UNPUBLISHED

UNITED STATES COURT OF APPEALS

FOR THE FOURTH CIRCUIT

No. 07-1667

LIBERTY NURSING AND REHABILITATION CENTER - MECKLENBURG

COUNTY,

Petitioner,

v.

MICHAEL LEAVITT, Secretary of the United States Department of

Health and Human Services; U.S. DEPARTMENT OF HEALTH & HUMAN

SERVICES,

Respondents.

On Petition for Review of an Order of the United States Department

of Health and Human Services. (A-07-67)

Submitted: March 28, 2008 Decided: October 2, 2008

Before MOTZ, KING, and SHEDD, Circuit Judges.

Petition denied by unpublished per curiam opinion.

Joseph L. Bianculli, HEALTH CARE LAWYERS, PLC, Arlington, Virginia,

for Petitioner. Peter D. Keisler, Assistant Attorney General,

Daniel Meron, General Counsel, Howard H. Lewis, Acting Chief

Counsel, Erica C. Matos, Assistant Regional Counsel, Atlanta,

Georgia, for Respondents. 

Unpublished opinions are not binding precedent in this circuit.
1

We have jurisdiction to consider Liberty’s petition pursuant

to 42 U.S.C. § 1320a-7a (2000).

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PER CURIAM:

Liberty Nursing and Rehabilitation Center-Mecklenberg

(“Liberty”), a skilled nursing care facility, seeks review of a

final decision of the Secretary of the Department of Health and

Human Services (“Secretary”).1 That decision affirmed an

administrative law judge (“ALJ”) decision upholding: (i) findings

that Liberty failed to comply with Medicaid and Medicare program

requirements; and (ii) the imposition of civil monetary penalties

(“CMP”) against Liberty for its noncompliance. We deny Liberty’s

petition for review. 

When the question before this court is whether an agency

has properly interpreted and applied its own regulations, the

reviewing court must give the agency’s interpretation “substantial

deference.” See Thomas Jefferson Univ. v. Shalala, 512 U.S. 504,

512 (1994). This court must defer to the Secretary’s reasonable

interpretation of its regulations so long as it is not “plainly

erroneous or inconsistent with the regulation[s].” See id.

Moreover, this court will defer to the Secretary’s findings of fact

if they are “supported by substantial evidence on the record

considered as a whole.” See 42 U.S.C. § 1320a-7a(e) (2000).

Substantial evidence is “evidence which a reasoning mind would

accept as sufficient to support a particular conclusion. It
2

We reject Liberty’s assertion that the Secretary lacks

authority to issue citations for violations involving motor

vehicles. Because 42 C.F.R. § 483.25(h)(1) (2008) speaks of the

residents’ environment, it is to be interpreted as broadly as is

necessary to protect residents in all locations under the

facility’s control, including facility vehicles. It would be

incongruous to hold that residents travel at their own risk when

the facility to which they have entrusted their care transports

them off-site. 

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consists of more than a mere scintilla of evidence but may be

somewhat less than a preponderance.” See Shively v. Heckler, 739

F.2d 987, 989 (4th Cir. 1984) (internal citation and quotation

marks omitted).

We find the record contains evidence that a reasoning

mind would accept as sufficient to support the Secretary’s

conclusion that Liberty did not comply with agency regulations.2

Accordingly, neither the ALJ nor the Secretary abused their

discretion in upholding the imposition of CMPs. See 42 C.F.R.

§ 488.438(e) (2008). We therefore deny Liberty’s petition for

review. We dispense with oral argument because the facts and legal

contentions are adequately presented in the materials before the

court and argument would not aid the decisional process.

PETITION DENIED