THI RD DI VI SI ON
GOBEI L, J.

, COOM ER and HODGES, JJ.

N O T IC E : M otions for r e c ons i de r a tion m us t be ph y sic a l ly r e ce iv ed i n our c le r k ’s offic e w ithin te n da y s of the da te of de c is ion to be de e m ed tim e ly file d.

http://w w w .ga a ppe a l s .us /r ule s

M ar ch 13, 2019



# I n th e Co u r t o f

A p p eals o f

G eo r g ia

A1 8 A 2 0 0 9

. COBB HOSPITAL, INC. d / b / a W ELLSTAR COBB
HOSPITAL et al

. v

. GEORGIA DEPARTM ENT OF
COM M UNITY HEALTH et al

.

H O D G E S , J u d g e.

In M arch 2 01 6

, Em o ry Un i v ers i ty d /b /a Em o ry Un i v ers i t y H os p it al Sm y rn a

(“ EUHS”) fi l ed a n a p p l i cat i on wi t h t h e Geo rg i a Dep art m en t o f Co m m u n i ty Heal th

(“ DCH”) fo r a new cert i fi cat e o f n e e d (“ CON”) t o u n d ert ak e i m p ro v em en t s an d

ren o v at i o n s t o t al i n g ap p ro x i m at el y $ 3 3

. 8 m i ll i on at t h e fo rm er Em o ry -Ad v en t i s t

Ho s pi t al

. Co b b Ho s p i t al

, In c. d/ b / a W el ls t ar Co b b Ho s p i t al an d Ken n es t o n e Ho s p i t al

,

In c., d / b / a W el l s tar Ken n es t o n e Ho s p i t al (co l le c tive ly

, “ W e llsta r ” ) obj e c te d to E U HS’

ap p li cat io n , arg u i n g t h at t he ap p l i cat io n “ s eek s t o d ev el o p a n ew h o sp i t al ” rat h er t h an

reo p en in g an d ren o v at i n g t h e fo rm er E m o ry -A d v en t i s t Ho s p i t al

. Th e DCH g ran t ed

EUHS’ ap p l i cat i o n an d award ed i t a n ew CON fo r t h e p ro p o s ed i m p ro v em en t s an dren o v at i o n s

. W el l s t ar ap peal ed t o t h e Cert i fi cat e o f Need Ap p eal Pan el (OCGA § 3 1

-

6 -4 4 ) (“ CON Ap p eal Pan el ”), an d a p a n e l h e a ri n g o ffi cer affi rm ed t h e DCH’ s

d eci s i o n . W el l st ar o b

ject ed t o t h e p an el h eari n g o ffi cer’ s ju d g m en t an d ap p eal ed t o

t h e DCH co m

m is s i o n er, arg ui ng , i n p art

, t h at t h e p an el h e a r i ng o ffi cer erro n eo u s l y

co n cl u d ed th at “ [i ] t i s n o t t h e fu n ct io n o f t h e CON Ap p eal Pan el to co n s i d er q u es t i on s

o f CON an d l i cen s u re s tat u s

. . . .” Th e D CH co m m i ss i o n er affi rm ed t h e p an el h eari n g

o ffi cer’ s d eci si o n, an d t h e Su p eri o r Co u rt of Co b b Co u n t y d en i ed W el ls t ar’ s p et i t i o n

fo r ju di ci al rev i ew.

In t h i s ap peal

, we are as k ed t o d eci d e wh et h er th e CON Ap p eal Pan el

, i n an

ap p eal fro m a d eci s i o n b y t h e DCH o n a h eal th care faci l i t y ’ s ap p l i cat i o n fo r a n ew

cert ifi cat e o f n eed

, h as th e au t h o ri t y t o i n dep en d en t l y rev i ew t h e s t at u s o f t h e

faci li t y ’ s exi s t i n g cert i fi cat e o f n eed

. 1 W e co n cl u d e t h at th e p lai n l an g u ag e o f OCGA

§ 3 1 -6 -4 4 an d Ga. Co m

p

. R. & Reg s

. r. 2 7 4-1 -.0 9 p recl u d es t h e CON Ap p eal Pan el

fro m rev i ewi n g t he DCH’ s i n i t i al d et erm i nat i on reg ard i n g a h eal t h care faci l i t y ’ s

ex i s t in g CON s t at u s ; rat h er, an y s u ch ch al l en g es t o t h e DCH’ s i n i t i al d et erm i n at i o n

1 Th e CON Ap p eal Pan el “ co n si s ts o f a pan el o f i n d ep en den t h eari n g o ffi cers [t hat ] i s an ag en cy

s ep arat e fro m DCH an d s erv es t o rev i ew DCH’ s i ni t i a l d eci s i o n
t o g ran t o r d en y a CON ap p l i cat i o n

. OCGA § 3 1 -6 -4 4 (a).” Ken nes t o ne Ho s p

. v. Dep t. o f Co mmu n i t

y Hea l t h , 3 46 Ga. Ap p . 7 0 , 7 2 , n . 5 (8 1 5 SE2 d 2 6 6 ) (2 0 1 8 ).

2m

u st b e b ro ug h t t h ro u g h a d i fferen t pro ces s

. Becau s e t here i s no d i s pu t e t h at

s u b s t an t i al ev i d en ce su p po rt ed t h e p an el h eari n g o ffi cer’ s fi n d i n gs o f fact an d t h at t h e

o ffi cer’ s co n cl us i on s o f l a w t h a t EUHS was en t i t l ed t o a n ew CON bas ed o n t h o s e

fact s were s o u n d

, we affi rm t h e s u p eri o r co u rt ’ s ju d g m en t d en y i n g W el l s t ar’ s p et i t i o n

fo r ju di ci al rev i ew.

Th e reco rd rev eal s t h at Sm y rn a Ho s p i tal

, In c., an 8 8 -b ed co m m u n i t y h o s p i t al

,

o p en ed on So u t h Co b b Dri v e i n Sm y rn a in 1 97 4

. Ad v en t i s t Heal t h Sy s t em acq u i red

t h e ho s p i t al i n 1 97 6

. In 19 9 5

, Em o ry Heal t hca re en tered a j o i n t v en t ure ag reem en t

wi t h Ad v en t i s t H eal t h Sy s t em an d o b t ai n ed a 3 5 % s h are o wn ers hi p i n t h e ho s p i t al ;

t h ereaft er, t h e h o sp i tal w as ren am ed Em o ry -Ad v e n t i s t Ho s pi t al

. Du e to d ecl i n i n g

rev en u e s , Em o ry -Ad ven t i s t ceas ed o p erat i o n s o n Oct o b er 31

, 20 1 4

. In Ap ri l 2 0 1 5,

Em o ry U nive r s ity a c qu ired s o le o wn ers h i p o f t h e h o s p i t al

, wh i ch was ren am ed Em o ry

Un i vers it y

Ho s p i t al Sm

y rn a an d reo p en ed o n Oct ob er 2 0 , 2 0 1 5

. 2

Si n ce i t fi rs t o p en ed as Sm y rn a Ho sp i t al i n 1 9 74

, t h e h o sp i t al h ad n ev er h ad a

m ajo r i m p ro v em en t

, ren o v at i on , o r u p g rad e. As a r e s u l t

, EUHS ap pl ied fo r a

cert ifi cat e o f n eed i n March 2 0 1 6 i n ord er to p ro ceed wi t h i m p ro vem en t s an d

2 Em o ry Heal t h c a re p urch as ed t h e rem ai n i n g i nt eres t i n t h e ho s pi t al fro m Em o ry -Ad v en t i s t

, In c. On t h e s am e d at e, Em ory Heal t h care q u i tcl ai m ed i t s i n t eres t

t o Em o ry Un iv ers i t y

.

3ren o v at i o n s t o t al i n g ap pro xi m at el y $ 33 .8 m i l l i o n

. 3 W el l s t ar ob ject ed to EUHS’

ap p li cat io n , arg u i n g t h at t he ap p l i cat io n “ s eek s t o d ev el op a n ew h o s p i t al ” rat h er t h an

r e o p e n in g an d ren o v at i n g t h e fo rm er Em o ry -Ad v en t is t Ho sp i t al

. Al t h ou g h i t l i s t e d

ei g h t r eas o n s fo r i t s o bject i o n t o EUHS’ ap p l i cat io n , W el l s tar’ s p ri m ary arg u m en t

was t h at “ [t ] he CON au t h o ri t y o f t h e fo rm er Em o ry -Ad v en t i s t Ho s p i t al h as l ap s ed .”

As a res u l t

, W el l s t a r a s s ert ed t h at EUHS n ev er o b t ai n ed CON au t h o ri t y t o o ffer

h o s p it al serv ices an d t h at EUHS’ ap pl i cat io n “ m us t b e rev i ewed as a n ew h o s p i t al

req u i ri n g n ew CON ap p ro v al .” 4

In i t s ev al u at i o n o f EUHS’ ap p l icat i o n, t h e DCH n o t ed t h at EUHS fi l ed i t s

a p p l i cat i on “ t o ren o v at e an d u p g rad e i ts cu rren t h o sp i t al faci l i t y .” In ad d i t i o n , t h e

DCH d et erm i n ed t h at

3 Th e pro p o s ed i m

p ro v em en t s i n cl u d e ad di n g t wo o p erat i n g ro o m s , i n creas i n g
t h e si ze of th e ex i s t in g o perat i n g ro om s , reco n fi g u ri n g an d ren o vat i n g t h e fi rs t fl o o r
t o p erm i t “ effi ci en t an d s afe p at i en t fl o w th ro u gh o ut t h e faci l it y , ” ren o v at i n g t h e

s eco n d an d th i rd fl oo rs , i m p ro v i ng t h e IT i n fras t ru ct u re , a n d o t h er ren o v at i o n s to b ri n g t h e h o s pi t al u p t o cu rren t an d accep t ed s t an dard s

.

4 Sp eci fci al l y , W el ls t ar arg u ed t hat : (1 ) E m o r y Heal th care’ s fai l u re t o s eek

ap p ro v al o f i t s p urch as e of Em o ry -Ad v en t i s t u n d er t h e Ho s p i t al Acq u i s i t i o n Act (OCGA § 3 1 -7 -4 0 0 et s eq .) ren d ered t he t ran s act i o n n u l l an d v o i d an d i n v al i d at ed t h e

ex i s t i n g C O N ; (2 ) th e l ack o f a v al i d l i cen s e t o o perat e a h o sp i t al m ean t Em o ry

Ad v en t i st ’ s CO N c o u l d n o t be t ran s ferred t o EUHS; an d (3 ) ev en i f Em o ry

Ad v en t i st ’ s CON t ran sferred t o EUHS, EU H S ’ fai l u re t o o ffer in p at i en t s erv i ces wi t h i n 1 2 m o n t h s o f Em o ry -Ad v en t i s t ’ s cl o s u re cau s ed t he CON t o l ap s e.

4EUHS, fo rm erl y k n o wn as Em o ry Ad ven t i s t Ho s p it al (EAH), cl o s ed o n

Oct o b er 31

, 2 0 1 4 an d re-o p en ed Oct o ber 2 0

, 2 01 5

, acco rd i ng t o Dep art m en t reco rd s

. In Ap ri l 2 0 1 5

, Em o ry Un iv ers i t y acq u i red fu l l t i t l e

t o EAH, an d ren am ed i t EUH S

. As s u ch

, EUHS m ai n t ai n s an act iv e

CON s t at us .[ 5 ]

Fo l l o w i n g i ts rev iew, t h e DCH g ran t ed EUHS’ ap p l i cat i o n an d i s s ued E UHS a CON

fo r t h e p ro po s ed i m

p ro v em en ts an d ren o v at i o n s

.

W el l s t ar ap p eal ed t h e DCH’ s award t o t h e CON Ap p eal Pan el

. In a m o t i o n fo r

s u m m ary ad ju d i cat io n , W el l s t ar arg u ed

, i n p art

, t h at t h e DCH e r r e d i n award i n g a

CON t o EUHS “ t o ‘ ren o v at e an d u p g rad e’ t h e fo rm er Em o ry -Ad v en t is t Ho s p i t al

. .

. faci l i t y d es p i t e t h e fact th at [EUHS] h as n o CON au t h o ri zat i o n t o o p erat e a h o s p i t al

t h ere.” As a res u l t, W el l s t ar as sert ed t h at EUHS “ m u s t o b t ai n n ew CON au t h o ri t y to

o p erat e a h o s p it al [,] ” wh i ch ap pl i es m o re ex t en s i v e an d ri g o ro u s g ui d el i n es

. 6 EUHS

rep l i ed t h at t h e DC H h a s t h e s o l e au t h o ri t y t o d et erm i n e w h et h er an ap p l i can t

m ai n t ai n ed a p ro p er CON an d, as a res u l t, EUHS fi l ed i t s o wn m o t i on fo r s u m m ary

5 Fu rt h er s u p p o rt i n g t h e p an el h eari n g offi cer’ s co n cl u s i on was an em ai l fro m
t h e DCH co m

m i ss i o n er co nfi rm i n g t h at th e b u y er o f a cl o s ed ho s p i t al “ s t ep s i n t o [t h e]

s h o es o f [t he] s el l er’ s au t h o ri zat i o n s . . . .”

6 W el l s t ar p res en t ed t h e s am e s u b s t an ti v e arg u m en t s t o t he CON Ap p eal Pan el

t h at i t rai s ed i n i ts o b

ject i o n t o t h e DCH’ s i n i t i al d eci s i o n . See n

. 4 , s up ra.

5d et erm i n at i o n s eek i n g t o ex cl u d e an y ev i d en ce co n c e r n i n g t he v al i d i t y o f EUHS’

CON.

Th e p an el h eari n g o ffi cer fi rs t n o ted t h at W el l st ar rai sed “ [i t s ] arg um en t s i n t h e

wro ng fo ru m .” In fact

, t h e p an el h eari n g o ffi cer fo u n d t h at “ [i ] t i s n o t th e fu n ct i o n o f

t h e CON Ap p eal Pan el to co n s i d er q u es t i o ns o f CON an d li cen s u re s t at u s

. . . .” Th e

p an el h eari n g o f

f i c e r o b s erv ed t h at t h e At t o rn ey Gen eral ’ s Offi ce h ad t h e s o l e

au t h o ri t y t o o vers ee Em o ry H eal t h care’ s p u rch as e o f Em o ry -Ad v en t is t u n d er t h e

Ho s pi t al Acq u i s it i o n Act (OCGA § 3 1 -7 -4 0 0 et s eq .) an d t h at t h e DCH had t h e s o l e

au t h o ri t y t o as cert ai n t h e v al id i t y o f EUHS’ CON t o o p erat e a h eal th care faci l i t y

. 7

See OCGA § 3 1 -6 -2 1. As a res u l t

, t h e p an el h eari n g o ffi cer g ran t ed EUHS’ m o t i o n

t o ex cl u de “ W el l s t ar’ s arg u m en t s res p ect i n g CON s t at u s , At t o rn ey Gen eral Rev i ew,

an d l i cen su re s tat u s fro m t h e s co p e o f t h e h eari n g in th at th e Heari n g Offi cer d o es n ot

h av e t h e au t h o ri ty

t o d eci de t h es e q u es t i o n s .”

Fo l l owi n g an ev i d en t iary he a r ing, the pa ne l h eari n g o ffi cer affi rm ed t he DCH’ s

d eci s i o n g ran t i n g EUHS’ ap p l i cat i o n an d i s s u i n g t h e CON. 8 W el l s t ar o b ject ed t o t h e

7 Aft er it s rev iew, th e At t o rn ey Gen eral ’ s Offi ce det erm i n ed t h at t h e t ransa c tion

was n ot s u bject t o t h e Ho s p i t al Acq u i s i t i o n Act

.

8 Rel ev a n t t o t h i s ap p eal

, t he p an el h eari n g o ffi cer fo un d t h at

, d es p i t e W el l s t ar’ s arg u m en t t h a t t h e DCH “ s h o u l d h av e ap p l i ed t h e serv i ce-s p eci fi c s h o rt

6p an el h eari ng o ffi cer’ s d eci si o n an d ap p eal ed t h e d eci s i o n t o t h e DCH co m m i s s i o n er,

wh o affi rm ed t h e p an el heari n g o ffi cer’ s ju d g m en t

. 9

W el l s t ar t h en p et i t i o ned fo r ju d i ci al rev i ew o f t h e co m m i s s io n er’ s d eci s i o n in

t h e Su peri o r Co urt of Co b b Co u n t y

. Th e s u p eri o r co urt d en i ed ju di ci al rev i ew o f t h e

Co m m i s s i o n er’ s d eci s i o n , 1 0 an d we g ran t ed W el ls tar’ s ap p l i cat io n fo r d i s cret i o n ary

ap p eal . Th i s ap p eal fo l l o wed

.

1

. Fi rs t

, We l l s t a r co nt en d s t h at t h e CON Ap p eal Pan el h eari n g o ffi cer

erro neo u s l y co n cl u d ed t h at h e “ l ack ed au t h o ri t y t o i n d ep en d en t l y d eci d e i f [EUHS]

i s a CON-au t h o ri zed h o s p i t al .” Fo r t h e fo l lo wi n g reas o n s , we fi n d n o erro r.

s t ay acu t e-care h o s p i t al ru l es ” t o EUHS’ CON ap pl icat i o n , “ EUHS h as a v al id
h o s p it al p erm i t, h as CON au t h o ri zat i o n f r o m t he [DCH]

, an d i s n o t s eek i ng t o ad d
b ed s to t h e h os p i t al .” (Fo o t n ot e o m i t t e d

. ) As a res u lt

, t h e p an el h eari n g o ffi cer d et erm i n ed t hat “ t h e ap p l i cab l e rev i ew co n s i derat i o ns fo r [EUHS’ CON ap p li cat i o n ]

, wh i ch i n cl u d e s an ex i s t i n g faci l i t y ap p l y i n g fo r a ren o vat i on CON, are t h e Gen eral

Rev iew Co n si derat i o n s

. . . .” See OCGA § 3 1 -6 -4 2 (a); Ga. Co m p

. R & Reg s. r. 1 1 1

- 2 -2 -.0 9 (1 ).

9 Th e d eci s i o n b y t he DCH co m m i s s i o n e r “ s h al l b e th e fi nal d ep art m en t d eci s i o n fo r p u rp o s e s o f Ch ap t er 1 3 o f Ti tl e 5 0

, t he ‘ Geo rg i a Ad m in i s t rat i v e Pro ced ure Act .’ ” OCGA § 31 -6 -4 4 (m ).

1 0 O f n o t e, t h e s u p eri o r co u rt fo u n d th at “ u nd er t h e co n t ro l l i n g s t at u t es , t h e ju ri s d i ct i o n to d et erm i n e wh et h er EUHS h as v al i dl y m ai n t ai n ed t h e fo rm er Em o ry Ad v en t i st Ho s pi t al ’ s CON au t h o ri t y i s s q u arel y v es t ed i n th e [DCH]

. Th e [DCH] h as

s ai d t hat EUHS m ai n t ai n s an act i v e CON s t at u s

. . . . Th e CON Ap p eal Pan el d o es n ot h av e t h e au t h o ri ty

t o rev ers e t h e [DCH] o n t h is i s su e.”

7(a) Cer t i f ica t e o f Need Req u i r emen t

.

Un d er Geo rg i a l aw, “ an y n ew i n s t i t u t i o nal h eal t h s erv i ce [i s ] req u i red t o o b t ai n

a cert i fi cat e o f need

. . . .” O C G A § 3 1 -6 -4 0 (a). “ Th e CON p ro g ram , wh i ch i s

ad m i n is t ered b y [t h e] DCH, es t ab l i s h es a s y s t em o f m an d at o ry rev i ew req u i ri n g t h at

,

b efo re n ew i n s ti t u t i o nal heal t h s erv i ces an d faci li t ies can b e d ev el o p ed

, t h e d ev el o p er

m u st ap pl y fo r an d recei v e a CON fro m t h e D CH. OCGA §§ 3 1

- 6

- 1 ; 3 1 -6 -4 0 (a),

(b ).” (Ci t at i o n an d p un ct u at i on o m i t t ed .) Ken n es t o n e H o s p

. v. Dep t

. o

f Co mmu n i t

y

Hea lt h

, 3 4 6 Ga. Ap p . 7 0 (8 15 SE2 d 2 6 6 ) (2 0 1 8 ).

Th e l eg i s lat u re ced es t h i s au t h o ri t y t o t h e [DCH] b ecau s e t h e p u b l i c i s

b et t er s erv ed b y h av i ng ex p ert s i n t h e co m p lex i t i es o f h eal t h care

p l an ni n g m ak e th es e deci s i o n s

. Th e i s s u e s are co m p li cat ed

, an d th e

ap p l icab l e l aws , ru l es , reg u l at i o n s , an d p reced en ts req u ire m u ch s tu dy

,

es p eci al l y fo r a d eci s i o n -m ak er wh o i s n o t al read y fam i l i ar wi t h t h em

.

Dep t. o f Co mmu n it

y H ea l t h v. G wi n n et t Co u n ty Ho s p

. Sys

. , 2 62 Ga. A p p

. 8 7 9

, 8 8 1

-

8 8 2 (5 8 6 SE2 d 7 6 2 ) (2 0 03 ). Pu rs u an t t o OCGA § 3 1 -6 -4 2 (a), t he DCH “ sh al l i s s u e

a cert i fi cat e o f need t o each ap p l i can t wh o se ap p l i cat i on i s co n si st en t wi t h [t h e

co n si d erat io n s s et fo rt h i n OCGA § 3 1 -6 -4 2 ] an d su ch ru l es deem ed ap pl i cab l e t o a

p ro ject

. ” To t h at en d

, “ [t ] h e DCH rev i ews CON ap p l i cat i o n s an d i s s ues d eci s i on s

g ran t i n g o r d en y i ng a CON u n d er s tat u t o ry co n s i d erat i on s i n OCGA § 3 1 -6 -4 2 an d

8unde r ge ne r a l a nd spe c if ic rev i ew co n s i d erat i o n s i n ru l es an d reg u l at i o n s p ro m u lga te d

b y th e DCH as s et fo rt h i n Ga. Co m p

. R. & Re g s

. [r.] 1 1 1-2 -1 -.0 1 an d 1 1 1 -2 -2 -.0 1

t h ro u g h 11 1 -2 -2 -.4 3 .” AS MC, LLC v. No r t h s i d

e Ho sp
., In c. , 3 4 4 Ga. A p p

. 57 6

, 5 7 7

(8 1 0 SE2 d 6 6 3 ) (2 0 1 8 ).

Pert i n e n t t o t hi s cas e, a cert i fi cat e o f n eed i s req u i red fo r: “ (1 ) [t ] h e

co n st ru ct i o n , d ev el o p m en t

, o r o t h er es t ab l i s h m en t o f a new h eal t h care faci l i t y ; [an d ]

(2 ) [a] n y ex p en d i t u re b y o r on b eh al f o f a h eal t h care faci l it y i n ex ces s o f $ 2

. 5 m i l l i o n

wh i ch

, u n d e r g en eral l y accep t ed acco u n ti n g p ri nci p l es co ns i s ten t l y ap p l i ed

, i s a

c a p i t a l ex p en d i t u re.

. . .” OCGA § § 3 1 -6 -4 0 (a) (1 ), (2 ). A CON ap p l i cat i o n f o r a

cap i t al ex p en di t u re i s rev i ewed o n l y u n der t h e DCH’ s g en eral rev i ew co n s i d erat i o n s ,

s ee OCGA § 3 1 -6 -4 2 (a) an d Ga. Co m p

. R. & Reg s

. r. 1 11 -2 -2 -. 0 9 (1 ), 1 1 wh i l e an

ap p li cat io n fo r co ns t r u c t i o n o r dev el o p m en t o f a “ n ew h eal t h care faci l i t y ” i s

re v i e w ed u n d er b o t h g en eral an d s erv i ce-s peci fi c req ui rem en t s an d rev i ew

co n si d erat io n s

. See Ga. Co m p

. R. & Reg s

. r. 11 1 -2 -2 -.1 1 (1 ) (a) (1 ), 11 1 -2 -2 -.2 0 (1 )

(a), (3 ). Acco rd De

p t

. o f C o mmu n it y Hea l t h v. No rt h s i d

e Ho s p., In c. , 2 9 5 Ga. 4 4 6,

1 1 OCGA § 3 1

- 6

- 4 2 ( a ) co n t ai n s a l i s t i n g o f 1 7 fact o rs wh ich t h e DCH m u s t

co n si d er w h en rev i ewi n g a CON ap p l i cat i o n

. Th e co n s i d erat i o ns l i s t ed i n Ga. Co m p. R. & Reg s

. r. 1 1 1 -2 -2 -.0 9 (1 ) (a)
- (q ) o ff e r m o r e det ai l t h an t h e co ns i d erat i on s

co d ifi ed at OCGA § 3 1 -6 -4 2 (a), b u t are o t h erwi s e i d en t i cal

.

94 4 6 -4 4 7

, n

. 4 (7 6 1 SE2 d 74 ) (2 0 1 4 ) ( “ m o re s t ri ng en t s erv i ce-s p eci fi c rev i ew

co n si d erat io n s ” ap p ly t o ap p l i cat i o n s fo r n ew CON fo r “ am b u l a t o ry s u rg ery

s erv i ces ”; i f th e ad d i t i on al s erv i ces are “ p art o f a h os p i t al ” an d do no t in creas e t h e

n u m b er o f am b u l at ory o p erat i n g ro om s , h o wev er, o n l y g en eral co n si derat io n s n eed

b e rev i ewed ) (ci t i ng Ga. Co m p . R. & Reg s

. r. 1 1 1 -2 -2 -.4 0 (1 ) (a) an d (d )).

(b ) S co p e o f Revi ew o f t he DCH’s Cer t i

f i ca t e o f Need Deci si on

.

Fo l l owi n g th e D CH’ s i n i t i al d eci s io n gran t i n g o r d en y i n g an ap p l i cat i o n fo r a

n ew CON,

[a] n y ap p l i can t fo r a p ro

ject [o r] an y co m

p et i n g h eal th care faci l i t y t hat

h as n o t i fi ed t h e [DCH] p ri o r t o it s d eci si on t hat s u ch faci l i t y is o p p o s ed

t o t h e ap p l i cat i o n b efo re t h e [DCH]

. . . wh o is ag g ri ev ed b y a d eci s i o n

o f t h e [DCH] s h al l hav e t h e ri g h t t o an i n i t i al ad m i n i s t rat i v e ap peal

h eari n g b efo re an ap p eal p an el h eari n g offi cer o r to i n t e r v e n e i n s u ch

h eari n g

. . . .

OCGA § 3 1 -6 -4 4 (d ). Th e CON Ap p eal Pan el he a r i n g o ffi cer’ s ro le is defi n ed in

OCGA § 3 1 -6 -4 4 (f), wh i ch p ro v i d es , i n rel ev an t p art :

Th e i s s u e fo r t he deci si o n b y t h e h eari n g o ffi cer s h al l b e w h e t h e r , an d

t h e h eari n g o ffi cer s h al l o rd er t h e i s s u an ce o f a cert i fi cat e of n eed if, i n

t h e heari n g offi cer’ s ju d g m en t

, t h e ap p l i cat i o n i s co n s i s t en t wi t h th e

c o ns i d erat i on s as s et fo rt h i n Co d e Sect io n 3 1 -6 -4 2 an d t he [DCH]’s

10ru l es , as t he h eari ng o ffi cer d eem s s u ch co n s i d erat i on s an d ru l es

ap p l icab l e t o t h e rev iew o f t h e p ro ject .[ 1 2 ]

See al s o Dep t

. o

f Co mmu n i t

y Hea l t h v. S

a ti l la Hea l t h S

er vs
., In c. , 2 6 6 Ga. Ap p

. 8 8 0,

8 8 4 (1 ) (c) (5 9 8 SE2 d 5 1 4 ) (2 0 04 ). O CGA § 3 1-6 -4 4 (f) (1 ) fu rt h er p ro v id es t h at t h e

p an el h eari n g o ffi cer m ay co n s i der “ wh et h er t h e [DCH] co m m i t t ed p re

j u d i c i a l

p ro ced ural erro r i n i t s co n s i d erat i on o f t h e ap p l icat io n. . . .” 1 3

M o reo v er, t h e DCH al s o m an d at ed th at cert ai n i s s u es “ s h al l n o t b e co n s i d ered

at an in i t i al ad m i n is t rat i ve ap p e al h eari n g an d are im m at eri al t o t he h eari n g [,] ”

i n cl u d i n g “ t h e co rrect n es s

. . . o f t h e co n si d erat io n s , ru l es , o r s t an d ard s b y wh i ch t h e

p ro p os ed p ro

ject was rev iewed b y

t h e [DCH] ” an d “ t h e d et erm i n at i o n o f wh et h er a

p ro p os ed p ro

ject i s s u b ject to rev i ew u nd er OCGA § 3 1-6 -1 et s eq

. an d t h e [DCH] ’ s

R u l es

. ” (Em

p h as i s s u p p l ied .) G a. Co m p

. R. & Reg s

. r. 2 7 4 -1 -.0 9 (2 ) (a), (b )

. “ T h e

ap p oi n t ed h eari ng o ffi cer co n d u ct s a fu l l ev id en t i ary h eari n g, OCGA § 3 1 -6 -4 4 (e),

a n d t h e ap peal h eari n g co n d uct ed b y t h e ap peal p an el h eari ng offi cer s h al l b e a d e

n o v o rev i ew o f t h e d eci si o n o f t h e [DCH]

. OCGA § 3 1 -6 -4 4 (f).” (Pu n ct u at i o n

1 2 Ga. Co m

p. R. & Reg s . r. 2 7 4 -1 -.0 9 (1 ) (a) co n t ai n s an i den t i cal p ro v i s i o n

.

1 3 See al s o Ga. Co m

p . R. & Reg s . r. 2 7 4 -1 -.0 9 (1 ) (b ) (s am e).

11o m it t ed .) Ken n es t o n e Ho s p

. , s u p ra, 3 4 6 Ga. Ap p

. at 7 2

, n

. 5

. ; s ee al s o Ga. Co m p

. R.

& Reg s . r. 2 7 4 -1 -.0 9 (3 ).

Th ereaft er, an ag g ri ev ed p art y m ay p et i t i o n th e DCH co m m i s s i o ner fo r rev i ew

o f t h e p an el h eari n g o ffi cer’ s d eci s i on

. See OCGA § 3 1 -6 -4 4 (i ), (k ). Fi n al l y , a p art y

m ay seek ju d i ci al rev iew o f t h e D CH co m m is s io n er’ s d eci s i o n i n su p eri o r co u rt

. 1 4 See

OCGA § § 3 1-6 -4 4 .1 , 5 0 -1 3 -1 9 (a), (b ).

(c) Revi ew o

f EUHS ’ Ap

p li ca ti o n f

o r a Cer t i f i ca te o f Need

.

Here, t h e DCH fo un d t h at EUHS ap p l i ed fo r a CON “ t o ren o vat e an d u p g rad e

i t s cu rren t h o s p i t al faci l i t y .” A s a res ul t

, th e DCH rev i ewed E UHS’ ap p l i cat i o n

“ acco rd i n g t o t h e rel ev an t Cert i fi cat e o f Need ru l es o ut l i n ed i n t he Gen eral Rev i ew

Co n s i d erat i o n s .” See OCGA § 3 1 -6 -4 0 (a) (2 ); Ga. Co m p

. R. & Reg s

. r. 1 1 1 -2 -2 -.0 9.

(i ) Gen eral l y , o u r st an d a r d of r e vie w r e q uir e s tha t w e de te r

m in e “ wh et h er

‘ su b s t an t i al ev i d en ce’ s u p p ort s t h e [DCH] ’ s fi n d i n g s o f fact

, an d wh et h er t h e

1 4 A s u p eri o r co u rt “ m ay rev ers e o r m o di fy t h e fi n al d eci s i o n o n ly i f s u b s t an t i al
ri gh t s o f t h e ap p el l an t h av e been p reju d i ced b ecau s e t he p ro ced u res fo ll o wed b y t h e [DCH]

, t h e h eari n g o ffi cer, o r t h e co m m i s s i o n er o r t h e ad m i n i s t rat iv e fi n d i n g s , i n feren ces , an d co n cl u s io ns co nt ai n ed i n t h e fi n al d eci si o n are: (1 ) [i ] n v i o l at i o n o f

co n st i t u t io n al o r s t at u t o ry p ro v i s i o n s ; (2 ) [i ] n ex ces s o f t h e s t at u t o ry au t ho ri t y o f t h e [DCH] ; (3 ) [m ] ad e up o n u n l awfu l p ro ced u res ; (4 ) [a] ffect ed by ot her erro r o f l aw; (5 ) [n ] o t s u p p o rt ed b y su b s t an t ial ev i d en ce

. . .; or (6 ) [a] rb it rary o r cap ri ci o u s o r ch aract eri zed b y ab u s e o f d i s cret i o n o r cl earl y u n w arran t ed ex erci s e o f d i s cret i o n.” OCGA § 3 1 -6 -4 4 .1 (a).

12co n cl u s i o n s o f l aw d rawn fro m t h o s e fi n d in g s o f fact are s ou n d .” (Ci tat i o n o m i t t ed .)

Pa l myr a P a r k H

o s p

. v

. Ph o eb e S

u mt er Med

. Cen t er , 3 1 0 Ga. Ap p

. 48 7

, 4 8 8 (7 1 4

S E2 d 7 1 ) ( 2 0 1 1 ). In t hi s cas e, t h e p art i es d o n o t d i s p ut e t h at

, t o t h e ex t en t EUHS’

ap p li cat io n i s rev i ewed as an ap p l i cat i o n fo r a n ew CON fo r a cap i t al ex p en d i t u re, t h e

DCH’ s d eci s i o n i s su p p ort ed b y t h e p an el h eari n g offi cer’ s fi nd i n g s o f fact an d t h at

i t s co n cl u s i o ns o f l aw were s ou n d

. Becau s e t h ere i s n o arg u m en t t h at t h e DCH’ s

d eci s i o n t o i s s u e EUHS a n ew CON fo r a cap i tal ex p en d it u re was n o t s u p p o rt ed b y

t h e ev i d en ce o r w as l eg al ly un s o u n d

, we affi rm t h e s u peri o r co u r t ’s d en i al o f

W el l s t ar’ s p et i t i on fo r ju d i ci al rev i ew.

(i i ) N e v ert h el es s, i n wh at i t des cri b es as an “ ou t co m e det erm i n at i ve”

i s su e o f i t s ap p eal fro m

t h e DCH co m

m i s s i o n er’ s o rd er affi rm i n g t h e p an el h eari n g

o ffi cer’ s d et erm i n at i on o f t h e s co p e o f rev i ew, W el l s t ar co n t en d s t h a t t h e DCH’ s

i n i t i al d et erm i n at i o n o f EUHS’ ex i st i ng CON s t at u s was erro neo u s an d s h o u l d h av e

b een rev i ewed b y th e p an el h eari ng o f f i c e r

. H o w ev er, W el l s t ar’ s arg um en t i s n ot

p ro p er wi t h i n t h e l i m it ed fram ewo rk o f t h e CON Ap p eal Pan el

. Acc o r d i ng l y , t h i s

p ro v id es n o b as is fo r rev ers al an d W el l s t ar m u s t av ai l i t s el f o f o t h er rem ed i es

.

To res o l v e t h i s i s s u e, we t u rn fi rs t t o t h e g o v ern i n g s t at ut es an d ag en cy ru l es

an d reg u l at i on s . W h en ex am i n in g s t at u t o ry p ro v i s i o n s ,

13we ap p l y t h e fu n d am en t al ru l es o f s tat u t o ry co n s t ru ct io n t h at req u i re u s

t o co n s t ru e t he s t at ut e acco rd i n g t o it s t er m s , t o g iv e wo rd s th ei r p l ai n

an d o rd in ary m ean in g , an d t o av o i d a co ns t ru ct i o n t h at m ak es s o m e

l an g uag e m ere s u rp l u s ag e. T h u s , a s t at u te s h o u l d be read acco rd i n g t o

i t s n at ural an d m o s t o b v i ou s im p o rt of t he lan g u ag e wi t h o u t res o rt i n g t o

s u b t l e an d fo rced co n s t ru ct i on s fo r t h e p u r p o s e o f ei t h er l i m i t i n g o r

ex t en d i n g i t s o p erat i o n

.

(Ci t at i o n s an d p u n ct u at i on o m i t t ed

. ) L a k evi ew Beh a vi o r a l Hea l t h S ys

. v. UHS

Pea ch f or d

, LP

, 32 1 Ga. Ap p

. 8 2 0

, 8 2 2 (1 ) (7 4 3 SE2 d 49 2 ) (2 0 1 3). Si m i l arl y , “ [i ] n

co n st ru i n g ag en cy reg u lat i o n s , we em p l o y th e b as i c ru l es o f s t at u t o ry co ns t ru ct i o n

an d l o o k t o t h e p l ai n m ean i n g o f t h e reg u l at i o n t o d et erm i n e i t s m ean i ng .” (Ci t at i o n

o m it t ed .) W

a lker v. Dep t. o

f Tr an s p. , 2 7 9 G a. Ap p

. 28 7

, 2 9 2 (2 ) (a) (6 3 0 SE2 d 8 7 8 )

(2 0 0 6). Acco rd i n gl y ,

[w] h en an ad m i n i s t rat i v e ag en cy d eci s i o n is t h e s u b ject o f ju d i ci al

rev i ew, j u d ici al d eferen ce i s t o b e affo rd ed t h e ag en cy ’ s i n t erp ret at i o n

o f ru l es an d reg u lat io n s i t h as en act ed t o fu l fi l l t h e fu n ct i o n g i ven i t b y

t h e l eg i sl at i v e b ran ch

. An d i n co n st ru in g ad m i n i s t rat i v e ru l es , th e

u l t i m at e cri t eri o n i s t h e ad m i n is t rat i v e i n t erp ret at i o n, wh i ch b eco m es o f

co n t ro ll i n g w ei g h t un l es s i t i s p l ai n l y erro n eo u s o r in co n si s t en t wi th th e

ru l e.

(Ci t at i o n an d p u nct u at io n o m i tt ed .) AS MC

, s u p ra, 3 4 4 Ga. Ap p . at 5 8 2

.

14In s h o rt

, we “ m u s t d efer t o t h e [DCH] ’ s deci s io n s reg ard i n g po l i cy , as wel l as

t o t h e [DCH] ’ s i n t erp r e t a t i o n an d en fo rcem en t of i t s o wn ru l es .” 1 5 Sa t i l l a Hea l th

S er vs

. , s up ra, 2 6 6 Ga. Ap p

. at 8 8 7 (1 ) (c); s ee al so W al ker

, s u p ra, 2 7 9 Ga. A p p

. at 2 9 2

(2 ) (a). Th is i s s o b ecau s e

[a] g en ci es p ro v i d e a h i g h l e v e l o f ex p ert i s e an d an o p p o rt u n i t y fo r

s p eci al i zat i o n u n a v ai l ab le i n th e ju d i ci al or l eg i s l at i v e b ran ch es

. Th ey

are ab l e t o u s e t h es e s k i l l s , al o ng wi t h t h e p o li cy m an d at e an d d i scret i o n

en t ru s t ed t o t h em b y t h e l eg i s lat u re, t o m ak e ru l es an d en fo rce t h em i n

fas h io n i n g s o l u t i o n s to v ery co m p l ex p ro b lem s. T hus, th ei r d eci s i o n s are

n o t t o b e t ak en l i g h tl y or m i n i m i zed b y t h e ju d i ci ary

. Rev iew o v erb ro ad

i n s co p e wo u l d h a v e t h e effect o f s u b s t i tu t i n g t h e ju d g m en t o f a j u d ge

o r ju ry fo r t h at o f t h e ag en c y, t h e r eb y nu l l i fy in g t h e b en efi ts o f

l eg i s l at i v e d el eg at i o n t o a s p eci al ized b o d y

.

Ben tl ey v. Ch a st a in

, 24 2 Ga. 34 8

, 3 5 0 -3 5 1 (1 ) (2 4 9 SE2 d 3 8 ) (1 9 7 8 ). In t h e co n t ex t

o f t h e DCH,

1 5 N o t hi n g i n t h is op i n i o n s h o u l d b e read t o su g g es t t hat ou r h i s t o ry o f ag en cy d eferen ce i s wh o l ly wi t h ou t b o u n d ari es

. To t h e co nt rary , ag en cy d eferen ce i s

n at u ral l y l i m i t ed t o th e au t h o ri t y g ran t ed t he ag en cy b y t h e Gen eral A s s em b l y an d

m u st be ap pl ied i n a m an n er co n s i s t en t wi t h t h e Geo rg i a co n st i tu t i o n

. Here, fo r t h e

reas on s ex p l ai n ed i nfra, we s im p l y h o l d t h at t h e DCH d eci s i o n o n an ap p l i cat i o n fo r

a new CON i s en t i t l ed t o deferen ce b e c a u s e i t fal ls wi th i n t h e DCH’ s ex cl u s i v e

au t h o ri t y

.

15[t ] h e ad m in i s t rat i on o f th e CON p ro gram req u i r es a p art i cu l arl y h i g h

l ev el o f ex p e r t i s e an d s p eci al i zat i o n

. T h e DCH ru les p ro m u l g at ed t o

ad m i n i s ter th e p ro g ram are d et ai l ed an d l en g th y

. See, e.g ., Ga. Co m p

. R.

& Reg s

. r. 1 1 1-2 -2 -.0 7

, wh i ch d es cri b es t he rev i ew p ro ced u res fo r CON

ap p l icat i o ns

. Bo t h th e h o s p it al s eek i n g a CON an d t h e ho s p i t al s

o p p o s i ng i t g at her an d org an i ze v as t am o u n t s o f d at a, ex p ert t es ti m o ny ,

an d o t h er ev id en ce wh i ch are p res en t ed t o t h e ag en cy s t aff, wh i ch t h en

i n t erp ret s an d s y n t h es i zes t h e ev i d en ce an d ap p l i es i t t o t he ag en cy ru l es

. Se e OC GA § 3 1-6 -4 3

. Th e i n i t i al s taff d eci s i o n m u s t b e i ss u ed wi t h i n

a r el at iv el y sh o rt peri o d o f t i m e, at m o s t 1 5 0 d ay s aft er t h e CON

ap p l icat i o n i s co m

p l et e. OCGA § 3 1 -6 -4 3 (d ), (i ).

Fu rt her ad m in is t rat i v e rev i ew is al so h i gh l y s p eci al i zed

. Th e h eari n g

o f f i c er wh o rev i ews th e i n i t i al DCH s t aff d eci s i o n i s o n e o f fi v e

m em b ers o f t he CON Pan el

, al l o f wh o m are ap p o i n t ed b y t h e Go v ern o r

an d are at t orn ey s “ wh o are fam i li ar wi t h t h e heal t h care i n du s t ry b u t

wh o do no t h av e a fi na n c i al in t eres t i n or rep res en t o r h av e an y

co m p en s at i o n arran g em e n t wi t h an y h eal t h care faci l i t y

. ” OCGA §

3 1 -6 -4 4 (a), (b ).

Pa l myr a Pa r

k Ho s p
., In c. , s u p ra, 3 1 0 Ga. Ap p

. at 49 1 -4 9 2 (1 ). Ul t i m at el y , “ o u r d u t y

i s n o t to rev i ew wh et h er th e reco rd s u p p o rt s t h e s u p eri o r co u rt ’ s d eci s io n b u t wh et h er

t h e reco rd s u p po rt s t h e fi n al d eci s i o n o f t h e ad m i n i s t rat i v e ag en cy .” (Ci t a t i o n an d

p u n ct u at i o n o m it t ed .) S

a t i l l a Hea l t h S

er vs

. , s up ra, 2 6 6 Ga. Ap p . at 8 8 5 (1 ) (c).

16W el l s t ar’ s arg u m en t t h at t h e p an el h eari n g o ffi cer s h o u l d “ i n d ep en d en t l y

d eci d e” wh et h er EUHS m ai n t ai n ed an a c t i v e CON s tat u s t o o perat e a h eal t h care

faci li t y i s fl awed fo r tw o r e a so n s

. Fi rs t

, t h e p l ai n lan g u ag e o f OCGA § 3 1 -6 -4 4

p recl u d es t h e p an el heari n g offi cer fro m co ns i d eri n g a c ha l l en g e t o a CON ap p l i can t ’ s

ex i s t in g CON st at us . Seco n d, t he ex cl u s iv e au t h o ri ty t o d et erm i n e wh et her a h eal th

care faci l i t y m ai n t ai ns an act i v e CON h as b een l eg i s l at i v e l y r e l e g at ed t o o t h er

d i v i s i on s o f t h e DCH.

(A) Pl a i n La n g u a g e o

f OCGA §

3 1 -6 -4 4

.

On ap p eal fro m t h e D CH’ s d eci s i o n on a CON ap p l i cat i o n , th e s c o p e o f t h e

p a n e l h eari n g o ffi cer’ s rev iew i s l i m i t ed t o “ wh et her,

. . . i n t h e h eari ng o ffi c e r ’s

ju d g m en t

, th e ap p l i cat i o n i s co n s i s t en t wi t h t h e co n si d erat i on s as s e t fo rt h i n Co d e

Sect i o n 3 1 -6 -4 2 a n d th e [DCH] ’ s ru l es , as t h e h eari n g o ffi cer deem s s u ch

co n si d erat io n s an d ru l es ap p l i cab l e t o t h e r e v i ew o f th e pro ject .” OCGA § 3 1 -6 -4 4

(f); s ee al s o G a

. C o m

. R. & Reg s. r. 2 7 4 -1 -.0 9 (s am e). A cco rd i n g l y , t h e p l ai n

l an g u ag e o f t h e s t at u t e m an d at es t h at t h e p an el h eari n g o ffi cer m ay on l y rev i ew

wh et h er a CON ap p l i cat i o n i s co n s i s t en t wi t h : (1 ) t h e 1 7 g en eral co n s i d erat i o n s s et

fo rt h i n OCGA § 31 -6 -4 2 (a); (2 ) t h e 1 7 g en eral co n s id erat i on s set fo rt h i n Ga. Co m p.

R & Reg s

. r. 1 1 1 -2 -2 -.0 9 (1 ) (a)
- (q ); an d (3 ) an y ad d i t i o n al s erv i ce-s p eci fi c

17co n si d erat io n s , pro m u lg at ed b y t h e DCH an d l i s t ed i n Ga. Co m p

. R. & Reg s

. r. 1 1 1

-

2 -2 -.1 1 (1 ), t h at m ay ap p l y t o t h e CON ap p l i cat i o n u n d er rev i ew. 1 6 In ad d i t i o n , Ga.

Co m p

. R. & Reg s

. r. 2 7 4 -1 -.0 9 (2 ) (b ) d irect s t h at t he pan el h eari ng o ffi cer i s

s p eci fi cal l y p recl u d ed fro m co n s i d e r i n g “ t h e d et erm i n at i o n of wh et h er a p ro p o s ed

p ro ject i s s ub

ject t o rev i ew u nd er OCGA § 3 1 -6 -1 et s eq . an d t h e [DCH] ’ s Ru l es .”

In th at reg ard

, no n e o f t h e co n s i d erat i o n s u nd er ei t h er OCGA § 3 1 -6 -4 2 o r Ga.

Co m p

. R. & Reg s

. r

. 1 1 1 -2 -2 ad d res s a h eal t h care faci l i t y ’ s ex i s t i n g CON s t at u s

.

Rat h er, t he p an el h eari n g o ffi cer s i m p ly rev i ews wh e t h e r t h e CON ap pl icat i o n at

i s su e, w h i ch h as b een rev i ew e d a n d ei t h er gran t ed o r d en i ed b y th e DCH, i s

co n si s t en t wi t h t h es e en u m erat ed co n s i d erat i o n s

. See OCGA § 3 1-6 -4 4 (f). Th e

Gen eral As s em

b l y , i n en act i n g OCGA § 3 1 -6 -4 4

, d i d no t en d o w t h e p an el h eari n g

o ffi cer wi t h an y o t h er au t ho ri t y

. Acco rd i n g l y , u n der t h e p l ai n l an gu ag e o f b o th

OCGA § 3 1 -6 -4 2 an d Ga. Co m p

. R. & Reg

. 2 7 4-1 -.0 9 (1 ) (a) an d (b ), a CON Ap p eal

Pan el h eari n g o ffi cer d o e s n o t h av e th e au t h o ri t y t o ex am i n e t h e DCH’ s i n i t i al

1 6 Her e , t he wo rd s “ co n s i derat i o n ” an d “ ru l e” are t erm s o f art wh i ch s peci fi cal l y refer t o t h e p ro v i s i o n s o f O CGA § 3 1 -6 -4 2 an d Ga. Co m p

. R. & Reg s. r. 1 1 1 -2 -2 -.0 9

an d 1 1 1 -2 -2 -.1 1

, r e s p e c t i v el y

. See g en eral l y Ag S o u th Fa r m Cr ed i t

, ACA v. Go wen Ti mb er Co

. , 33 6 Ga. A p p. 5 8 1

, 5 8 9 (2 ) (b ) (i ) (7 8 4 SE2 d 9 1 3) (2 0 16 ) (“ i f a s t at u t e i s
p l ai n an d u n am

b i g u o u s, i t s wo rd s (ex cep t fo r t erm s o f art o r t h o se wi t h a p art i cu l ar

m ean i n g i n co nn ect i on wi t h a s p eci fi c t rad e o r s u b ject m at t er) m

u s t b e as si g n ed t h ei r

co m m o n an d o rd i n ary m ean i ng ”) (ci t at i o n o m i t t ed ).

18d et erm i n at i o n o f a h eal th care fa c i l i t y ’ s ex i s t i n g CON s t at u s

. See, e.g ., La kevi ew ,

s u p ra, 3 21 Ga. Ap p

. at 8 2 2 (1 ); W a l ker

, s u pra, 2 7 9 Ga. Ap p . at 2 9 2 (2 ) (a).

W el l s t ar rel i es p ri n ci p al l y o n Fl o yd Co u n t y B d. o f Co mmr s v. Fl o yd Co u n t y

Mer it S ys

. Bd

. fo r t h e p ro p os i t i o n t h at “ i n ci d en t al p o w e r s reas on ab ly n eces s ary to

carry o u t

. . . ex p r e s s p o w ers are i n cl u d ed b y i m pl i cat io n .” 2 4 6 Ga. 4 4

, 4 5 (1 ) (2 6 8

SE2 d 6 5 1 ) (1 9 80 ). In Fl o

yd Co u n t y , o u r Su p rem e Co u rt n o t ed t h at an act creat i n g t h e

M eri t Sy s t em Bo a r d p l a c ed “ b ro ad res p o ns i b i l it i es on t h at b o dy i n reg ard t o t h e

h i ri n g, fi ri n g , p ro m o t i o n , et c., o f co u nt y em p lo y ees co m i n g u n d er i t s pro v i si o n s .” Id

.

at 4 5 (2 ). As a res u lt

, t h e Co u rt o b s erv ed t h at “ [i ] t wo ul d st rai n t h e m i n d t o t h i n k t h at

s u ch a b o d y co u l d fu n ct i o n w i t ho u t p ers o n n el

. ” Id

. Acco rd i n g ly

, t h e Co u rt co n cl u d ed

t h at t h e M eri t Sy s t em Bo ard

, r a t h e r t h an th e co u n t y b o ard o f co m m i s s io n ers , “ h ad

i m p l i ed p o wers t o h i re an d di s ch arg e em p l o y ees i n k eep i n g wi t h i t s an n u al b u d g et

,

t h e s am e b ei n g reas o n ab l y n eces s ary t o e x e c u t e t h e p o wers co n ferred .” Id

. In t h i s

cas e, th ere i s n o s u ch n eed t o s earch fo r i n ci d en t al p o wers b ecau s e t he CON Ap p eal

Pan el ’ s ex p res s p o wers , as d es cri b ed ab o v e, fu l ly d e f i n e i t s l i m i t ed au t h o ri t y

. See

OCGA § 3 1 -6 -4 4 ; Ga. Co m p

. R. & Reg s. r. 27 4 -1 -.0 9

. As a res u l t

, W el l s t ar’ s

arg u m en t i s u n av ai l i ng

.

19No r i s W el l s t ar res cu ed b y p ro v is io n s st at in g t h at t h e pan el h eari n g o ffi cer

co n du ct s “ a de n o v o rev i ew o f t h e deci s i o n o f t he [DCH] .” OCGA § 3 1 -6 -4 4 (f); s ee

al s o Ga. Co m

p

. R. & Reg s

. r. 2 74 -1 -.0 9 (3 ). To t h e co n t rary , d e n o v o i s a st an d ard o f

rev i ew, rat h er t h an a d es cri p t i o n o f wh at i s rev i ewab l e p urs u an t t o a reg u lat o ry an d

s t at u to ry rev i ew s ch em e. See, e.g

., W a sh

. S t a t e Dep t. o

f Co rr ect i on s v. W

as h . S t a t e

Per s o n n el Ap

p ea ls Bd

. , 9 6 7 P 2 d 6

, 9 ( C) (W as h

. Ap p

. 1 9 9 8 ) (“ W e rev i ew an

ad m i n is t rat i v e a g en cy act i o n d e n o v o

. Bu t t he s co p e o f r evi ew i s li mi ted

. . . . ”)

(em p h as i s s u p p li ed ; ci t at io n s o m it t ed ). St at ed d ifferen t l y , t h e CON Ap peal Pan el

h eari n g o ffi cer co n d u ct s a d e n o vo rev i ew o n l y of t h e co ns i d erat i o n s i d en t i fi ed in

OCGA § 3 1 -6 -4 2 (a) an d Ga. Co m p . R & Reg s . r. 1 1 1 -2 -2 -.0 9 (1 ) (a)
- (q ), an d an y

ad d it i o n al s erv ice-s p eci fi c co ns i d erat i o ns l i s t ed i n Ga. Co m p

. R. & Reg s

. r. 1 1 1 -2 -2

-

.1 1 (1 ), t h at m ay ap pl y , rat h er t h an a wh o l es al e rev i ew o f th e DCH’ s en t i re d eci s i o n

m ak i n g p ro ces s

.

In t h i s reg ard

, W el l st ar’ s rel i an ce u p o n Lo n g l ea f En er g y As s o c s

. , L LC v.

Fr i en d s of t h e Ch a t t a h o och ee, In c. fo r an ex p an s i v e d efi n i ti o n o f “ d e n o v o ” i s

m i s p l aced

. 2 9 8 Ga. Ap p

. 7 5 3

, 7 68 (7 ) (6 8 1 SE2 d 2 0 3 ) (2 0 0 9 ). In Lo ng l ea f

, we q u o t ed

an ad m i n i s t rat i v e ru l e o f t h e En v i ro n m en tal Pro t ect i o n Di v i s i o n of t h e Dep art m en t

o f Nat ural Res o u rces p ro v i d in g t h at a n ad m in i s t rat i ve rev i ew h eari ng “ ‘ s h al l b e d e

20n o v o i n n at u re a n d t he evi d en ce o n t h e is s u es i n a n

y h e a ri n g i s n o t l i mi t ed t o t h e

evi d en ce p r es en t ed t o or co n s id er ed b y t h e Ref er r i n g Ag en cy p r i o r t o i t

s d eci s i o n

. ’

Ga. Co m p

. R. & Reg s. r. 6 1 6 -1 -2 -.2 1 (1 ), (3 ).” (Em p h a s i s s u p p li ed ; pu n ct u at i o n

o m it t ed .) Id

. In co n t ras t t o t he ru le at i s s u e i n Lo n g l e a f

, t h e ru l es an d reg u l at i on s

g o v ern i n g t h e CON Ap p eal Pan el d o n o t au t h ori ze s u ch a b ro ad s co p e of rev i ew. See

Ga. Co m p

. R. & R e g s

. r. 2 7 4 -1 -.0 9 (2 ) (i d en t ify i n g is s u es t h at “ s h al l n o t b e

co n si d ered at an i n i t i al ad m i ni s t rat i v e ap p eal h eari n g a n d are im m at eri al t o t h e

h eari n g ”), (3 ) (“ Th e ap p eal h eari n g co n d u ct ed b y t h e Ap p eal Pan el heari ng o ffi cer

s h al l be a d e n o vo rev i ew o f th e d eci s i o n o f t h e [DCH]

. ”). Acco rd in g l y , Lo n g l ea f i s

i n ap p o s it e.

(B) Co mp an i o n S t a t u tes t o OCGA § 3 1 -6 -4 4

.

Ou r co n cl u si o n i s bu t t res s ed b y o th er s tat u t es wh i ch m u s t b e read i n p ari m at eri

wi t h OCGA § 3 1 -6 -4 4. See gen eral l y Jo rd a n v. Ma r r i ot t In t l

., In c. , 3 4 6 Ga. Ap p

. 7 0 6,

7 1 2 (1 ) (b ) (8 1 6 SE2 d 82 2 ) (2 01 8 ) (t h ree co ord i n at i n g s t at u t es “ m u s t b e read i n p ari

m at eri a, w h i ch m ean s s i m p l y t hat t h ey m

u s t b e h arm o n i zed , an d m ay n o t b e read in

a v acu u m ”) (ci t at i o n an d p u n ct u at i o n o m i t t ed ).

Th e Gen eral A s s em

b l y g ran t ed t h e DCH ex cl u s iv e au t h o ri t y t o ad m i n i s t er t h e

CON p ro g ram

. See OCGA § 3 1 -6 -2 1 (a). To th at en d

, t h e DCH h as t h e au t h o ri t y t o,

21am on g o t h er t hi n g s : (1 ) “ ad op t

, p r o m u l g at e, an d im

p l em en t ru l es an d reg u l at i on s

s u ffi ci en t t o ad m i n i s t er

. . . t h e cert i fi cat e o f need p ro g ram ; ” (2 ) “ defi n e, by ru l e, t h e

fo rm , co n t en t

, s ch ed u l es , an d p ro ced u re fo r s u bm i s s i o n o f ap p li cat i o n s f or c e r tif ic a te s

o f n e e d ; ” a n d (3 ) “ g ran t

, den y , o r rev o k e a cert i fi cat e o f n eed as ap p l i ed fo r o r

am en d ed [.] ” OCGA § 3 1 -6 -2 1 (b ) (4 ), (5 ), an d (1 0 ).

Si m i l arl y , Art i cl e 3 o f Ti t l e 3 1

, Ch ap t er 6 p ro vi d es t h e DCH wi t h au t h o ri t y to

“ t o rev o k e a cert ifi cat e o f n eed

, i n wh o l e o r in p art ” fo r a v ari t et y of reas o n s (OCGA

§ 3 1 -6 -4 5 (a)), fi n e a h eal t h care faci l i ty f o r v i o l a t i o n s o f t h e cert i fi cat e o f n eed

req u i rem en t (OCGA § 3 1 -6 -4 5 (c)), fi l e an act i o n fo r i n ju n ct i v e rel i ef t o en fo rce t h e

req u i rem en t s o f th e CON p ro g ram (OCGA § 3 1 -6 -4 5 (d )), an d co nd u ct i n v es ti g at i on s

i n t o al l eg ed v i ol at i o n o f t h e C ON p r o g r a m (OCGA § 3 1 -6 -4 5 (e)). In ad d it i o n , t h e

DCH m ay d en y a l i cen s e t o o p erat e t o “ [a] n y h e a l t h care faci l i t y o fferi n g a n ew

i n s t i t u t i o n al h eal th s erv ice wi t h o u t h av i ng o b t ai n ed a cert i fi cat e o f n eed an d wh i ch

h as n o t b een p rev i o u sl y li cen s ed as a h eal t h care faci l i t y

. . . .” OCGA § 3 1 -6 -4 5 (b ).

W i th t h e ex cep t i o n o f t h e D CH’ s d eci s i o n t o g ran t o r d en y an ap pl i cat i o n fo r a CON,

s ee O CGA § 3 1-6 -4 4 (a), n on e o f t h es e act i o n s b y DCH wo u ld b e rev i ewab l e b y t h e

22CON Ap p eal P a n el

. 1 7 Th erefo re, a rev i ew o f t h es e st at ut es co n fi rm s t h at t h e s o l e

au t h o ri t y t o rev i ew a heal t h care faci l i ty ’ s ex i s t in g CON s tat u s res t s w i t h t h e DCH. 1 8

In s u m , we co ncl u d e t hat W el ls t ar’ s arg u m en t

— t h at th e CON Ap p eal Pan el

h e ari n g o ffi cer m ay i n dep en den t l y rev i ew t h e ex i st i n g CON s t at u s o f a h eal t h care

faci li t y i n an ap p eal fro m a DCH d e c i s i o n o n t h e faci l i t y ’ s ap p l i cat i o n fo r a n ew

CON — i s fo recl o s ed b y

t h e p l ai n l an g u ag e o f OCGA § 3 1-6 -4 4 an d Ga. Co m p . R.

& Reg s

. r. 2 7 4 -1 -.0 9. Rat h er, i s su es co n cern i n g a faci l i t y ’ s ex i s t in g CON s tat u s m u s t

b e ad d res s ed b y th e rem ed i es co d i fi ed i n OCGA § 3 1

- 6

- 4 5

. Were we t o accep t

W el l s t ar’ s ex p an s i ve v i ew o f t h e p an el h eari n g o ffi cer’ s ro l e t o al l ow rev i ew o f a

l i m i tl es s un i vers e o f i s s u es n o t rel at ed t o t h e CON ap p l i cat i o n , we w o u l d n eces s ari l y

b es t o w au t h o ri ty up o n t h e p an el h eari n g offi cer n o t s u p p l i ed b y t h e Gen eral

As s em b l y

. Th i s , we wi l l no t d o

. We t h erefo re affi rm t h e s u p eri o r co u rt ’ s d en i al o f

W el l s t ar’ s p et i t i on fo r ju d i ci al rev i ew.

1 7 See OCGA § 3 1 -6 -4 4 (a) (“ Th e pu rp o s e o f t h e ap p eal p an el sh al l b e t o s erv e

as a p an el o f i n dep en d en t h eari n g o ffi cers t o rev i ew t he [DCH] ’ s i n i t i al d eci s i o n to

g ran t o r d en y

a cert i fi cat e o f n eed ap p l i cat i o n .”).

1 8 Si m i l arl y , i ss u es co n cern i n g wh et h er a h o s p i tal t ran s act io n m u s t b e rev i ewed

p u rs u an t t o t h e H o s p i t al Acq u i s i t i o n Act (OCGA § 3 1 -7 -4 0 0 et seq .) a r e s u b j e c t to

t h e p ro v i s i o n s o f t h at s t at u t e, wh i ch i s ad m i n i s t ered ex cl u si v el y b y t h e At t o rn ey Gen eral ’ s Offi ce. See OCGA § 3 1 -7 -4 0 1 et s eq

.

232

. In i t s s eco n d en u m erat i o n o f erro r, W el l s t ar arg u es t h at th e pan el h e a r i n g

o ffi cer’ s d eci s i o n w as “ m ad e u p o n u nl awfu l p ro ced u res ” an d t h at t h e d eci s i o n

v i o l at ed W el l s t a r ’ s d u e p ro ces s ri g ht s u n d er t he Un i t ed St at es an d Geo rg i a

co n st i t u t io n s

. Pret erm i t t i n g wh et h er W el l s t ar pro p erl y rai s ed t hi s i s s u e befo re t h e

CON Ap p eal Pan el

, a rev i ew o f t h e d eci s i o n s b y t h e p an el h eari n g o f fi cer an d t h e

DCH co m

m i s s io ner rev eal s t h at nei t h er o ffi ci al ru led on t h at d i s t in ct i s s ue.

“ Co n s ti t u t i o n al is s u es m

us t b e rai s ed at t h e earl i es t o pp o rt un i t y i n t h e tri al co u rt a n d

r u l ed u p o n t o b e p res erv ed .” (Ci t at i o n s o m i t t ed

. ) S i ng l et o n v. D ep t

. o f Hu ma n

Res o u r ces , 2 6 3 Ga. Ap p

. 6 5 3

, 6 5 4 (1 ) (a) (5 8 8 SE2 d 7 57 ) (2 00 3 ). As a res ul t

, “ u n l es s

ru l ed u po n b y t h e t ri al co u rt

, co n s ti t ut i on al i s s u es can n o t b e r e v i e wed o n ap p eal

,

b ecau s e t h e ap p e l l at e co u rt l ack s j u ri s d i ct i o n t o co n s i d er a co n s t it u t i o n al is s u e n ot

ru l ed u p o n b y t h e t ri al co u rt .” (Ci t at i o n om i t t ed .) Id

. See al s o Jo h n Ha r d y Gr o u p
, In c.

v. Ca yo La rg o Ho t el

As s o c. , 2 8 6 Ga. Ap p

. 5 8 8, 5 8 9 (1 ) (6 4 9 SE2 d 8 2 6 ) (2 0 0 7 ) (“ A

co n st i t u t io n al is s u e i s wa i v e d b y th e fai l ure o f t he t ri al co u rt t o ru l e u p o n i t .”)

(ci t at i o n an d p u nct u at io n o m i t ted ). Acco rd i n g l y , t h i s en u m erat i o n p res en t s n o t h i n g

fo r o u r rev iew.

In co n cl us i on , n ei th er OCGA § 3 1 -6 -4 4 n o r Ga. Co m p

. R. & Reg s

. r. 2 7 4 -1 -.0 9

p ro v id e t h e CON Ap peal Pan el wi t h au t h o ri t y t o rev i ew t h e ex i s ti n g CON s t at u s o f

24a h eal t h care faci li t y i n an ap p e a l f r o m th e DCH’ s deci s i o n o n an ap p l i cat i o n fo r a

n ew cert i fi cat e o f need

. Becau s e t h e CON Ap peal Pan el h eari n g offi c e r c o rrect l y

co n cl u d ed th at “ [i ] t i s n ot t he fu n ct i o n o f t h e CON Ap p eal Pan el t o co n s i d er q u es t i on s

o f CON an d l i cen su re s t at u s ,” an d i n t h e ab s en ce o f arg u m en t th at t h e p an el h eari n g

o ffi cer’ s fi n d i n g s o f fact were u n s u p p o rt ed or th e o ffi cer’ s co n cl u s i o n s o f l aw were

u n s o un d

, we affi rm t h e s u p e r i o r co u rt ’ s ju d g m en t den y i n g W el ls tar’ s p et i t i o n fo r

ju d i ci al rev i ew.

Ju d g men t a f f i r m ed . Go b ei l

a n d Co o mer , JJ., co n cu r.

25