Opinion ID: 1594490
Heading Depth: 1
Heading Rank: 2

Heading: arbitrary, capricious, abuse of discretion by department of health

Text: Department is not, unto its own self, true. Yankton County and the City of Yankton seem to be meaningless to the Department's decision. In fact, on page 33 of its brief, the Department reflects, the Department's evidence indicated a need for additional beds in Yankton County is of no moment. As indicated, the Department uses, and is required to use, the service area population served by the facility's proposed project set forth in the MFP as the primary criteria for determining bed need. In my opinion, from reading this case, Yankton County and, particularly, the City of Yankton, is the applicable service area and the Department of Health superficially substitutes methodology for reality. In its June 12 decision, the Department clearly expressed that its decision to deny the application was based on a lack of bed need as indicated by the relevant formulas. The trial court found that the Department of Health used its bed need formulas exclusively and expressed that it was compelled to write an addendum to the trial court's decision. This agency clearly refused to recognize an exception which was established by a state regulation. This is a mistake of law; it is an error of law; it is a misapprehension of law. Inwood Labs. v. Ives Labs., 456 U.S. 844, 102 S.Ct. 2182, 72 L.Ed.2d 606 (1982). Oft over, the Department, not only below, but in its brief, structures itself legally in this position: Bed need is determined by using only the bed need formulas. To project need, by a formula only, is unrealistic. Department maintains that its formula is absolutely accurate and reliable. You cannot apply formulas in total isolation. It does not make sense. See Department of Health v. Lutheran Hosp. & Homes Soc., 227 Neb. 116, 125-29, 416 N.W.2d 222, 228-29 (1987). In In re Application by St. Luke's Hosp., 414 N.W.2d 297 (S.D.1987), this Court recognized that, spiritually, the state health plan was not a plan which provided total, absolute, mandatory rules and regulations to either be complied with or violated. Rather, our state health plan, so said this Court, was to establish broad policies and general goals. Surely, a goal cannot be to prevent elderly people from having a bed when they need it because of some strict interpretation of a formula.