Case Title: In re Mayo Health Care, Inc.

Citation: 175 Vt. 605, 2003 VT 69, 830 A.2d 129

Docket Number: 

State: vermont

Court: Vermont Supreme Court

Date: 2003-07-22T00:00:00Z

Document:
In re Mayo Health Care, Inc. (2002-326); 175 Vt. 605; 830 A.2d 129

2003 VT 69

[Filed 22-Jul-2003]

                                 ENTRY ORDER

                                 2003 VT 69

                      SUPREME COURT DOCKET NO. 2002-326
  	
                              APRIL TERM, 2003

  In re Mayo Health Care, Inc.	       }	APPEALED FROM:
                                       }
                                       }
                                       }	Washington Superior Court
                                       }	
                                       }
                                       }	DOCKET NO. 69-2-01 Wncv

                                                Trial Judge: Alan W. Cheever

             In the above-entitled cause, the Clerk will enter:

       ¶  1.  Appellant Mayo Health Care, Inc. (Mayo) appeals from a trial
  court order granting summary judgment to the Agency of Human Services
  Division of Rate Setting (Division).  Mayo is a licensed nursing facility
  in Northfield, Vermont that receives reimbursement from the State for care
  delivered to its Medicaid residents.  This dispute arises out of efforts by
  Mayo to obtain a rate adjustment from the Division following a decision by
  the Division to disallow wages for unlicensed geriatric aides in
  calculating Medicaid reimbursement rates.  Mayo contends that the trial
  court incorrectly construed the rules governing appeals from Division
  decisions to grant summary judgment in favor of the Division on procedural
  grounds.  Mayo also appeals from the denial of its summary judgment motion. 
  Mayo claims that the Division's disallowance of the wages for geriatric
  aides (geriaides) was inconsistent with its prior rulings and should not
  have been enforced retroactively.  We affirm. 
   
       ¶  2.  This dispute centers around the appeals procedures laid out
  in the Vermont Division of Rate Setting Rules (V.D.R.S.R), which govern the
  establishment of Medicaid payment rates for long-term care facilities.  The
  rules provide several routes through which Medicaid providers are able to
  apply for a rate adjustment.  We agree with the trial court that the
  correctness of the categorization of geriaide costs as indirect costs is
  not properly at issue herein because Mayo failed to raise the issue in the
  filings it made with the Division.  This case started when Mayo filed an
  application for a rate adjustment pursuant to V.D.R.S.R. § 8.2. (FN1)  Section
  8.2 establishes that a nursing care provider can apply for a higher rate of
  reimbursement to cover "additional costs that are a necessary result of
  complying with changes in applicable federal and state laws, and
  regulations, or the orders of a State agency that specifically requires an
  increase in staff or other expenditures."  The Division's final order
  denied Mayo's application, and Mayo appealed to the superior court pursuant
  to 33 V.S.A. § 909(a)(2), granting nursing home facilities the right to a
  de novo appeal from a final order of the Division.  The superior court
  ruled on the parties' cross motions for summary judgment, denying Mayo's
  motion and rendering judgment for the Division.

       ¶  3.  This Court reviews a decision to grant summary judgment de
  novo.  Agency of Natural Res. v. U.S. Fire Ins. Co., 173 Vt. 302, 305,