FI RST DI VI SI ON

BA RNES, P. J.

, GOBEI L and M A RKLE, 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.

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. ga a ppe a ls .us /r ule s

Januar y 31, 2022



# I n th e Co u r t o f

A p p eals o f

G eo r g ia

A2 1 A1 54 4

. SOUTHEAST GEORGIA HEALTH SYSTEM

, INC. v

. F R A N K W

. B E R R Y

, I N H I S C A P A C I T Y A S

COM M ISSIONER, et al

.

G O B E I L

, J u d g e.

So u t h eas t Geo rg i a Heal t h Sy s t em , In c. ( “ S G H S ”) ap p eal s fro m t h e s u p eri o r

co u rt ’ s o rd er di s m i s s i n g it s m an d am u s p et i t i o n t h at so u g h t to co m p el Fran k W

. Berry

,

Co m m i s s i o n er o f t he Dep a r t m en t of Co m m u n i t y Heal t h (“ DCH”), t o i n v es t i g at e

al l eg at i o n s t h at a ri val h o s p i t al was r u n n i n g m ore o p erat i n g ro o m s t h an i t was

p erm i t t ed an d to en fo rce t he st at u t es t h at DCH ad m i n i s ters

. Fo r t h e reas o n s s et fo rt h

b el o w, we affi rm

t h e t ri al co u rt ’ s d eci s i o n

.

W e rev i ew d e n o v o a t ri al co u rt o rd er g ran ti n g a m ot i on to d i s m is s a m an d am u s

p et i t i o n b ro ug ht u n der OCGA § 9 -1 1 -1 2 (b ) (6 ). Hi l d eb r a n d v. Ci t

y o f W a r n er

Ro b in s , 3 5 4 Ga. Ap p

. 1 6 4

, 16 4 (8 4 0 SE2 d 5 0 3) (2 0 2 0 ). Th e reco rd i n t h i s cas e s h o wst h at SGHS i s a n o n p ro fi t co rp orat io n t h at o perat es two co m m u n i t y h o s p i t a l s i n t h e

ci t i es of Bru ns wi ck (Gl y n n Co un t y ) an d St

. M ary ’ s (Cam d en Co un t y ), b o th o f wh i ch

o f f e r o ut p at i en t s u rg i cal serv i ces

. Prem i er Su rg ery Cen t er (“ Prem i er”) i s a l i m i t ed

l i ab i l i t y co m

p an y t h at o p erat es a s u rg i cal cen t er i n Gl y n n Co u nt y , wh i ch al s o o ffers

o u t p at i en t s u rg i cal s erv i ces

.

In J an u ary 20 2 0

, SGHS req u es t ed t h at DCH i n v es ti g at e wh et h er Prem i er was

ru n n in g a t h ird o p erat i n g ro o m (“ OR”) t h at was u n au t h o ri zed un d er G eo rg i a’ s

Cert i fi cat e o f Need (“ CON”) p ro g r a m

. 1 Un der t h e CON p ro g ram , an o rg an i zat i o n

m u st s u b m it an ap p li cat i o n an d o b t ai n a CON wh en ev er it is dev el o pi n g , ex p an d i n g,

o r o fferi n g a n ew h eal t h care faci l i t y o r n ew i n s ti t u t io n al heal t h s erv i ce as s rt fo rt h in

OCGA § 3 1 -6 -4 0 (a). Th e DCH is t he ad m in i s t rat iv e ag en cy t as k ed wi th

ad m i n is t eri n g t h e CON p ro g ram

. OCGA § 3 1 -6 -2 1 (a). Aft er rev i ewi n g i t s reco rd s ,

DCH d et erm i n ed th at Prem i er was au t h o ri zed t o o p erat e t h ree O Rs an d d ecl i n ed to

i n i t i at e a fo rm al i n v es t i g at i o n i n t o t h e m at ter. In Ap ri l 2 0 2 0, SGHS fi l ed a req u es t fo r

1 Th e St at e o f Geo rg i a h as en act ed l aws “ t o en s u re acces s t o q u al i t y h eal t h care

s erv i ces an d t o en s ure t h at h eal t h care serv i ces an d faci l i t i es are d ev el o p ed i n an

o rd erl y an d eco n o m i cal m an n er an d are m ad e av ai l ab l e t o al l ci t i zen s an d t h at o n l y

t h o s e h eal t h care s erv i ces fo u n d t o be i n t h e p u b l i c i nt eres t s hal l b e p ro v i d ed i n t h i s

s t at e.” OCGA § 3 1 -6 -1

.

2an ad m i n i s t rat i v e ap p eal o f DCH’ s d eci s i o n no t t o in v es ti g at e. DCH d en i e d t h e

req u es t

.

Th ereaft er, i n Oct o ber 2 0 2 0

, SGHS fi l ed a p et i t i o n fo r a wri t o f m an d am u s ,

req u es t i ng t hat th e s u p eri o r co u rt o rd er Berry

, i n hi s c ap aci t y as DCH’ s

Co m m i s s i o n er, “ t o det erm i n e t h at Prem i er’ s o perat i o n o f a th i rd OR i s i n v i ol at i o n o f

t h e C O N l aws an d t o i s s u e a ceas e an d d es i s t ord er ag ai ns t fu rt h er o p erat i o n o f t h e

t h i rd O R.” SGHS as s ert ed t h at Berry was refu s i n g t o p erfo rm h is n o n-d i s cret i o n ary

d u t y t o en fo rce t h e CON l aws , an d m an d am u s was i t s o n l y av en u e fo r rel i ef.

Berry an s wered t h e m an d am u s p et i t i o n, an d fi l ed a m o t i o n t o d is m i s s t h e

p et i t i o n fo r fai lu re t o st at e a cl ai m

. Th e t ri al co u rt g ran t ed Berry ’ s m o t i o n t o d i s m i s s

.

Sp eci fi cal l y , t he t ri al co u rt fo u n d t h at DCH h ad th e au th o ri t y , b u t n o t t h e d u t y , to

co n du ct i n ves ti g at i o n s i n t o p o t e n t i al CON v i o l at i o n s an d s eek i n ju n ct i v e rel i ef to

en fo rce t h e CON s t at ut es

. Th u s , t h e t ri al co u rt f o u n d t h a t SGHS h ad n o t s h o wn

en t i t l em en t t o m a n d am

u s rel i ef an d d i s m i s sed t h e p et i t i o n

. Th e i n s t an t ap p eal

fo l l o w ed

.

A wri t o f m an d am

u s “ i s an ex t rao rd in ary rem ed y t o co m p el a p u b l i c o ffi cer to

p erfo rm a req ui red d u t y wh en t h ere i s n o o t h er ad eq u at e leg al rem ed y .” Lo ve v.

Fu l t o n Co u n t

y Bd

. o f Ta x As s es s o r

s , 3 1 1 Ga. 6 8 2

, 6 9 2 (3 ) (a) (8 5 9 SE2 d 3 3 ) (2 0 2 1 )

3(ci t at i o n an d p u n c t u a ti o n o m i t t ed ); s ee al s o O CGA § 9 -6 -2 0 (al l owi n g wri t o f

m an d am u s t o co m pel p u b l i c o ffi ci al s t o p erfo rm an ce i f n o o t h er s p eci fi c leg al rem ed y

ex i s t s). M an dam

u s i s p ro p er “ o n l y i f (1 ) n o ot h er ad eq u at e l eg al rem ed y i s av ai l ab l e

t o effect u at e t h e rel i ef s ou g h t ; an d (2 ) t he ap p l i can t h as a cl ear l eg al ri g h t t o s u ch

rel i ef.” Lo ve , 3 1 1 Ga. at 6 9 2 -6 9 3 (3 ) (a) (ci t at i o n a n d p u nct u at i o n o m i tt ed ). Un d er

Geo rg i a l aw, SGHS h as n o o t h er ad eq u at e l eg al rem ed y av ai l ab l e t o ach i ev e th e rel i ef

s o u g ht

. Di ver

s i f i ed Hea l t h Mg mt

. S

vcs

., In c. v. Vi s i t i n g Nu r

s es As s n

. of Co r d

el e, In c. ,

2 5 4 Ga. 5 0 0

, 5 0 2 (4 ) (3 3 0 SE2 d 8 8 5 ) (1 9 8 5 ) (a co m p et i t o r can n o t s u e fo r i n

ju n ct i v e

rel i ef as an “ i n teres t ed pers o n ” un d er t h e CON s t at u t es ). Th erefo re, t h e o n l y q u es t i o n

rem ai n i n g i s wh et her SGHS s h o wed a cl ear l eg al ri gh t t o t h e rel i ef s o u g h t

.

M an d am us can li e t o co m

p el a p u b l i c o ffi ci al t o ex erci se d i s cret i o n “ b u t n o t to

d i rect t h e m a n n er i n wh i ch t hat d i s cret i o n i s ex erci s ed .” Bl a n d F a r ms

, LLC v. Ga

.

Dep t. of Ag r i cu l t u r e , 2 8 1 G a. 1 9 2

, 19 3 (6 3 7 SE2 d 3 7 ) (2 0 0 6 ). “ [W ] h et h er o ffi ci al

act i on i s req ui red d ep en d s o n t h e l aw g o v ern i n g t he s u b ject m at t er in q u es t i o n .” Bi b b

Co u n t y v. Mo n r o e Co u n t

y , 2 9 4 Ga. 7 3 0 , 7 3 5 (2 ) (b ) (7 5 5 SE2 d 7 6 0 ) (2 0 14 ).

As d es cri b ed ab o v e, Geo rg i a l aw au t h ori zes D CH t o g ov ern t h e CON p ro g ram

.

OCGA § 3 1 -6 -2 1 (a). T h e s t at u t e d efi n i n g DCH’ s m an d at o ry du t ies s t at e s t h a t t h e

“ fu nct io n s o f t h e d ep art m en t s h a l l b e

. . .” an d t h en en u m erat es s ev eral d u t i es ,

4i n cl u d i n g ad o p t i n g ru les an d reg u l a t i o n s t o ad m i n i s t er th e CON p ro g ram , an d

g ran t i n g , d en y in g , o r rev o k i ng CON ap p l i cat i on s . OCGA § 3 1 -6 -2 1 (b ) (1 ) - (1 2 ).

Ho wev er, t hi s s am e s t at u t o ry s ch em e im po s es o n ly t h e au t h o ri ty

, n ot t h e d u t y ,

t o i n i t i at e a fo rm al i n v es t i g at io n i n t o each an d ev ery al leg ed CON v i o l at i o n. OCGA

§ 3 1-6 -4 5 (e). Th e s t at u t e s t at es t h at D CH “ s hal l h a v e t h e a u t h o ri ty t o m ak e p u b l i c

o r p ri v at e i n v es t i g at i o n s

. . . t o d et erm i n e wh et her al l p ro v i s i o n s o f [t h e CON p ro g ram

h av e] b een v i o l at ed

. ” Id

. Th i s d i s cret io n ary l an gu ag e o n l y v es t s D CH wi t h t h e

au t h o ri t y t o co n d u ct i n v es t i g at io n s , an d d o es no t im p o s e a s t at u t ory d u ty t o co n d u ct

a s p eci fi c i nv es t i g at i o n ev ery t i m e an al l eg at i o n is m ad e. 2 Cf. Ni mmer v. S t r i ckl a n d

,

2 4 2 Ga

. 4 3 0

, 4 3 1 (1 ) (2 4 9 SE2 d 2 3 3 ) (1 9 7 8) (n o t i n g un d er s t at u t e reg ard i n g

co l l ect i o n o f sa le s t ax , wh ere t h e St at e Rev en u e Co m m i s si o n er “ ‘ s hal l h av e au t h o ri t y ’

t o p ro ceed d i rect l y ag ai n s t t he pu rch as er t o reco v er t h e t ax ,” t he Co m m i s si o n er co u ld

p ro ceed ag ai n s t t h e pu rch as er b ecau se “ s h al l h av e t h e au t h o ri t y ” was p erm i s s i v e, n ot

m an d at o ry , l an g uag e) (ci t at i o n o m i t t ed ). E m p h as i zi n g i ts di s cret i on ary di rect i o n , t h e

s t at u te go es o n t o s t at e t h at in v es t i g at io n s i n t o p ot en t i al s t at u t ory vi o l at i o ns “ ma y b e

2 Al t h ou g h “ s h al l ” t y

pi cal l y c o n v ey s a m an d at e, i t do es n o t wh en co u ch ed

wi t h i n th e l arg er p h ras e “ s h al l h av e t h e au t h o ri t y [.] ” See A n t o n i n Scal i a & Bry an A.

Garn er, Read i ng Law: Th e In t erp ret at io n o f Leg al Tex t s 1 1 2

- 1 1 3 (2 0 1 2) 1 s t ed

. (n o t i ng “ s h al l ” i s t rad i ti o n al l y a m an d at o ry wo rd an d creat es a d u t y , u n l es s co n t ex t
i n d i cat es o t h erwi se).

5i n i t i at ed at a n y t i m e i n t h e d i s cret i o n o f t h e d ep art m en t

. . . .” OCGA § 3 1 -6 -4 5 (e)

(em p h as i s su pp l i ed ). In s u m

m ary , d i s cret i o n in th i s co n tex t al s o m ean s t h e d i s cret i o n

t o d ecl i ne t o fo rm al ly i n v es t i g at e p o s s i b l e CON v i o l at i o ns

. Fo r th es e reas o n s, t h e t ri al

co u rt d i d n o t err i n fi n di n g t h at SGHS d id n o t s h o w t h at i t h ad a cl ear l eg al ri g h t t o

t h e rem ed y b ei n g s o u g h t, as D CH was n o t req u i red t o u n d ert ak e th e a c t i o n s o u g h t

.

SGHS arg u es th at t h e t ri al co u rt

, in fi n d i n g t h at DCH d i d n o t hav e a d u ty to

i n v es t i g at e SGHS’ s al l eg at i o ns ag ai n s t Prem i er an d en fo rce t h e C ON s t at u t es ,

d i s r e g ard ed a l i n e o f Su p rem e Co u rt cas es

. Sp eci fi cal l y , SGHS p oi n t s t o t h e

Ro a ch / S t ep h en s o n l i n e o f cas es i n wh i ch t h e Su prem e Co urt f o u n d t h at t h e St at e

Heal t h P l a n n i n g an d D ev el o p m en t Ag en cy (“ SHPA”), t he precu rs o r t o th e DCH,

ex ceed ed i t s s t at u t o ry

au t h o ri t y

.

In t h e cas es ci t ed b y SGHS, t h e SHPA was fo u n d t o h av e ex ceed ed i t s

au t h o ri t y ei t her b y u n il at eral l y i s s u i n g reg u l at i on s ex em p ti n g faci l i t i es fro m CON

au t h o ri zat i o n o r u n i l at eral l y det erm i n i ng t h at cert ai n faci l it i es d i d n o t req ui re CON

au t h o ri zat i o n

. 3 See HCA Hea l t h S vcs

., In c. v. Ro a ch (“

R o a ch I ”), 2 6 3 G a. 7 9 8

, 8 0 1

3 Al l o f t h es e cas es were d eci ded p ri o r t o am en d m en ts t o t h e CON s t at u t es in

2 0 0 8

. Befo re 2 0 08

, a CON w as req u i red fo r t h e “ co n s t 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 n ew heal t h care faci l i ty .” OCGA § § 3 1 -6 -2 (1 4 ) (A), 3 1-6 -4 0 (a) (2 0 0 2). In 2 0 0 8

, t h e l an g u ag e was ch an g ed t o req u i re a CON fo r “ co n s t ru ct i o n, d ev el o p m en t

, o r o t h e r es t ab l i s h m en t of a n ew, exp a n ded

, o r r el o ca ted h eal t h care

6(3 ) (b ) (4 3 9 SE2 d 4 9 4 ) (1 9 9 4) ( f i n d i n g SHPA act ed b ey o n d i t s au t ho ri t y t o wai v e

CON req ui rem en t s fo r rel o cat i o n o f a faci l i t y b ecau s e Geo rg i a l aw d id n o t g i v e SHPA

au t h o ri t y t o ex em

p t faci l i ti es fro m CON au t h ori zat i o n u n d er th es e ci rcu m s t an ces ),

o v erru l ed o n o t h er gro un d s , Ma r s h v. Cl a r ke Co u nt y S ch o o l Di s t

. , 29 2 Ga. 28

, 2 9 -3 0

(7 3 2 SE2 d 4 4 3 ) (2 0 1 2 ); No rt h Fu l t o n Med

. Cen t er

, In c. v. Ro ach (“

Ro a ch II ”), 2 6 5

Ga. 12 5

, 1 2 6

, 12 7 -1 2 8 (2 ) (4 5 3 SE2 d 4 6 3 ) (1 9 94 ) (h ol d in g m an d am us rel i ef

ap p ro p ri at e wh ere SHPA ad o pt ed a ru l e ex em pt i n g rel o cat i o n o f faci li t ies fro m CON

rev i ew o n t h e m o rn i n g o f t ri al b ecau s e t h e ru l e was i s s u ed aft er No rt h Fu l t o n h ad

i n i t i at ed t h e act i o n , an d No rt h Fu l t o n d i d n o t h av e an ad eq u at e l eg al rem ed y ); HCA

Hea lt h S vcs

. o f Ga

., In c. v. Ro a ch ( R o a ch III ), 26 5 Ga. 5 0 1

, 50 1

, 5 0 2 -5 03 (2 ) (4 5 8

SE2 d 1 1 8 ) (1 99 5 ) (h o l d i n g SHPA’ s reg u l at i o n , pro m u l g at ed befo re t ri al

, au t h o ri zi n g

rel o cat io n o f h eal t h care faci l i t i e s wi t h i n th ree m i l es wi t h o u t CON rev iew i n v al id

b ecau s e SHPA d i d n o t h av e co n s ti t ut i o n a l a u t h o ri t y to deci d e wh at faci l it i es were

ex em p t fro m CON rev i ew); No r t h Fu l to n Med

. Cen t er v. S t ep h en s o n , 2 6 9 Ga. 5 4 0,

5 4 1 -5 4 2

, 5 4 2-5 4 4 (1 ) (5 0 1 SE2 d 7 98 ) (1 9 9 8 ) (fi nd i n g SHPA act ed b ey o n d i t s s co p e

o f au t h ori t y i n en act i n g a s eco n d rel o cat i o n ru l e t h at gran t ed S H P A t h e ab i l i t y to

faci li t y , ” an d ad d ed cert ai n ex cep t i o n s

. OCGA § 3 1 -6 -4 0 (a) (1 ) (2 0 2 1 ) (em p h as i s

s u p p li ed ).

7ex em

p t fro m CON rev i ew th e rel o cat i o n o f s u rg i cal cen t ers b ecau s e SHPA g av e i t s el f

“ t h e co m p l et e an d u nb ri d l ed au t h o ri t y ” t o d e t e r m i n e wh i ch faci li t ies were ex em pt

fro m CON rev i ew, d i rect ly c o n f l i c t i n g wi t h t h e p o wer o f t h e Gen eral As s em b ly to

d et erm i n e t h e s co p e o f a s t at ut e).

In co n t ras t t o t h e s i tu at i o n s p res en t ed i n t h e R o a ch an d S t ep hen s o n cas es , t h e

DCH d i d n o t i s su e reg ul at i o n s o u t s i d e o f it s s t at u t o ry au t h o ri t y o r o t h e r wi s e act

be y ond its sta

tu t ory au t h ori ty

. In s t ead

, DCH d ecl i n ed t o i n i t i at e a fo rm al in v es t i g at ion

o f an al l e g e d CON v i o l at i on , a d i s cret i o n ary act i o n u n d er t h e rel ev an t st at u t o ry

s ch em e. An d al t h o u g h th e Su p rem e Co u rt i n Ro a ch I s tat ed t h at SHPA “ d o es n o t h av e

d i s cret i o n i n en fo rci n g t he CON p ro g ram [,] ” t h e co n t ex t rev eal s th at t h e Co u rt was

referri n g t o t h e SHPA’ s d eci s i o n t o ex em p t a faci l i t y fro m th e CON p ro g ram wi t h o ut

an y s t at ut o ry au t h o ri ty fo r i t s d e c i s i o n

. Ro a ch I

, 2 6 3 Ga. at 8 0 0 (3 ). In t h e i n s t an t

ap p e a l

, ho wev er, DCH d i d n o t ex em p t Prem i er fro m t h e CON req u irem en t ; i t

d et erm i n ed t hat

, b as ed o n i t s reco rd s , Prem i er w a s o p erat i ng wi t h i n i t s ap p ro v ed CON

l i m i ts

, a n d d e c l i n ed t o in ves ti g at e fu rt h er. Th u s, we ag ree wi t h t h e t ri al co u rt t h at

SGHS d i d n o t s ho w t h at i t was en t i tl ed t o m an d am u s r e l i e f. 4 Fo r t h es e reas o n s , we

4 M an dam

u s m ay al s o b e ap pro p ri at e wh en an o ffi ci al co m m i t s a g ro s s ab u s e

o f d is cret i o n , m ean in g t h at t h e o ffi ci al perfo rm s an act i o n in a way “ t h at i s arb i t rary , cap ri ci ou s , an d un reas on ab l e.” Lo ve , 31 1 Ga. at 6 9 3 (3 ) (a); s ee al s o OCGA § 9 -6 -2 1

8affi rm t h e tri al co u rt ’ s d eci si o n g r a n t i n g Berry ’ s m o t i o n t o d i sm i s s SGHS’ s

m an d am u s p et it io n

.

Ju d g men t a f f i r m ed . Ba r nes , P. J., a n d

Ma r kl e, J., co n cu r

.

(a) (“ M an d am

u s s hal l no t l i e

. . . t o a p u b li c o ffi cer wh o h as an ab s o lu t e d i s cret i o n to

act o r no t t o act u nl es s t h ere i s a g ro s s ab u s e o f s u ch d i scret i o n.”). Ho wev er, SGHS

d i d n o t al l eg e a g ro ss ab us e o f d i scret i o n i n it s m an d am u s p et i t i o n, an d t h erefo re t o

t h e ex t en t i s rai s es i t n o w, t h e i s s u e i s wai v ed

. Lo cke’s Gr a ph i c & Vi n

yl S i g n s

, In c.

v. Ci t ico r p Ven do r Fi n a n ce, In c. , 2 8 5 G a. Ap p

. 82 6

, 8 28 ( 2 ) (a) (6 4 8 SE2 d 1 5 6 ) (2 0 0 7) (“ An arg u m en t n o t rai s ed i n t h e t ri al co u rt i s wai ved an d can no t b e rai s ed fo r

t h e fi rs t t i m e o n ap p eal .”).

9