Plott Nursing Home v. Burwell, No. 12-70174 (9th Cir. 2015)
Annotate this CaseThe Secretary of the United States Department of Health and Human Services imposed a civil money penalty on Plott Nursing Home in California for Plott’s violations of the Medicare Act’s standards of care for nursing home patients. The Department’s Appeals Board largely affirmed. Plott petitioned for review. The Ninth Circuit affirmed in part and reversed in part, holding (1) sufficient evidence supported the Secretary’s determination that Plott violated the quality of care for bed sores; (2) the Secretary’s finding that Plott violated the quality of care for urinary tract infections was not supported by substantial evidence on the record; and (3) Plott was entitled to administrative review of all cited deficiencies. Remanded with directions to review or dismiss the violations that were not reviewed by the agency.
Court Description: Medicare Act. The panel reversed in part the Secretary of Health and Human Services’ imposition of a civil monetary penalty for violations of the Medicare Act’s standards of care for nursing home patients, and remanded. The panel affirmed the Secretary’s determination that the Plott Nursing Home in California violated the quality of care for bed sores, reversed the Secretary’s determination that the nursing home violated the quality of care for urinary tract infection, and held that the nursing home was entitled to administrative review of all cited deficiencies and a remand with directions to review or dismiss the violations that were not reviewed by the agency. The panel also held that regarding the public website, the agency need not afford review before survey results were posted, but must allow review and correction as required by the Medicare Act. The panel remanded to the Department of Health and Human Services Appeals Board to review or dismiss the unreviewed and appealed deficiencies alleged, and to reconsider the civil money penalty assessed against the nursing home. Judge Christen concurred with the majority’s holding concerning the two deficiencies that formed the basis for the $500 per day penalty (bed sores and urinary tract infection). PLOTT NURSING HOME V. BURWELL 3 Judge Christen dissented from Part C of the majority’s analysis concerning the holding as to the unreviewed deficiencies.
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