Title: Saint Francis Memorial Hospital v. State Department of Public Health

State: california

Issuer: California Supreme Court

Document:

IN THE SUPREME COURT OF 
CALIFORNIA 
 
SAINT FRANCIS MEMORIAL HOSPITAL, 
Plaintiff and Appellant, 
v. 
STATE DEPARTMENT OF PUBLIC HEALTH, Defendant and 
Respondent. 
 
S249132 
 
First Appellate District, Division One 
A150545 
 
San Mateo County Superior Court 
CIV537118 
 
 
June 29, 2020 
 
Justice Cuéllar authored the opinion of the Court, in which 
Chief Justice Cantil-Sakauye and Justices Chin, Corrigan, Liu, 
Kruger, and Groban concurred. 
 
 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE 
DEPARTMENT OF PUBLIC HEALTH 
S249132 
 
Opinion of the Court by Cuéllar, J. 
 
 
California law permits — but also sets certain limits on — 
judicial review of adjudicatory decisions made by agencies 
responsible for implementing public policies on health, natural 
resources, employment, and other issues.  One example is 
Government Code section 11523,1 which lets parties seek 
judicial review of an agency’s adjudicatory decision by filing a 
petition for a writ of administrative mandate “within 30 days 
after the last day on which reconsideration can be ordered.”  Yet 
lurking in the backdrop for most limitations periods is equitable 
tolling:  a judicially created doctrine allowing courts to toll the 
statute of limitations when justice so requires. 
 
What we must resolve in this case is whether equitable 
tolling can ever lessen the otherwise strict time limit on the 
availability of writs of administrative mandate under section 
11523, and if so, whether the doctrine applies in this case.  The 
answer to the first question is yes.  Section 11523 allows for 
equitable tolling because nothing in the statute’s language, 
structure, or legislative history demonstrates a legislatively 
enacted expectation to prohibit equitable tolling — which 
                                        
1  
All statutory references are to the Government Code 
unless otherwise noted. 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
2 
otherwise tends to function as a crucial backdrop to statutes of 
limitations.   
 
Close scrutiny of that backdrop also reveals that the first 
two elements of tolling are satisfied in this case:  timely notice 
and lack of prejudice.  Equitable tolling nonetheless also 
depends on a third element — the reasonable and good faith 
conduct of the party invoking it — and we cannot from this 
record glean, nor has the Court of Appeal thoroughly addressed, 
whether Saint Francis satisfies that element.  So we vacate the 
judgment and remand for the Court of Appeal to determine 
whether the third element of equitable tolling is satisfied.  
I. 
 
When the State Department of Public Health (the 
Department) learned that doctors at Saint Francis Memorial 
Hospital left a surgical sponge in a patient during a 2010 
surgery, it imposed a $50,000 fine on the hospital.  The 
Department alleged that Saint Francis had “failed to develop 
and implement a [sponge] count procedure” and lacked a policy 
to properly train its staff, as required by California Code of 
Regulations, title 22, section 70223, subdivision (b)(2).   
 
Saint Francis appealed.  After a hearing, an administrative 
law judge (ALJ) issued a proposed decision in Saint Francis’s 
favor.  The ALJ reasoned that the regulations were not 
“intended to impose a penalty for any adverse occurrence during 
the provision of surgical services” — they only required Saint 
Francis to “develop[] and implement[] surgical safety [policies].”  
Because those policies existed at the time of the incident, Saint 
Francis wasn’t liable for violating the regulations. 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
3 
 
On administrative review, however, the Department 
reversed the ALJ’s proposed decision and upheld the penalty 
against Saint Francis.2  It reasoned that “the term ‘implement’ 
informs licensees that they must not only develop and maintain 
a policy, [but] must actually use the policy.”  Saint Francis had 
failed to put its sponge-count policy into practice — “[h]ad [it] 
done so, the sponge count would have revealed that a four-inch 
by eight-inch surgical sponge was still inside the patient” — so 
the hospital had violated the regulations.  The Department 
served Saint Francis with its decision — which was “effective 
immediately” — on December 16, 2015.3  
 
Two weeks later, on December 30, 2015, Saint Francis filed 
a request for reconsideration under section 11521.  This section 
typically allows an agency to order reconsideration of its 
                                        
2  
After an ALJ issues a proposed decision, there is “a second 
level of decisionmaking in which the [Department] decides 
whether to adopt the ALJ’s proposed decision.” (Department of 
Alcoholic Beverage Control v. Alcoholic Beverage Control 
Appeals Bd. (2006) 40 Cal.4th 1, 5.)  If it chooses not to adopt 
the proposed decision in its entirety, the Department may: 
reduce or mitigate the penalty but otherwise adopt the decision 
(§ 11517, subd. (c)(2)(B)), make technical or minor changes to 
the decision (§ 11517, subd. (c)(2)(C)), reject the proposed 
decision and refer the matter back to the ALJ (§ 11517, subd. 
(c)(2)(D)), or reject the proposed decision “and decide the case 
upon the record, including the transcript, or upon an agreed 
statement of the parties, with or without taking additional 
evidence” (§ 11517, subd. (c)(2)(E)).  
3  
Although the Department issued its final decision on 
December 15, 2015, the Department conceded in its briefs and 
at oral argument that the relevant date for the purposes of the 
statute of limitations is December 16, 2015 — the date the 
Department served Saint Francis with its final decision.   
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
4 
decision within “30 days after the delivery or mailing of a 
decision to a respondent.”  (§ 11521, subd. (a).)  According to 
Saint Francis, the Department had mistakenly placed the 
burden of proof on the hospital, and by failing to consider 
evidence introduced by Saint Francis at the administrative 
hearing.  The Department sought to rebut these arguments on 
the merits in its response, which it filed on January 8, 2016.   
 
On January 14, 2016, Saint Francis’s legal counsel wrote 
to counsel for the Department.  Counsel for Saint Francis sought 
to confirm his understanding that the Department had until 
“next Tuesday [January 19] to decide the request [for 
reconsideration].”  Saint Francis explained that, if the request 
for reconsideration was denied, it “intend[ed] to petition for a 
writ of mandate with the Superior Court.”  On January 19, 2016 
— which, as the parties later learned, was after the deadline by 
which Saint Francis should have filed its petition for a writ of 
administrative mandate — counsel for the Department 
responded:  “I believe you are correct.”  The Department’s 
counsel didn’t mention that section 11523’s 30-day statute of 
limitations for filing a petition for a writ of administrative 
mandate had begun running on the effective date of the 
Department’s decision, December 16, 2015, and expired on 
January 15, 2016.  Instead, counsel for the Department offered 
to put Saint Francis in touch with the lawyer who would be 
representing the Department in the superior court proceedings.      
 
The Department also denied Saint Francis’s request for 
reconsideration on January 14, 2016.  It explained that because 
the Department’s decision was “effective immediately,” Saint 
Francis couldn’t seek reconsideration of the Department’s 
decision.  The Department was thus “unable to consider [Saint 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
5 
Francis’s] Request for Reconsideration[,] which is deemed 
denied.”   
 
On January 26, 2016 — just 11 days after the Department 
denied Saint Francis’s request for reconsideration, but 41 days 
after being served with the Department’s final decision — Saint 
Francis filed a petition for a writ of administrative mandate in 
superior court.  (See § 11521.)  The Department demurred on 
the ground that the petition was untimely under section 11523, 
which requires that a writ petition “be filed within 30 days after 
the last day on which reconsideration can be ordered.”  After 
allowing Saint Francis to amend its petition, the court sustained 
the Department’s demurrer.  It reasoned that Saint Francis’s 
petition was time-barred, and “that Saint Francis’s ‘mistake [] 
as to [the] law . . . [was] not a sufficient basis to excuse [a] late 
filing.’ ”  (Saint Francis Memorial Hospital v. State Dept. of 
Public Health (2018) 24 Cal.App.5th 617, 621 (Saint Francis).)   
 
The Court of Appeal affirmed.  In so doing, it acknowledged 
that “Saint Francis’s mistake about the availability of 
reconsideration was made in good faith” and “that Saint Francis 
notified the Department of its intent to file a writ petition.”  
(Saint Francis, supra, 24 Cal.App.5th at p. 624.)  The court 
nonetheless held that because “Saint Francis’s request for 
reconsideration did not constitute the timely pursuit of an 
available remedy[,] . . . [¶] . . . these circumstances are 
insufficient to toll the running of [section 11523’s] 30-day 
[limitations] period.”  (Ibid.)  We granted review to decide 
whether equitable tolling may apply to petitions filed under 
section 11523 and, if so, whether the Court of Appeal erred in 
concluding that tolling did not apply to this case.        
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
6 
II. 
 
We first consider whether equitable tolling may apply to 
section 11523.  The Department argues it cannot because 
equitable tolling is inconsistent with the statute’s “text, 
structure, and legislative history.”   
 
Equitable tolling is a “judicially created, nonstatutory 
doctrine” that “ ‘suspend[s] or extend[s] a statute of limitations 
as necessary to ensure fundamental practicality and fairness.’ ”  
(McDonald v. Antelope Valley Community College Dist. (2008) 
45 Cal.4th 88, 99 (McDonald).)  The doctrine applies 
“occasionally and in special situations” to “soften the harsh 
impact of technical rules which might otherwise prevent a good 
faith litigant from having a day in court.”  (Addison v. State 
(1978) 21 Cal.3d 313, 316 (Addison).)  Courts draw authority to 
toll a filing deadline from their inherent equitable powers — not 
from what the Legislature has declared in any particular 
statute.  (See Elkins v. Derby (1974) 12 Cal.3d 410, 420, fn. 9 
(Elkins).)  For that reason, we presume that statutory deadlines 
are subject to equitable tolling.  (See Irwin v. Department of 
Veterans Affairs (1990) 498 U.S. 89, 95–96 (Irwin).) 
 
But that presumption can be overcome.  Equitable tolling, 
we’ve also observed, “is not immune” from the operation of 
statutes.  (McDonald, supra, 45 Cal.4th at p. 105.)  A court may 
conclude that explicit statutory language or a manifest policy 
underlying a statute simply cannot be reconciled with 
permitting equitable tolling, “even in the absence of an explicit 
prohibition.”  (Ibid.)  We adopted that conclusion in Lantzy v. 
Centex Homes, where we held that the Legislature had sought 
to preclude Code of Civil Procedure section 337.15’s statute of 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
7 
limitations from being tolled.  (Lantzy v. Centex Homes (2003) 
31 Cal.4th 363 (Lantzy).) 
 
Contrary to the Department’s assertions, we find no 
indication 
that 
the 
Legislature’s 
purpose 
encompassed 
prohibiting section 11523’s statute of limitations from being 
tolled.  Our analysis begins with the statute’s language and 
structure.  A petition for a writ of mandate “shall be filed within 
30 days after the last day on which reconsideration can be 
ordered.”  (§ 11523.)  Although the statute — like all statutes of 
limitations — sets forth a deadline by which writ petitions must 
be filed, its language and structure is no different from that of 
other statutes of limitations that are subject to equitable tolling.  
(See, e.g., McDonald, supra, 45 Cal.4th at p. 106 [tolling 
available under statute stating:  “ ‘No [] complaint may be filed 
after the expiration of one year from the date upon which the 
alleged unlawful practice or refusal to cooperate occurred’ ”]; 
Tarkington v. California Unemployment Ins. Appeals Bd. (2009) 
172 Cal.App.4th 1494, 1502, fn. 6 [tolling available under 
statute that required parties “ ‘to seek judicial review from an 
appeals board decision . . . not later than six months after the 
date of the decision of the appeals board’ ”].)  So the fact that 
section 11523 sets a deadline for filing a petition for a writ of 
administrative mandate does not, by itself, demonstrate that 
the Legislature sought to prohibit tolling.    
 
Nor does the length of section 11523’s statute of limitations 
demonstrate a legislative purpose to forbid the availability of 
equitable tolling.  A 10-year statute of limitations, we’ve 
reasoned, is “so ‘exceptionally long’ ” that it “indicates the 
Legislature’s effort to provide, within the strict statutory period 
itself, a reasonable time to” file suit.  (Lantzy, supra, 31 Cal.4th 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
8 
at p. 379.)  But section 11523’s 30-day limitations period is 
relatively brief, so it carries with it no such inference.    
 
The Department nonetheless identifies two features of the 
statute purportedly revealing that the Legislature sought to 
preclude tolling.  The Department first contends that section 
11523’s 30-day deadline is significant because “[o]rdinary 
mandamus writs do not have a specific filing deadline.”  So the 
Legislature’s adoption of a statute of limitations, it argues, was 
a departure from the usual state of affairs that we should 
interpret as indicative of a legislatively enacted expectation that 
tolling be prohibited.  The Department also relies on the fact 
that section 11523 already tolls the statute of limitations in one 
situation:  when a petitioner requests the administrative record 
within 10 days of the deadline for requesting reconsideration.  
(§ 11523.)  That the Legislature explicitly included this one 
situation under which tolling is permitted demonstrates, the 
Department contends, why section 11523 prohibits tolling under 
any other circumstance.  (See California Redevelopment Assn. v. 
Matosantos (2011) 53 Cal.4th 231, 261 [describing the legal 
maxim inclusio unius est exclusio alterius (the inclusion of one 
is the exclusion of another)].) 
 
When we interpret a legislative provision and make sense 
of its purpose in the larger statutory scheme, however, our task 
“ ‘is to discern the sense of the statute, and therefore its words, 
in the legal and broader culture. ’ ”  (Hodges v. Superior Court 
(1999) 21 Cal.4th 109, 114, italics omitted.)  Even the 
Department acknowledges that equitable tolling “is part of the 
established backdrop of American law” — a backdrop we 
presume the Legislature understands when drafting limitations 
periods.  (Lozano v. Montoya Alvarez (2014) 572 U.S. 1, 11.)  
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
9 
That background principle isn’t made explicit in statutes of 
limitations — whose purpose, after all, are to set firm deadlines 
by which parties must file suit.  (See Chase Securities Corp. v. 
Donaldson (1945) 325 U.S. 304, 314 [statutes of limitations “do[] 
not discriminate between the just and the unjust claim, or the 
voidable and unavoidable delay”].)  So the Legislature’s adoption 
of the statute of limitations in section 11523 may very well have 
reflected a goal that petitions for a writ of administrative 
mandate be filed within 30 days — but it does not, by itself, give 
rise to the inference that the Legislature sought to foreclose 
equitable tolling.  Our courts have emphasized how equitable 
tolling can advance “important [public] policy considerations,” 
effectively offering the kind of narrowly drawn flexibility for 
unusual situations that allows the Legislature to preserve strict 
default rules.  (Collier v. City of Pasadena (1983) 142 Cal.App.3d 
917, 926; accord McDonald, supra, 45 Cal.4th at p. 100.)  A 
requirement that parties seek judicial review within 30 days 
under section 11523 doesn’t prohibit courts’ exercise of their 
equitable powers to toll that limitations period when justice so 
requires.       
   
 
Nor is the judiciary powerless to toll the statute of 
limitations in situations besides the one mentioned in section 
11523.  A plaintiff’s timely request for the administrative record 
extends the statute of limitations by “30 days after its delivery 
to him or her.”  (§ 11523.)  Such an exception is sensible:  It 
would be unreasonable, after all, to require plaintiffs to file writ 
petitions before they receive the record on which their petitions 
will be based.  But section 11523 does not “contain exclusivity 
language [] that courts have interpreted as confining tolling to 
specific listed bases.”  (McDonald, supra, 45 Cal.4th at p. 107 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
10 
[citing “ ‘ “in no event” shall the prescriptive period be tolled 
except under those circumstances specified in the statute’ ” and 
no tolling “ ‘for any reason except as provided’ therein” as 
examples of such language].)  The single exception to section 
11523’s 30-day limitations period bears little relation to the 
purpose of equitable tolling:  to excuse noncompliance with the 
statute of limitations in exceptional circumstances in which a 
party didn’t act within the limitations period because of an 
obstacle not acknowledged in the statute.  We decline to infer 
from that single exception that it was within the ambit of the 
Legislature’s purpose to bar tolling in any other circumstance.  
(See Young v. United States (2002) 535 U.S. 43, 49 [The 
Legislature is presumed to draft limitations periods in light of 
the “hornbook law that limitations periods are ‘customarily 
subject to “equitable tolling” ’ ”].) 
 
Similarly unavailing to the Department’s position is the 
legislative history of section 11523.  In contrast to what we 
discerned from the legislative history of Code of Civil Procedure 
section 337.15, it does not “reflect[] a clear intent” that equitable 
tolling ought not be available under section 11523.  (McDonald, 
supra, 45 Cal.4th at p. 105.)  Code of Civil Procedure section 
337.15, as we explained in Lantzy, was enacted in “response to 
[a] considerable expansion of California’s common law of 
construction liability.”  (Lantzy, supra, 31 Cal.4th at p. 374.)  In 
the decades preceding the statute’s enactment, “members of the 
building industry [] faced exposure to liability for all defects in 
their past projects so long as these defects remained 
undiscovered and undiscoverable by reasonable inspection.”  (Id. 
at p. 375.)  The absence of a strict limitations period “produc[ed] 
a risk for which insurance was available only at prohibitive cost 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
11 
. . . thus threatening the industry’s economic health.”  (Id. at p. 
376.) 
 
It was against this backdrop that the Legislature enacted 
the 10-year limitations period in Code of Civil Procedure section 
337.15.  The Legislature appears to have “carefully considered 
how to provide a fair time to discover construction defects, and 
to sue upon such defects if necessary, while still protecting a 
vital industry from the damaging consequences of indefinite 
liability exposure.”  (Lantzy, supra, 31 Cal.4th at p. 377.)  It 
ultimately “specified in section 337.15 that whatever limitations 
periods might otherwise apply, ‘no action’ for injury to property 
arising from latent construction defects ‘may be brought’ more 
than 10 years after substantial completion of the project.”  (Ibid., 
italics omitted.)  The statute’s 10-year limitations period, 
therefore, was intended “to be firm and final.”  (Ibid.)  
 
Nothing in the legislative history of section 11523 supports 
a similar conclusion.  Indeed, the limited history that exists 
could reasonably be read to support the availability of equitable 
tolling.  The Legislature amended section 11523 in 1971 to allow 
plaintiffs who requested the administrative record 30 days, 
instead of five days, to file a petition for a writ of administrative 
mandate after receiving the record.  (Stats. 1971, ch. 984, § 1, p. 
1896.)  The analysis prepared by the Department of General 
Services advised the Governor that although the amendment 
“may on occasion cause subsequent judicial review proceedings 
to commence somewhat later than would be the case under 
existing law[,] . . . such delays would not be likely to measurably 
affect departmental interests, either favorably or adversely.”  
(Dept. of Gen. Services, Enrolled Bill Rep. on Assem. Bill No. 
2067 (1971-1972 Reg. Sess.) Sept. 29, 1971, p. 1.)  If the 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
12 
executive branch wasn’t persuaded that extending the deadline 
from five to 30 days would tend to make a difference in these 
cases, it seems harder still to conclude that it was within the 
ambit of the Legislature’s purpose for the 30-day deadline to 
function as an austere, unforgiving limitation period, 
notwithstanding any equitable considerations buttressing the 
case for tolling. 
 
The Department doesn’t point us to contrary evidence.  Its 
argument rests instead on the fact that the Legislature “has not 
extended the 30-day deadline to file a writ petition” or “added 
any additional statutory tolling provisions” since the statute’s 
enactment in 1945.  From this inaction, the Department would 
have us infer that the 30-day deadline is an inflexible one, 
immune from extension on equitable grounds.  Yet because 
legislatures acquiesce for scores of reasons, such acquiescence 
supports only limited inferences when we interpret statutes.  
(See Harris v. Capital Growth Investors XIV (1991) 52 Cal.3d 
1142, 1156.)  The lack of amendments may instead “ ‘ “indicate 
many [other] things[:] . . . the sheer pressure of other and more 
important business, political considerations, or a tendency to 
trust to the courts to correct their own errors . . . .” ’ ”  (People v. 
Whitmer (2014) 59 Cal.4th 733, 741.)  So we decline to attribute 
to the Legislature a purpose for which little or no evidence 
exists. 
 
We cull little if any evidence from section 11523’s text, 
context, and legislative history that the Legislature took a 
scalpel to equitable tolling under section 11523.  Because we 
presume that statutes of limitations are ordinarily subject to 
equitable tolling, the paucity of evidence that the Legislature 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
13 
ruled it out compels the conclusion that the 30-day statute of 
limitations may be tolled.    
 
But “may” here means possibility, and not just permission:  
That equitable tolling is available under section 11523 doesn’t 
mean it will apply in every — or even most — cases.  As we’ve 
explained, equitable tolling is a narrow remedy that applies to 
toll statutes of limitations only “occasionally and in special 
situations.”  (Addison, supra, 21 Cal.3d at p. 316; see also 
Lantzy, supra, 31 Cal.4th at p. 370 [equitable tolling should be 
applied only “in carefully considered situations”].)  So the 
conclusion that the Legislature hasn’t prohibited a statute of 
limitations from being tolled ought not transform equitable 
tolling into “a cure-all for an entirely common state of affairs.”  
(Wallace v. Kato (2007) 549 U.S. 384, 396 (Wallace).)  Courts 
must instead carefully examine the facts of each case to 
determine whether “justice and fairness” demand that the 
limitations period be tolled.  (Lambert v. Commonwealth Land 
Title Ins. Co. (1991) 53 Cal.3d 1072, 1081.)       
III. 
 
Having concluded that equitable tolling can apply under 
section 11523, we consider whether it does apply in this case.  
We begin by outlining the elements of the doctrine, along with 
the history from which they emerged. 
 
Our equitable tolling doctrine evolved from three lines of 
California cases, each relieving plaintiffs of the duty to abide by 
the statute of limitations.  (See Addison, supra, 21 Cal.3d at p. 
317.)  Courts found a basis to offer some flexibility from the 
statute of limitations when a plaintiff was already involved in 
one lawsuit, and filed a subsequent case that could lessen the 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
14 
damage or harm that would otherwise have to be remedied 
through a separate case.  (Id. at pp. 317–318.)  So too did courts 
toll statutes of limitations in situations where a plaintiff was 
required to pursue, and did indeed pursue, an administrative 
remedy before filing a civil action.  (Id. at p. 318.)  In a third line 
of cases, courts tolled the statute of limitations “ ‘to serve the 
ends of justice where technical forfeitures would unjustifiably 
prevent a trial on the merits.’ ”  (Id. at p. 319.)  
 
It was from all three of these strands of caselaw that 
equitable tolling emerged.  The doctrine allows our courts, “in 
carefully considered situations,” (Lantzy, supra, 31 Cal.4th at p. 
370) to exercise their inherent equitable powers to “soften the 
harsh impact of technical rules” (Addison, supra, 21 Cal.3d at p. 
316) by tolling statutes of limitations.  As we explained in 
Addison, equitable tolling today applies when three “elements” 
are present:  “[(1)] timely notice, and [(2)] lack of prejudice, to 
the defendant, and [(3)] reasonable and good faith conduct on 
the part of the plaintiff.”  (Addison, supra, 21 Cal.3d at p. 319.)  
These requirements are designed to “balanc[e] the injustice to 
the plaintiff occasioned by the bar of his claim against the effect 
upon the important public interest or policy expressed by the 
[operative] limitations statute.”  (Id. at p. 321.) 
 
A. 
 
Perhaps in an effort to somewhat tame the potentially 
capacious extent of the doctrine’s flexibility, some lower courts 
have interpreted equitable tolling to contain a rigid 
requirement:  pursuit of an alternative available administrative 
or legal remedy.  Leaning on our decision in McDonald, the 
Court of Appeal explained that “equitable tolling applies ‘ “ 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
15 
‘[w]hen an injured person has several legal remedies and, 
reasonably and in good faith, pursues one.’ ” ’ ”  (Saint Francis, 
supra, 24 Cal.App.5th at p. 623; see also Hansen v. Board of 
Registered Nursing (2012) 208 Cal.App.4th 664, 672 [equitable 
tolling available when “a party with multiple available remedies 
pursues one in a timely manner”].)  Because “Saint Francis’s 
request for reconsideration did not constitute the timely pursuit 
of an available remedy since reconsideration was unavailable,” 
the court concluded that section 11523’s statute of limitations 
shouldn’t be tolled.  (Saint Francis, supra, 24 Cal.App.5th at p. 
624.)          
 
But as the Department itself acknowledges, our past cases 
stop short of categorically conditioning tolling on a plaintiff’s 
pursuit of a viable remedy.  (J.M. v. Huntington Beach Union 
High School Dist. (2017) 2 Cal.5th 648, 658 (J.M.).)  The doctrine 
is sufficiently supple “to ‘ensure fundamental practicality and 
fairness.’ ”  (Ibid.)  And even in cases where a party seeking 
tolling pursued an alternative remedy, we’ve concluded that 
pursuit of a remedy “embarked upon in good faith, [yet] found to 
be defective for some reason,” doesn’t foreclose a statute of 
limitations from being tolled.  (McDonald, supra, 45 Cal.4th at 
p. 100.)  We applied equitable tolling in Addison, for example, to 
extend the statute of limitations where the plaintiffs first sought 
relief in federal court, which dismissed their suit for lack of 
jurisdiction, before filing their action in state court after the 
statute of limitations had expired.  (Addison, supra, 21 Cal.3d 
at p. 319.)  Although the plaintiffs’ first action was futile because 
of the federal court’s lack of jurisdiction, we reasoned that it 
“notified [defendants] of the action” and gave them “the 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
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Opinion of the Court by Cuéllar, J. 
 
 
16 
opportunity to begin gathering their evidence and preparing 
their defense.”  (Ibid.) 
 
The Court of Appeal correctly described one scenario under 
which equitable tolling may apply:  if a plaintiff pursues one of 
several available legal remedies, causing it to miss the statute 
of limitations for other remedies it later wishes to pursue.  Yet 
such facts are far from the only circumstances under which the 
doctrine may apply.  To determine whether equitable tolling 
may extend a statute of limitations, courts must analyze 
whether a plaintiff has established the doctrine’s three 
elements:  timely notice to the defendant, lack of prejudice to the 
defendant, and reasonable and good faith conduct by the 
plaintiff.  (Addison, supra, 21 Cal.3d at p. 319.) 
 
The Department asserts that Saint Francis cannot avail 
itself of equitable tolling because of the reason for its delayed 
filing:  its mistake in calculating the deadline.  Relying on Court 
of Appeal decisions such as Kupka v. Board of Administration 
(1981) 122 Cal.App.3d 791, 794, the Department contends the 
fact that Saint Francis “simply made a mistake in ascertaining 
its filing deadline” prevents us from tolling the statute of 
limitations.  Kupka nonetheless differs in meaningful respects 
from the case before us, and the Department’s argument 
oversimplifies the lesson Kupka offers.  That case did not involve 
an equitable tolling claim.  What the Court of Appeal held in 
Kupka was that a party’s mistake, neglect, or personal hardship 
could not, without more, excuse a late-filed petition under Code 
of Civil Procedure section 473.  (Kupka, supra, 122 Cal.App.3d 
at pp. 794–795.)   
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
17 
 
We agree that mistake or neglect alone doesn’t excuse a 
late-filed petition.  (See Irwin, supra, 498 U.S. at p. 96.)  But 
neither is that fact, when relevant, dispositive of a party’s 
equitable tolling claim; we must consider it as part of the 
analysis of whether a plaintiff has established equitable tolling’s 
elements.  (See Addison, supra, 21 Cal.3d at p. 319.)  This allows 
courts to balance “the injustice to the plaintiff occasioned by the 
bar of his claim against the effect upon the important public 
interest or policy expressed by the [operative] limitations 
statute.” (Id. at p. 321.)  So Saint Francis’s mistake in 
calculating the filing deadline under section 11523 isn’t 
necessarily fatal to its equitable tolling claim.  We must instead 
determine whether the hospital satisfies the three elements of 
equitable tolling.     
B. 
 
We begin with timely notice.  The Department contends 
that Saint Francis fails to satisfy the first element because its 
request for reconsideration was “unauthorized” under the 
statutory scheme.  In the Department’s view, a plaintiff’s 
pursuit of an alternative remedy that turns out to be flawed 
cannot provide notice of the party’s claims to the defendant.  
 
But that assertion rests on an overly rigid conception of 
equitable tolling’s first prong.  We have never concluded that 
pursuit of an alternative remedy is necessary for a plaintiff to 
provide timely notice of its claims to the defendant.  When 
considering whether a plaintiff provided timely notice, courts 
focus on whether the party’s actions caused the defendant to be 
“fully notified within the [statute of limitations] of plaintiffs’ 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
18 
claims and their intent to litigate.”  (Addison, supra, 21 Cal.3d 
at p. 321.)   
 
Saint Francis’s actions did just that.  On December 30, 
2015 — well before section 11523’s statute of limitations was set 
to expire — Saint Francis filed a request for reconsideration.  
Although this request was later “found to be defective for some 
reason” (McDonald, supra, 45 Cal.4th at p. 100) — because the 
Department’s 
“effective 
immediately” 
decision 
rendered 
reconsideration unavailable to Saint Francis — it provided the 
Department with timely notice that Saint Francis was seeking 
to appeal the Department’s penalty against the hospital.   
 
That Saint Francis provided the Department with timely 
notice is underscored by what happened next.  On January 14, 
2016, one day before section 11523’s statute of limitations was 
set to expire, Saint Francis notified the Department’s counsel of 
its intent to file a petition for a writ of administrative mandate 
if the request for reconsideration was unsuccessful.  The 
Department’s counsel — apparently unaware that Saint 
Francis’s 
petition 
was 
already four 
days overdue 
— 
acknowledged the forthcoming petition on January 19, 2016. 
The most plausible interpretation of these facts is that Saint 
Francis’s request for reconsideration, together with its 
communications with the Department’s counsel, notified the 
Department of its intent to seek review of the Department’s 
penalty against the hospital.  Because equitable tolling is 
designed to apply when a plaintiff has “ ‘satisfied the notification 
purpose of a limitations statute’ ” (McDonald, supra, 45 Cal.4th 
at p. 102), ignoring this inference would undermine the 
doctrine’s underlying rationale and purpose.  
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
19 
 
The first element of equitable tolling — that a plaintiff 
must provide timely notice of its claims to the defendant — has 
remained the same since the doctrine’s inception.  (Addison, 
supra, 45 Cal.4th at p. 319.)  That element ought to be 
interpreted literally:  When confronted with equitable tolling 
claims, courts must examine each case on its facts to determine 
whether the defendant received timely notice of the plaintiff’s 
intent to file suit.  Because Saint Francis’s request for 
reconsideration, together with the e-mail notifying the 
Department’s counsel of its intent to file a petition for a writ of 
administrative mandate, provided the Department with timely 
notice of the hospital’s claim, we conclude that Saint Francis has 
satisfied the first element of equitable tolling. 
C. 
 
The Department next argues that Saint Francis’s equitable 
tolling claim fails because the hospital cannot satisfy the second 
element:  lack of prejudice to the defendant.  (See McDonald, 
supra, 45 Cal.4th at p. 102.)  We disagree.   
 
The Department has suffered prejudice, it contends, 
because Saint Francis’s late filing circumvented its “rel[iance] 
on legislative rules establishing the finality of its adjudicative 
decisions in order to execute its statutory charge of safeguarding 
the public health.”  That argument ignores the core focus of our 
prejudice analysis:  whether application of equitable tolling 
would prevent the defendant from defending a claim on the 
merits.  (See Addison, supra, 21 Cal.3d at p. 318.)  Given that 
the Department defended its assessment of the fine against 
Saint Francis throughout the administrative proceedings, we 
don’t see how tolling section 11523’s statute of limitations would 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
20 
undermine the Department’s ability to defend the propriety of 
that same penalty in superior court. 
 
Consider the implications of embracing the Department’s 
argument regarding prejudice:  We’d be all but compelled to find 
prejudice in just about every equitable tolling case.  Virtually all 
parties, after all, tend to rely on statutes of limitations in the 
course of litigation.  And the Department presents no 
explanation of why it, in particular, suffers greater prejudice 
because of its public charge.  The Department’s contention also 
fails to recognize that the finality of adjudicative decisions is 
already undermined by section 11523, which expressly allows 
those decisions to be appealed — appeals which can, and 
typically do, postpone the finality of the Department’s decisions 
for years.  For these reasons, we conclude that tolling the statute 
of limitations wouldn’t prejudice the Department. 
D. 
 
The third element of equitable tolling requires reasonable 
and good faith conduct by the plaintiff.  The Department 
contends Saint Francis cannot satisfy this element because its 
late filing was due solely to its mistake in calculating the statute 
of limitations under section 11523.   
 
Our equitable tolling cases have offered little insight on 
what constitutes reasonable and good faith conduct.  Without 
discussing the third element specifically, we suggested in 
Addison that the plaintiffs’ actions were reasonable and carried 
out in good faith because they “promptly asserted [their cause of 
action] in the proper state court” after the federal court 
dismissed it for lack of jurisdiction.  (Addison, supra, 21 Cal.3d 
at p. 319.)  More recently, we concluded that a party didn’t act 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
21 
reasonably, and thus was not entitled to equitable tolling, when 
he “pursue[d] a court action when the claims filing requirements 
[had] not been satisfied.”  (J.M., supra, 2 Cal.5th at p. 657.)      
 
As these examples illustrate, our caselaw has sometimes 
suggested that “reasonable” and “good faith” have much the 
same meaning in the context of equitable tolling, but other times 
construed the terms as creating separate and distinct 
requirements.  We are not the first to grapple with what each of 
these terms require.  (See, e.g., Kansas City Power & Light Co. 
v. Ford Motor Credit Co. (8th Cir. 1993) 995 F.2d 1422, 1430 
[good faith is an “amorphous concept, capable of many forms yet 
requiring none”]; Prosser & Keeton, Torts (5th ed. 1984) § 32, p. 
175 [“The conduct of the reasonable person will vary with the 
situation with which he is confronted”].)  Yet what makes the 
most sense in light of our precedent, equitable tolling’s 
underlying purpose, and its narrow scope in our system, is to 
construe the third element to encompass two distinct 
requirements:  A plaintiff’s conduct must be objectively 
reasonable and subjectively in good faith.   
 
When it comes to reasonableness, the “ultimate test” is 
“objective.”  (People v. Humphrey (1996) 13 Cal.4th 1073, 1083.)  
An analysis of reasonableness focuses not on a party’s intentions 
or the motives behind a party’s actions, but instead on whether 
that party’s actions were fair, proper, and sensible in light of the 
circumstances.  We use this objective analysis to assess 
ineffective assistance of counsel claims under the Sixth 
Amendment (see People v. Mai (2013) 57 Cal.4th 986, 1009 
[“defendant must demonstrate . . . counsel’s performance was 
deficient, in that it fell below an objective standard of 
reasonableness under prevailing professional norms”]), for 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
22 
example, and in the context of insurance law to determine which 
party must pay an insured’s site investigation costs (see Aerojet–
General Corp. v. Transport Indemnity Co. (1997) 17 Cal.4th 38, 
62 [“Whether the insured’s site investigation expenses are 
defense costs that the insurer must incur in fulfilling its duty to 
defend must be determined objectively”]).  A party seeking 
equitable tolling must satisfy a similar standard:  It must 
demonstrate that its late filing was objectively reasonable under 
the circumstances.   
 
Good faith pivots instead on a party’s intentions.  It is a 
test “ordinarily used to describe that state of mind denoting 
honesty of purpose, freedom from intention to defraud, and, 
generally speaking, [] being faithful to one’s duty or obligation.”  
(People v. Nunn (1956) 46 Cal.2d 460, 468.)  To determine 
whether a defendant is entitled to attorney fees, for example, 
courts employ a subjective analysis and ask whether the 
plaintiff brought an action in good faith.  (Code Civ. Proc., 
§ 1038, subd. (a).)  The third element of equitable tolling 
likewise requires courts to determine whether a party’s late 
filing was subjectively in good faith — whether it was the result 
of an honest mistake or was instead motivated by a dishonest 
purpose.   
 
Construing equitable tolling’s third element to contain an 
objective and subjective requirement fits the doctrine’s 
underlying rationales.  Equitable tolling applies only “in 
carefully considered situations to prevent the unjust technical 
forfeiture of causes of action.”  (Lantzy, supra, 31 Cal.4th at p. 
370.)  It does not, as courts have explained, “extend to . . . garden 
variety claim[s] of excusable neglect.”  (Irwin, supra, 498 U.S. at 
p. 96.)  Yet if we were to apply equitable tolling to situations 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
23 
when a party demonstrates only reasonable conduct or good 
faith –– but not both –– we would risk shaping the doctrine into 
one that becomes a norm instead of an exception.  Limiting the 
doctrine’s applicability to only those cases in which a party 
demonstrates objective reasonableness and subjective good faith 
precludes the doctrine from being “a cure-all for an entirely 
common state of affairs,” while ensuring that it provides a 
narrow form of relief in “unusual circumstances” when justice so 
requires.  (Wallace, supra, 549 U.S. at p. 396.)  
 
The Court of Appeal didn’t address whether Saint Francis’s 
actions were reasonable and in good faith.  At oral argument, 
the parties argued for the first time that certain facts bore on 
the question of whether Saint Francis satisfies the third 
element.  But the record before us leaves some opacity about 
whether Saint Francis’s conduct was reasonable and in good 
faith.  As we’ve often done in such situations, we remand the 
case for the Court of Appeal to determine whether Saint Francis 
satisfies the third element, and thus is entitled to equitable 
tolling.  (See Montrose Chemical Corp. of California v. Superior 
Court (2020) 9 Cal.5th 215, 238; San Diegans for Open 
Government v. Public Facilities Financing Authority of City of 
San Diego (2019) 8 Cal.5th 733, 746–747 [contentions raised for 
the first time at oral argument "should be answered first by the 
Court of Appeal"].)   
IV. 
Statutes of limitations serve important purposes:  They 
motivate plaintiffs to act diligently and protect defendants from 
having to defend against stale claims.  But equitable tolling 
plays a vital role in our judicial system, too:  It allows courts to 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
24 
exercise their inherent equitable powers to excuse parties’ 
failure to comply with technical deadlines when justice so 
requires.  To appropriately balance these two competing ends, 
we recognize the Legislature’s ability to forbid equitable tolling 
in certain statutes, and we require plaintiffs to establish timely 
notice, lack of prejudice to the defendant, and reasonable and 
good faith conduct by the plaintiffs before they are entitled 
equitable tolling.  For the doctrine to fulfill its purpose, however, 
we continue to presume that tolling is available in the absence 
of evidence to the contrary, and allow courts to determine on a 
case-by-case basis whether tolling is warranted under the facts 
presented, with careful consideration of the policies underlying 
the doctrine.  (See generally Elkins, supra, 12 Cal.3d at pp. 417–
420.)    
As to whether equitable tolling may apply when agency 
adjudicatory decisions are at issue, the text and context of 
section 11523 persuade us:   The Legislature did not prohibit the 
statute’s 30-day limitations period from being tolled.  And the 
facts of this case demonstrate that Saint Francis satisfied the 
doctrine’s first and second elements.  Although the hospital’s 
belated filing arose from a mistake about the filing deadline 
under section 11523 — a mistake that appears to have been 
shared by the Department — it provided timely notice to the 
Department of its intent to file a petition for a writ of 
administrative mandate.  And nothing in the record 
demonstrates that the Department was prejudiced by Saint 
Francis’s late filing.  Because the Court of Appeal didn’t address 
equitable tolling’s third element, we vacate the judgment and 
SAINT FRANCIS MEMORIAL HOSPITAL v. STATE DEPARTMENT OF 
PUBLIC HEALTH 
Opinion of the Court by Cuéllar, J. 
 
 
25 
remand the case to the Court of Appeal for further proceedings 
consistent with this opinion.    
 
 
 
 
 
 
 
 
CUÉLLAR, J. 
 
We Concur: 
CANTIL-SAKAUYE, C. J. 
CHIN, J. 
CORRIGAN, J. 
LIU, J. 
KRUGER, J. 
GROBAN, J. 
 
 
See next page for addresses and telephone numbers for counsel who argued in Supreme Court. 
 
Name of Opinion Saint Francis Memorial Hospital v. State Department of Public Health 
__________________________________________________________________________________ 
 
Unpublished Opinion 
Original Appeal 
Original Proceeding  
Review Granted XX 24 Cal.App.5th 617 
Rehearing Granted 
 
__________________________________________________________________________________ 
 
Opinion No. S249132 
Date Filed:  June 29, 2020 
__________________________________________________________________________________ 
 
Court:  Superior 
County:  San Mateo 
Judge:  George A. Miram 
 
__________________________________________________________________________________ 
 
Counsel: 
 
Sheuerman, Martini, Tabari, Zenere & Garvin and Cyrus A. Tabari for Plaintiff and Appellant. 
 
Xavier Becerra, Attorney General, Edward C. DuMont, State Solicitor General, Janill L. Richards, 
Principal Deputy State Solicitor General, Gonzalo C. Martinez, Deputy State Solicitor General, Julie 
Weng-Gutierrez, Assistant Attorney General, Samuel T. Harbourt, Susan M. Carson, Gregory D. Brown 
and Nimrod P. Elias, Deputy Attorneys General, for Defendant and Respondent. 
 
 
 
 
 
 
 
 
 
 
 
 
Counsel who argued in Supreme Court (not intended for publication with opinion): 
 
Cyrus Tabari 
Scheuerman, Martini, Tabari, Zenere & Garvin 
1033 Willow Street 
San Jose, CA 95125 
(408) 288-9700 
 
Samuel T. Harbourt 
Deputy Attorney General 
455 Golden Gate Ave., Suite 11000 
San Francisco, CA 94102-7004 
(415) 510-3919