r m o d i f y t h e d e c i s i o n o r
grant
other
appropriate
relief
from t h e agency
a c t i o n ... i f t h e c o u r t f i n d s t h a t t h e a g e n c y a c t i o n
i s due t o be s e t a s i d e o r m o d i f i e d u n d e r s t a n d a r d s
set f o r t h i n appeal or review s t a t u t e s a p p l i c a b l e t o
that
agency
or i f s u b s t a n t i a l rights
of the
p e t i t i o n e r have b e e n p r e j u d i c e d b e c a u s e t h e a g e n c y
a c t i o n i s a n y one o r more o f t h e f o l l o w i n g :
"(1)
In v i o l a t i o n of c o n s t i t u t i o n a l
statutory provisions;
or
"(2)
In excess of the s t a t u t o r y a u t h o r i t y
of t h e agency;
"(3)
rule;
I n v i o l a t i o n o f any p e r t i n e n t agency
"(4)
Made upon u n l a w f u l
"(5)
law;
A f f e c t e d by other e r r o r o f
procedure;
"(6)
C l e a r l y erroneous i n view of the
reliable,
probative,
and
substantial
e v i d e n c e o f t h e whole r e c o r d ; o r
5
2100476
"(7)
Unreasonable,
arbitrary,
or
c a p r i c i o u s , o r c h a r a c t e r i z e d b y an abuse o f
discretion
or
a
clearly
unwarranted
exercise of d i s c r e t i o n . "
Our
r e v i e w o f t h e CONRB's c o n c l u s i o n s o f l a w a n d a p p l i c a t i o n
o f t h e l a w t o t h e f a c t s i s de novo.
Ex p a r t e W i l b a n k s
Health
C a r e S e r v s . , I n c . , 986 So. 2d 422, 425 ( A l a . 2 0 0 7 ) .
Discussion
On
issuing
appeal,
Danberry
argues
that
t h e CONRB
erred i n
an e m e r g e n c y CON t o Somerby b e c a u s e , D a n b e r r y
Somerby's
"emergency"
emergency
under
CON
application
§ 22-21-268,
says,
d i d not present
A l a . Code
1975.
We
an
agree.
S e c t i o n 22-21-268 p r o v i d e s :
"Any p e r s o n may a p p l y , e i t h e r i n d e p e n d e n t l y a n d
w i t h o u t n o t i c e u n d e r S e c t i o n 2 2 - 2 1 - 2 6 7 [ ] o r as a
part
of
an
application
filed
under
Section
22-21-267, f o r an e m e r g e n c y c e r t i f i c a t e o f n e e d f o r
the
authorization
of capital
expenditures
made
n e c e s s a r y by unforeseen events which endanger t h e
h e a l t h and s a f e t y of the p a t i e n t s .
Emergency
capital
expenditures
include,
but
are not
n e c e s s a r i l y l i m i t e d t o , emergency e x p e n d i t u r e s t o
m a i n t a i n q u a l i t y c a r e , t o overcome f a i l u r e o f f i x e d
equipment, i n c l u d i n g h e a t i n g and a i r c o n d i t i o n i n g
equipment, e l e v a t o r s , e l e c t r i c a l t r a n s f o r m e r s and
s w i t c h gear,
sterilization
equipment,
emergency
generators,
water
supply
and
other
utility
2
S e c t i o n 22-21-267,
application process.
2
A l a . Code
6
1975, c o n c e r n s
t h e CON
2100476
c o n n e c t i o n s . A p p l i c a t i o n s f o r emergency c e r t i f i c a t e s
o f n e e d s h a l l i n c l u d e a d e s c r i p t i o n o f t h e work t o
be done a n d / o r e q u i p m e n t t o be p u r c h a s e d , t h e c o s t
thereof, j u s t i f i c a t i o n f o r considering the c a p i t a l
e x p e n d i t u r e as b e i n g o f an e m e r g e n c y n a t u r e a n d s u c h
other
information
as
t h e SHPDA
may
require.
Emergency c e r t i f i c a t e s
o f need i s s u e d hereunder
s h a l l be s u b j e c t t o s u c h s p e c i a l l i m i t a t i o n s a n d
r e s t r i c t i o n s as t h e d u r a t i o n a n d r i g h t o f e x t e n s i o n
o r r e n e w a l as may be p r e s c r i b e d i n t h e r u l e s a n d
r e g u l a t i o n s a d o p t e d b y t h e SHPDA."
R u l e 4 1 0 - 1 - 1 0 - . 0 1 ( 1 ) , A l a . Admin. Code (SHPDA), l i s t s t h e
same
examples
contained
an
o f emergency
capital
expenditures
that
are
i n § 22-21-268, e x c e p t t h a t t h e r u l e a l s o l i s t s , as
example
expenditures
disaster."
o f an e m e r g e n c y
capital
expenditure,
emergency
t o overcome "damage c a u s e d b y n a t u r a l o r manmade
The r u l e p r o v i d e s ,
i n pertinent
part:
"Emergency c a p i t a l e x p e n d i t u r e s i n c l u d e , b u t a r e n o t
n e c e s s a r i l y l i m i t e d t o , emergency e x p e n d i t u r e s t o
m a i n t a i n q u a l i t y c a r e , overcome f a i l u r e o f f i x e d
equipment, i n c l u d i n g h e a t i n g and a i r c o n d i t i o n i n g
equipment, e l e v a t o r s , e l e c t r i c a l t r a n s f o r m e r s , and
switch
gear,
sterilization
equipment, emergency
generators,
water
supply
and
other
utility
c o n n e c t i o n s a n d damage c a u s e d b y n a t u r a l o r manmade
disaster."
R u l e 410-1-10-.01(1)
(emphasis added).
.01(1) ( a ) , an a p p l i c a n t
f o r an e m e r g e n c y CON
d e m o n s t r a t e t h a t an e m e r g e n c y
Section
Under R u l e
410-1-10-
"must
clearly
exists."
22-21-268 p r o v i d e s
7
t h a t an e m e r g e n c y CON may be
2100476
i s s u e d f o r e x p e n d i t u r e s "made n e c e s s a r y b y u n f o r e s e e n e v e n t s "
that
"endanger t h e h e a l t h
statute
then
involving
qualify
lists
several
the f a i l u r e
and s a f e t y o f t h e p a t i e n t s . "
specific
of h o s p i t a l
f o r an e m e r g e n c y
CON,
The
examples o f e v e n t s , a l l
equipment,
provided
that
endanger t h e h e a l t h and s a f e t y o f t h e p a t i e n t s .
that
would
those
events
Rule
410-1-
1 0 - . 0 1 ( 1 ) p r o v i d e s a n o t h e r s p e c i f i c e x a m p l e : "damage c a u s e d b y
n a t u r a l o r manmade d i s a s t e r . "
Under t h e p r i n c i p l e o f e j u s d e m
generis,
"when g e n e r a l words o r p h r a s e s
specific
list
word o r phrase
of classes
of persons
i s interpreted
f o l l o w o r precede
or things,
the general
t o be o f t h e same n a t u r e o r
c l a s s a s t h o s e named i n t h e s p e c i f i c
list."
of
( A l a . C i v . App.
Montgomery,
Thus,
to
48 So. 3d 647, 650
merit
an
a
emergency
CON,
C o c k i n g v. C i t y
there
must
2010).
be
an
i d e n t i f i a b l e , u n f o r s e e n event, i n t h e n a t u r e o f o r comparable
to equipment f a i l u r e ,
n a t u r a l d i s a s t e r , o r manmade d i s a s t e r ,
t h a t endangers t h e h e a l t h and s a f e t y s t a t u s o f p a t i e n t s .
None o f t h e c h a r a c t e r i s t i c s o f an e m e r g e n c y d i s c u s s e d i n
§ 22-21-268 a n d R u l e 4 1 0 - 1 - 1 0 - . 0 1 ( 1 ) a r e f o u n d i n t h i s
case.
I n i t s e m e r g e n c y CON a p p l i c a t i o n , Somerby s t a t e d t h a t i t was
s e e k i n g an e m e r g e n c y CON " b a s e d
8
on i t s c u r r e n t
inability to
2100476
properly
care
f o r patients
conditions."
Somerby a s s e r t e d
Somerby w i l l
related
county
Somerby's
i s medically
that
to relocate
o f Shelby County
services.
to
be f o r c e d
care."
population
suffering
from
"[w]ithout
application
also
CON
approval
dementia
noted
that the
i s r a p i d l y growing and t h a t t h e
underserved
with
respect
community
separation
granting
offer
prevent
of f a m i l i e s . "
a
apartments
the
stressful
The d e c i s i o n
an e m e r g e n c y CON
continuum
independent
growth i n
The d e c i s i o n
i s an i m m e d i a t e n e e d f o r SCALF b e d s w i t h i n
to
Somerby
SCALF
t h e e m e r g e n c y CON
S h e l b y C o u n t y , p a r t i c u l a r l y among t h e e l d e r l y .
the
to
t h e CONRB n o t e d t h e r a p i d p o p u l a t i o n
s t a t e d that "there
related
facing
patients
In i t s written decision granting
Somerby,
dementia
living
of
care
to
apartments,
a l l w i t h i n t h e same
and
further
would
allow
residents
ALF
unnecessary
found
that
Somerby " t o
by
apartments
including
and
SCALF
facility."
I n s e e k i n g an e m e r g e n c y CON, Somerby e s s e n t i a l l y r e l i e d
on t h e same e v i d e n c e t h a t i t r e l i e d on i n i t s a p p l i c a t i o n f o r
a standard,
n o n e m e r g e n c y CON.
Somerby's a p p l i c a t i o n f o r an
e m e r g e n c y CON was b a s e d on e v i d e n c e i n d i c a t i n g t h a t t h e r e i s
a general
need
f o r SCALF b e d s i n S h e l b y C o u n t y ,
9
that
Somerby
2100476
could
provide
services
those
services
that
application
contemplated
that
w o u l d meet t h i s
w o u l d be v a l u a b l e
does
by
§
not
and c o n v e n i e n t .
demonstrate
22-21-268
need,
and
Rule
an
and t h a t
However,
emergency
as
410-1-10-.01(1).
Somerby's e m e r g e n c y CON a p p l i c a t i o n i s e s s e n t i a l l y a
standard
CON a p p l i c a t i o n d i s g u i s e d as an e m e r g e n c y CON a p p l i c a t i o n .
We
recognize
that
" [ i ] n t e r p r e t a t i o n s o f an a c t b y t h e
a d m i n i s t r a t i v e agency charged w i t h i t s enforcement, though n o t
conclusive,
a r e t o be g i v e n
court."
Hulcher
1980).
Similarly,
v. T a u n t o n ,
appear
as
reasonable
by the
reviewing
i n t e r p r e t a t i o n o f i t s own
i f i t i s reasonable,
F e r l i s i v. A l a b a m a M e d i c a i d
C i v . App. 1 9 8 5 ) .
weight
388 So. 2d 1203, 1206 ( A l a .
"an a g e n c y ' s
r e g u l a t i o n must s t a n d
not
great
as
some
other
e v e n t h o u g h i t may
interpretation."
A g e n c y , 481 So. 2d 400, 403 ( A l a .
However, " [ a ] n a d m i n i s t r a t i v e a g e n c y c a n n o t
u s u r p l e g i s l a t i v e powers o r c o n t r a v e n e a s t a t u t e . "
J o n e s M f g . Co., 589 So. 2d 208, 210 ( A l a . 1 9 9 1 ) .
Ex p a r t e
I n s o f a r as
t h e CONRB's g r a n t i n g Somerby an e m e r g e n c y CON may be v i e w e d as
demonstrating
regulatory
a liberal
provisions
interpretation
i n t e r p r e t a t i o n o f t h e s t a t u t o r y and
relating
i s contrary
to
emergency
t o the clear
10
CONs,
intent
of
that
those
2100476
provisions.
As t h e A l a b a m a Supreme C o u r t h a s o b s e r v e d :
" ' " ' I t i s s e t t l e d that courts should give
g r e a t w e i g h t t o any r e a s o n a b l e c o n s t r u c t i o n
of a r e g u l a t o r y s t a t u t e adopted by the
agency charged w i t h t h e enforcement o f t h a t
statute.
Clarke
v. S e c u r i t i e s
I n d u s t r y A s s n . , 479 U.S. 388, 403-404, 107
S. C t . 750, 93 L. E d . 2d 757
(1987)
( q u o t i n g I n v e s t m e n t Company I n s t i t u t e v.
Camp, 401 U.S. 617, 626-627, 91 S. C t .
1091, 28 L. E d . 2d 367 ( 1 9 7 1 ) ) .
"'Under t h e f o r m u l a t i o n
now f a m i l i a r ,
when we
confront
an
expert
administrator's
statutory
e x p o s i t i o n , we i n q u i r e f i r s t w h e t h e r " t h e i n t e n t o f
C o n g r e s s i s c l e a r " as t o " t h e p r e c i s e q u e s t i o n a t
issue."
C h e v r o n U.S.A. I n c . v . N a t u r a l R e s o u r c e s
D e f e n s e C o u n c i l , I n c . , 467 U.S. 837, 842, 104 S. C t .
2778, 81 L. E d . 2d 694 ( 1 9 8 4 ) .
I f so, "that i sthe
end o f t h e m a t t e r . " I b i d . B u t " i f t h e s t a t u t e i s
s i l e n t o r ambiguous w i t h r e s p e c t t o t h e s p e c i f i c
i s s u e , the q u e s t i o n f o r the court i s whether the
agency's
answer
i s based
on
a
permissible
c o n s t r u c t i o n o f t h e s t a t u t e . " I d . , a t 843, 104 S.
C t . , a t 2782. I f t h e a d m i n i s t r a t o r ' s r e a d i n g
fills
a gap o r d e f i n e s a t e r m i n a way t h a t i s r e a s o n a b l e
i n l i g h t o f t h e l e g i s l a t u r e ' s r e v e a l e d d e s i g n , we
give
the administrator's
judgment
"controlling
w e i g h t . " I d ^ , a t 844, 104 S. C t . , a t 2782.'"
QCC, I n c . v . H a l l ,
757 So. 2d 1115, 1119 ( A l a . 2000)
(quoting
N a t i o n s B a n k o f N o r t h C a r o l i n a , N.A. v . V a r i a b l e A n n u i t y
I n s . Co., 513 U.S. 2 5 1 , 256-57
By
defined
(1995)).
p r o v i d i n g s p e c i f i c examples, the l e g i s l a t u r e
the type of s i t u a t i o n
u n d e r § 22-21-268.
that
The s i t u a t i o n
11
Life
clearly
c o n s t i t u t e s an e m e r g e n c y
i n this
case c l e a r l y
does
2100476
not
f i t t h e "emergency" c a t e g o r y i n t e n d e d
r e f l e c t e d i n Rule 410-1-10-.01(1).
provisions
relating
by t h a t s t a t u t e and
The CONRB's r e a d i n g o f t h e
t o emergency
CONs t o i n c l u d e
Somerby's
s i t u a t i o n as an e m e r g e n c y i s n o t " ' r e a s o n a b l e i n l i g h t o f t h e
legislature's
Applying
the
revealed
design.'"
Hall,
757 So. 2d a t 1119.
an i n t e r p r e t a t i o n as b r o a d as t h e one e v i d e n c e d b y
CONRB w o u l d e s s e n t i a l l y n u l l i f y t h e s t a t u t e .
a construction,
a standard,
one t h a t r e f l e c t s a g e n e r a l
Under s u c h
n o n e m e r g e n c y CON a p p l i c a t i o n
need f o r h e a l t h
—
s e r v i c e s and t h e
a p p l i c a n t ' s q u a l i f i c a t i o n s f o r meeting t h a t need —
c o u l d be
s u c c e s s f u l l y p a c k a g e d as an e m e r g e n c y CON a p p l i c a t i o n , t h e r e b y
avoiding
lengthy
notice
approval
to
interested
process.
parties
Surely
and a p o t e n t i a l l y
the l e g i s l a t u r e d i d not
i n t e n d such a r e s u l t .
The
CONRB
erred
by g r a n t i n g
Somerby
an e m e r g e n c y
CON.
A c c o r d i n g l y , we r e v e r s e t h e c i r c u i t c o u r t ' s j u d g m e n t a f f i r m i n g
t h e CONRB's d e c i s i o n , a n d we remand t h e c a s e .
On remand, t h e
c i r c u i t c o u r t s h o u l d e n t e r an o r d e r v a c a t i n g t h e e m e r g e n c y CON
i n i t s e n t i r e t y ; however, t h a t o r d e r
s u c h a manner as t o r e q u i r e
should
n o t be w r i t t e n i n
Somerby t o remove
who a r e c u r r e n t l y i n SCALF b e d s .
12
i t s residents
In i t s reply b r i e f to this
2100476
court, Danberry s t i p u l a t e d t h a t , should t h i s court reverse the
circuit
c o u r t ' s j u d g m e n t , "Somerby
c o u l d keep t h e i r
SCALF r e s i d e n t s , b u t c o u l d n o t t a k e new ones u n l e s s
obtain[s]
SCALF b e d a u t h o r i z a t i o n t h r o u g h
process."
D a n b e r r y ' s r e p l y b r i e f a t 24.
existing
[Somerby]
the ordinary
CON
F u r t h e r m o r e , we do
n o t d e c i d e w h i c h , i f any, p a r t y s h o u l d o b t a i n t h e CON f o r t h e
36 SCALF beds n e e d e d i n S h e l b y C o u n t y , a n e e d i n d i c a t e d i n t h e
State Health
Plan; therefore, the c i r c u i t
court should
e n t e r i n g any judgment t h a t i m p a i r s t h e d e c i s i o n - m a k i n g
avoid
process
o f t h e CONRB on t h a t p o i n t .
REVERSED AND REMANDED WITH INSTRUCTIONS.
Moore, J . , c o n c u r s s p e c i a l l y , w i t h
writing.
Thomas, J . , c o n c u r s i n t h e r a t i o n a l e i n p a r t a n d c o n c u r s
in the result, with writing.
Thompson, P . J . , a n d P i t t m a n ,
13
J., dissent, with writings.
2100476
MOORE, J u d g e ,
As
specially.
I c o n s t r u e § 22-21-268, A l a . Code 1975,
certificate
finding
concurring
o f need
("CON") c a n be i s s u e d
an e m e r g e n c y
based
b y t h e C e r t i f i c a t e o f Need R e v i e w B o a r d
only
on a
("the CONRB")
3
that unforeseen events endangering the h e a l t h o r s a f e t y of t h e
a p p l i c a n t ' s p a t i e n t s may be r e m e d i e d o n l y b y i t s a p p r o v a l o f
c a p i t a l e x p e n d i t u r e s on an e x p e d i t e d b a s i s .
expenditure"
including
i s defined,
f o r purposes
" [ a ] n e x p e n d i t u r e ... w h i c h
capacity of the f a c i l i t y , "
of this
" [ a ] n e x p e n d i t u r e ... w h i c h
the
health services of the f a c i l i t y , "
"capital
case,
as
... [ c ] h a n g e s t h e b e d
§ 22-21-260(3)b.,
and
Code 1975.
The t e r m
A l a . Code 1 9 7 5 ,
... [ s ] u b s t a n t i a l l y
changes
§ 22-21-260(3)c., A l a .
B a s e d on t h o s e d e f i n i t i o n s ,
an e m e r g e n c y CON may
be i s s u e d i f t h e CONRB d e t e r m i n e s t h a t a f a c i l i t y must change
its
bed capacity
to offer
safeguard i t s patients
new h e a l t h
from t h e danger
services
i n order to
caused by unforeseen
By r e g u l a t i o n promulgated by t h e S t a t e H e a l t h P l a n n i n g
and D e v e l o p m e n t A g e n c y
("SHPDA"), t h e c h a i r m a n a n d v i c e
c h a i r m a n o f t h e CONRB a r e a u t h o r i z e d t o i s s u e an e m e r g e n c y CON
b a s e d upon t h e i r d e t e r m i n a t i o n t h a t "an e m e r g e n c y a c t u a l l y
exists."
R u l e 4 1 0 - 1 - 1 0 - . 0 1 ( 1 ) ( b ) , A l a . Admin. Code (SHPDA).
The
CONRB t h e n r a t i f i e s
t h e e m e r g e n c y CON a t i t s n e x t
r e g u l a r l y scheduled meeting.
Rule 410-1-10-.01(1)(c), A l a .
Admin. Code (SHPDA).
3
14
2100476
events.
In
t h i s c a s e , STV
One
Nineteen
Somerby a t S t . V i n c e n t ' s One
application
S e n i o r L i v i n g , LLC,
Nineteen
f o r an e m e r g e n c y CON
("Somerby"), f i l e d
an
i n o r d e r t o expend funds
to
change some o f i t s e x i s t i n g b e d s a t i t s S h e l b y C o u n t y
from
standard
assisted-living-facility
specialty-care
d/b/a
assisted-living-facility
("ALF")
("SCALF")
facility
beds
to
beds,
so
t h a t Somerby c o u l d p r o v i d e , f o r t h e f i r s t t i m e , " p r o p e r [ ]
for
patients suffering
Pursuant
must
from
t o § 22-21-268,
include
expenditure
application,
an
dementia
as
being
Somerby
r a p i d l y growing
of
related conditions."
a p p l i c a n t f o r an
"justification
for
an
emergency
considering
the
emergency
Shelby
that
In
its
County
was
i n p o p u l a t i o n , c a u s i n g an i m m e d i a t e n e e d f o r
a d d i t i o n a l SCALF b e d s t o c a r e f o r d e m e n t i a - i m p a i r e d
and
CON
capital
nature."
out
pointed
care
that, without
t h e e m e r g e n c y CON,
residents
i t c o u l d n o t meet t h a t
n e e d and w o u l d have t o " r e l o c a t e p a t i e n t s " w i t h SCALF n e e d s .
Reviewing
CON,
the
content
i t appears
of
t h a t the
the
order
approving
CONRB a c c e p t e d
those
the
emergency
facts
as i t s
o n l y b a s i s f o r f i n d i n g t h a t an e m e r g e n c y e x i s t e d t h a t r e q u i r e d
i m m e d i a t e a p p r o v a l o f Somerby's p r o p o s e d c a p i t a l e x p e n d i t u r e s .
15
2100476
I a g r e e w i t h t h e m a i n o p i n i o n t h a t t h e r a p i d g r o w t h o f an
aging
population
i n a c e r t a i n a r e a may n o t be c o n s i d e r e d
an
" u n f o r e s e e n e v e n t " w i t h i n t h e m e a n i n g o f § 22-21-268.
So.
3d a t
did
not
. A s s u m i n g t h a t i t c o u l d , h o w e v e r , Somerby s t i l l
s t a t e i n i t s a p p l i c a t i o n t h a t t h e h e a l t h o r s a f e t y o f any
o f i t s r e s i d e n t s was p r e s e n t l y i n d a n g e r , a n d i t s a p p l i c a t i o n ,
by
maintaining
dementia
existed
must
that
that
those
residents
be r e l o c a t e d ,
could
who become
implied
immediately
that
respond
without a d d i t i o n a l c a p i t a l expenditures.
4
impaired
other
by
facilities
t o any such
danger
As t h e m a i n
opinion
c o r r e c t l y n o t e s , Somerby's a p p l i c a t i o n a n d t h e o r d e r
approving
t h e e m e r g e n c y CON c i t e d o n l y m a t t e r s o f c o n v e n i e n c e t o s u p p o r t
its
decision.
create
rather,
So. 3d a t
.
The l e g i s l a t u r e d i d n o t
emergency
CONs
t o redress
ordinary
CONs
are s p e c i f i c a l l y
concerns.
matters
of
convenience;
designed
f o r such
5
I n d e e d , a t o r a l a r g u m e n t , Somerby c l a r i f i e d t h a t t h e
r e c o r d showed t h a t s u c h f a c i l i t i e s were w i t h i n a r e l a t i v e l y
s h o r t d r i v i n g d i s t a n c e from i t s Shelby County f a c i l i t y and
t h a t t h e e m e r g e n c y CON w o u l d o n l y make i t more c o n v e n i e n t f o r
i t s r e s i d e n t s t o o b t a i n SCALF s e r v i c e s .
4
When q u e s t i o n e d on t h i s p o i n t a t o r a l a r g u m e n t , c o u n s e l
f o r t h e p a r t i e s a c k n o w l e d g e d t h a t t h e CONRB h a d n e v e r i n i t s
h i s t o r y i s s u e d an e m e r g e n c y CON on t h e b a s i s t h a t t h e S t a t e
5
16
2100476
Because
consider
I
the
do
not
rapid
"unforeseen
believe
growth
event,"
and
of
that
an
the
aging
because
I
do
legislature
population
not
l e g i s l a t u r e would equate a d e s i r e to provide
location
for health-care
c a p i t a l expenditures
I
conclude
issuing
with
that
the
the
affirming
services with
CONRB
e m e r g e n c y CON
main
the
t h e r e f o r e due
opinion
CONRB's
t o be
lacked
any
t o Somerby.
that
the
actions
and
to
believe
be
that
an
the
a more c o n v e n i e n t
a need f o r emergency
i n order to safeguard
the
would
existing patients,
rational
basis
Accordingly,
circuit
that
court
that
I
for
agree
erred
in
judgment
is
reversed.
H e a l t h P l a n had u n d e r e s t i m a t e d a n e e d f o r c e r t a i n b e d s i n a
p a r t i c u l a r area.
17
2100476
THOMAS, J u d g e , c o n c u r r i n g
concurring i n the result.
I
i n the rationale
agree t h a t t h e c i r c u i t
i n part
c o u r t ' s judgment a f f i r m i n g t h e
d e c i s i o n o f t h e C e r t i f i c a t e o f Need R e v i e w B o a r d
grant
an e m e r g e n c y
Nineteen
One
certificate
Senior L i v i n g ,
Nineteen
living-facility
o f need
("SCALF") b e d s must be r e v e r s e d .
CONRB i n d e t e r m i n i n g
based
on
a
circumstances
instances
("CON")
t o STV One
Vincent's
f o r 24 s p e c i a l t y - c a r e a s s i s t e d -
w o u l d n o t go s o f a r a s t o c o m p l e t e l y
the
("CONRB") t o
L L C , d/b/a Somerby a t S t .
("Somerby"),
and
However, I
l i m i t the discretion of
when an e m e r g e n c y s i t u a t i o n
change
in
the
similar
t o the present
i n w h i c h a change
State
exists
Health
Plan
case.
I can f o r e s e e
i n the State
Health
in
Plan
a l l
would
r e q u i r e i m m e d i a t e a n d e m e r g e n c y a c t i o n b y t h e CONRB t o p r o v i d e
necessary
expenditures
t o prevent
danger
t o t h e h e a l t h and
safety of p a t i e n t s .
Regarding
State
Health
the present
Plan
c a s e , t h e M a r c h 2010 change t o t h e
identified
C o u n t y f o r SCALF b e d s .
an u n d e r s e r v e d
A t t h e time
need
i n Shelby
t h a t Somerby s o u g h t i t s
e m e r g e n c y CON, i t was f a i r l y c e r t a i n t h a t i t was l i k e l y t o be
able t o f i l l
a t l e a s t a few o f t h o s e b e d s a l m o s t
upon t h e i r a v a i l a b i l i t y .
immediately
I n f a c t , Somerby was a b l e t o f i l l
18
4
2100476
o f t h e 24 SCALF b e d s w i t h i n t h e f i r s t
g r a n t e d t h e e m e r g e n c y CON.
few weeks a f t e r
Thus, I b e l i e v e t h a t , h a d
i t was
Somerby
l i m i t e d i t s e m e r g e n c y CON r e q u e s t t o o n l y t h o s e b e d s f o r w h i c h
it
had
an
immediate
immediately f i l l i n g ,
CON
need
and
a
reasonable
likelihood
of
i t c o u l d have q u a l i f i e d f o r an e m e r g e n c y
f o r t h a t l i m i t e d number o f SCALF b e d s .
However,
I agree
t h a t an e m e r g e n c y r e q u i r i n g t h e a d d i t i o n o f 24 SCALF beds a t
Somerby
d i d not
exist,
that
the
circuit
court's
judgment
a f f i r m i n g t h e g r a n t o f t h e e m e r g e n c y CON f o r t h o s e b e d s i s due
to
be
should
reversed,
craft
existing
that,
i t s judgment
SCALF
stipulation
and
residents
upon
remand,
the
s o as t o p r e v e n t
f r o m Somerby,
i n the r e p l y b r i e f
court
the removal of
consistent
f i l e d by D a n i e l
o f I n v e r n e s s I , LLC, d/b/a D a n b e r r y a t
19
circuit
with
Senior
Inverness.
the
Living
2100476
THOMPSON, P r e s i d i n g J u d g e ,
I
dissenting.
d i s a g r e e w i t h t h e main o p i n i o n ' s narrow r e a d i n g o f §
22-21-268, A l a . Code 1975. T h a t r e a d i n g a p p e a r s t o l i m i t t h e
granting
o f an e m e r g e n c y
certificate
o f need
c a p i t a l e x p e n d i t u r e s t o an "emergency" s i t u a t i o n
("CON") f o r
arising
from
an e q u i p m e n t f a i l u r e o r f r o m e q u i p m e n t damaged i n a manmade o r
natural
disaster.
authorization
of
However,
"capital
§ 22-21-268
also provides f o r
expenditures
made
necessary
by
unforeseen
events which endanger t h e h e a l t h and s a f e t y o f t h e
patients."
The s t a t u t e s t a t e s t h a t a u t h o r i z a t i o n o f c a p i t a l
expenditures
application
may
be
granted
pursuant
t o an e m e r g e n c y
i f those expenditures are necessary
care."
qualify
f o r a u t h o r i z a t i o n of c a p i t a l expenditures pursuant t o
emergency
expenditures
CON,
In l i s t i n g
t o "maintain
quality
an
Id.
CON
the statute e x p l i c i t l y
states that
"include, but are not necessarily
the enumerated examples.
g i v e s wide l a t i t u d e
("CONRB")
examples o f s i t u a t i o n s
in
I believe that that
to the C e r t i f i c a t e
determining
expenditures pursuant
Furthermore,
Id.
limited
when
to
t o an e m e r g e n c y CON.
as t h e m a i n o p i n i o n r e c o g n i z e s ,
20
such
to,"
language
o f Need R e v i e w
authorize
that
Board
capital
2100476
"it
i s well established that i n interpreting a
statute,
a
court
accepts
an
administrative
i n t e r p r e t a t i o n o f t h e s t a t u t e by t h e agency charged
with i t s administration, i f the interpretation i s
r e a s o n a b l e . ... A b s e n t a c o m p e l l i n g r e a s o n n o t t o
do s o , a c o u r t w i l l g i v e g r e a t w e i g h t t o an a g e n c y ' s
i n t e r p r e t a t i o n s o f a s t a t u t e a n d w i l l c o n s i d e r them
persuasive."
Ex
parte
State
Dep't o f Revenue,
1996); see a l s o ,
1206
e.g., Hulcher
( A l a . 1980).
"'[A]n
683 So. 2d 980, 983 ( A l a .
v. T a u n t o n , 388 So. 2d 1 2 0 3 ,
a g e n c y ' s i n t e r p r e t a t i o n o f i t s own
r u l e o r r e g u l a t i o n must s t a n d i f i t i s r e a s o n a b l e ,
i t may n o t a p p e a r a s r e a s o n a b l e
See
Sylacauga
662 So. 2 d [265] a t 268 [ ( A l a .
see a l s o F e r l i s i
A g e n c y v . West W a l k e r H o s p i c e ,
(Ala.
C i v . App.
v. A l a b a m a M e d i c a i d A g e n c y , 481 So.
2d 400, 403 ( A l a . C i v . App. 1 9 8 5 ) . "
Dev.
interpretation.'
H e a l t h Care C t r . [ , I n c . v. Alabama S t a t e H e a l t h
Planning Agency],
1994)];
a s some o t h e r
even though
State Health Planning &
Inc.,
993 So. 2 d 25, 29
C i v . App. 2 0 0 8 ) .
I
believe
the question
whether
the rapidly
growing
including the rapidly
growing
population
of Shelby
County,
population
of people
i n Shelby
constitutes
capital
an u n f o r e s e e n
expenditures
decision best
left
County
over
event warranting
pursuant
t o an
authorization of
emergency
t o t h e CONRB, n o t t h i s
21
t h e age o f 65,
court.
CON
is a
When t h e
2100476
d e f e r e n c e t h i s c o u r t must a p p l y t o t h e CONRB's i n t e r p r e t a t i o n s
o f § 22-21-268 a n d t h e r e g u l a t i o n s
accompanying t h a t
statute
a r e c o u p l e d w i t h t h e w i d e l a t i t u d e § 22-21-268 a p p e a r s t o g i v e
to
t h e CONRB,
grant
I must c o n c l u d e
the request
based
patients
on t h e " c u r r e n t
suffering
reasonable.
uphold
circuit
court's
respectfully
from
Accordingly,
t h e CONRB's
t h e CONRB's d e c i s i o n t o
o f STV One N i n e t e e n
d/b/a Somerby a t S t . V i n c e n t ' s
CON
that
Senior
L i v i n g , LLC,
One N i n e t e e n , f o r an e m e r g e n c y
inability
dementia
related
I believe
decision.
to properly
that
Because
care f o r
conditions"
this
I would
court
was
must
a f f i r m the
j u d g m e n t a f f i r m i n g t h e CONRB's d e c i s i o n ,
dissent.
22
I
2100476
PITTMAN, J u d g e ,
I
dissenting.
respectfully
dissent.
The e j u s d e m
generis
doctrine
applied
b y t h e m a i n o p i n i o n i s b u t an " a i d i n a s c e r t a i n i n g
giving
effect
Legislature
intent
conversely,
uncertainty";
to the l e g i s l a t i v e
i s apparent
i f " i t
where
there i s
that
C i t y o f M o b i l e , 248 A l a .
436, 440, 28 So. 2d 203,
Here,
has
the
legislature
expenditures"
such
necessarily
§
the
i n t e n d e d t h e g e n e r a l words t o go b e y o n d t h e c l a s s
s p e c i f i c a l l y d e s i g n a t e d , t h e r u l e does n o t a p p l y . "
involving
and
that
limited
defined
t h e term
(emphasis added).
Code 1975,
or instrument
the verb
said
t o do so n o t a s a w o r d o f l i m i t a t i o n , b u t a s a w o r d o f
(Ala.
670,
Board
See P r i n c e
1990); A c h e l i s
672 ( 1 9 2 4 ) .
i n t h i s manner,
situations
uses
enlargement.
"include"
Ala.
When a s t a t u t e
capital
but [is] not
enumerated
t h e f a i l u r e o f m e d i c a l equipment.
22-21-268
206 ( 1 9 4 6 ) .
"[e]mergency
"include[s],
t o , " various
Moore v .
v. H i g g i n s ,
v. Musgrove,
i t may p r o p e r l y be
572 So. 2 d 1217, 1219
212 A l a .
47, 50, 101 So.
I n my v i e w , t h e C e r t i f i c a t e o f Need R e v i e w
( t h e "CONRB") h a s t h e d i s c r e t i o n ,
when
circumstances
w a r r a n t , t o c l a s s i f y what i t d e t e r m i n e d i n t h i s c a s e t o be "an
immediate need f o r
{specialty-care-assisted-living-facility}
23
2100476
SCALF b e d s w i t h i n t h e community t o p r e v e n t t h e s t r e s s f u l a n d
unnecessary separation
that
"endanger[s] t h e h e a l t h
t h i s context
the
CONRB
literally
circuit
event"
a n d s a f e t y o f ... p a t i e n t s " i n
(§ 2 2 - 2 1 - 2 6 8 ) ; f u r t h e r , t h e r e c o r d r e f l e c t s
d i d so
dozens
("CON") g r a n t s
the
o f f a m i l i e s " a s an " u n f o r e s e e n
in a
manner
of s i m i l a r
by t h a t body.
that
emergency
was
consistent
that
with
certificate-of-need
I w o u l d a f f i r m t h e judgment o f
c o u r t u p h o l d i n g t h e g r a n t o f t h e e m e r g e n c y CON.
24
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