Case Title: In re Professional Nurses Service

Citation: 180 Vt. 479, 2006 VT 112, 913 A.2d 381

Docket Number: 

State: vermont

Court: Vermont Supreme Court

Date: 2006-11-09T00:00:00Z

Document:
In re Professional Nurses Service (2005-246); 180 Vt. 479; 913 A.2d 381

2006 VT 112

[Filed 09-Nov-2006]


       NOTICE:  This opinion is subject to motions for reargument under
  V.R.A.P. 40 as well as formal revision before publication in the Vermont
  Reports.  Readers are requested to notify the Reporter of Decisions,
  Vermont Supreme Court, 109 State Street, Montpelier, Vermont 05609-0801 of
  any errors in order that corrections may be made before this opinion goes
  to press.


                                 2006 VT 112

                                No. 2005-246


  In re Professional Nurses Service              Supreme Court
  Application for a Certificate of Need
                                                 On Appeal from
                                                 Commissioner of Banking, 
                                                 Insurance, Securities and 
                                                 Health Care Administration

                                                 May Term, 2006

  John P. Crowley, Commissioner

  Philip H. White and Kathleen B. O'Neill of Wilson & White, P.C.,
    Montpelier, and John D. Monahan, Jr. and Angela R. Clark of Dinse, Knapp &
    McAndrew, P.C., Burlington, for Appellants Vermont Assembly of Home Health
    Agencies.

  William H. Sorrell, Attorney General, and Bridget C. Asay, Assistant
    Attorney General, Montpelier, for Appellee Department of Banking,
    Insurance, Securities and Health Care Administration.

  Torin D. Togut, Lawrenceville, Georgia, for Appellee Professional Nurses
    Service, Inc.


  PRESENT:  Reiber, C.J., Dooley, Johnson, Skoglund and Burgess, JJ.

        
       ¶  1.  SKOGLUND, J.   This is an appeal by several regional home
  health agencies from a decision by the Commissioner of the Department of
  Banking, Insurance, Securities and Health Care Administration (BISHCA or
  Department) granting a certificate of need (CON) to Professional Nurses
  Service, Inc. (PNS) to provide the full range of home health care services
  in Vermont.  The CON effectively allows PNS to seek certification as a
  Medicare home health agency, and to compete for Medicare patients and other
  clients with the twelve regional nonprofit agencies, organized as the
  Vermont Assembly of Home Health Agencies (VAHHA).  The regional agencies
  claim that, in granting the CON, the Commissioner erroneously: (1) applied
  provisions of the CON Guidelines; (2) concluded that the additional service
  was necessary to address issues of cost, care, access, and other problems
  within the existing system; and (3) found that the existing agencies had
  not remedied the identified problems.  For the reasons set forth below, we
  affirm.


       ¶  2.  In January 2004, PNS filed a letter of intent with the
  Commissioner stating its intention to apply for a CON to become a home
  health agency authorized to provide a full range of home health services
  and thus become eligible for Medicare certification and reimbursement. 18
  V.S.A. § 9440(c)(2).  The following month, the Commissioner granted
  petitions by VAHHA and each of its twelve constituent members for
  interested party status.  Id. § 9440(c)(6).  The Commissioner determined
  that a CON was required for the proposal, and PNS submitted its application
  in April of 2004.  
   
       ¶  3.  Shortly thereafter, the agencies moved to dismiss the
  application, asserting that PNS had failed at the threshold to satisfy a
  mandatory statutory criterion entitling it to CON review.   The agencies
  relied on 18 V.S.A. § 9437(5), one of the five so called "mandatory"
  criteria for the granting of a CON.   See In re Prof'l Nurses Serv., Inc.,
  168 Vt. 611, 612,