Bryn Mawr Care, Inc. v. Sebelius

Bryn Mawr Chicago nursing home, a Medicaid provider, is subject to Illinois Department of Public Health (IDPH) inspections. In 2010, IDPH inspected the facility following allegations that a resident had been sexually assaulted. Bryn Mawr was eventually cited for three deficiencies, 42 C.F.R. 488.301, two based on sexual abuse and one based on failure to sufficiently monitor a resident. Bryn Mawr challenged the findings by Informal Dispute Resolution, which involved exchange of written information without a live hearing. IDPH simultaneously conducted internal review and found that the deficiencies based on allegations of sexual abuse were not sufficiently supported by credible evidence, but the third party upheld the deficiency findings. Ultimately IDPH maintained the deficiency findings. Meanwhile, Bryn Mawr also engaged in a parallel process to “correct” deficiencies. At the follow-up inspection, IDPH determined that the deficiencies had been corrected, so that remedies would not be imposed. IDPH passed the deficiency findings on to the Centers for Medicare and Medicaid Services, which published them on its website and factored them into its 5-Star Rating System. Bryn Mawr’s rating was supposed to fall from five to four stars because of the deficiencies, but CMS mistakenly reduced it to two stars. Regardless of a partial correction, Bryn Mawr was displeased that it had not had the opportunity to challenge the findings at a hearing and sued to compel a hearing. The district court granted summary judgment to defendants. The Seventh Circuit affirmed. View "Bryn Mawr Care, Inc. v. Sebelius" on Justia Law