Saber Health Care v. Ohio Dep't of Job & Family Servs.

• Decision Date: 04 August 2020
• Docket Number: Case No. 20CA1107
• Citation: 2020 Ohio 4044
• Parties: SABER HEALTH CARE d/b/a EAGLE CREEK, Appellants-Appellants, v. OHIO DEPARTMENT OF JOB AND FAMILY SERVICES, Appellee-Appellee.
• Court: Ohio Court of Appeals

2020 Ohio 4044

SABER HEALTH CARE d/b/a EAGLE CREEK, Appellants-Appellants, v. OHIO DEPARTMENT OF JOB AND FAMILY SERVICES, Appellee-Appellee.

Case No. 20CA1107

COURT OF APPEALS OF OHIO FOURTH APPELLATE DISTRICT ADAMS COUNTY

August 4, 2020

DECISION AND JUDGMENT ENTRY

APPEARANCES:

Nicholas A. Kulik, Harrisburg, Pennsylvania, for appellant.

Dave Yost, Attorney General, and Rebecca L. Thomas, Assistant Attorney General, Columbus, Ohio, for appellee.

CIVIL CASE FROM COMMON PLEAS COURT

ABELE, J.

{¶ 1} This is an appeal from an Adams County Common Pleas Court judgment that dismissed an appeal from a decision of the Ohio Department of Job and Family Services (ODJFS), appellee herein, that denied the now-deceased Thomas Adams's Medicaid application. Saber Health Care d/b/a Eagle Creek, appellant herein, assigns the following error for review:

"THE COURT OF COMMON PLEAS ERRED IN AFFIRMING THE APPELLEE'S DECISION BECAUSE PURSUANT TO R.C. 119.12, SABER HAS STANDING TO BRING FORTH THEIR APPEAL WHEN THEY ARE A PARTY THAT HAS BEEN ADVERSELY AFFECTED BY THE ADMINISTRATIVE

ADJUDICATION OF APPLICANT'S MEDICAID DECISION."

{¶ 2} In August 2018, Adams, through his guardian, designated Eagle Creek Nursing Center as his authorized representative. Shortly thereafter, Adams applied for medicaid. On October 18, 2018, Adams died.

{¶ 3} In February 2019, appellee denied Adams's application for Medicaid. Appellant, as Adams's authorized representative, requested a state hearing on the denial of his Medicaid application. After a hearing, Adams's application for Medicaid again was denied. Appellant, again acting as Adams's authorized representative, appealed the decision. Appellee later affirmed this decision. On June 6, 2019, Adams (although deceased for more than seven months) appealed to the Adams County Common Pleas Court¹ the administrative decision that denied his medicaid application.

{¶ 4} Later, Adams voluntarily dismissed his administrative appeal. The notice of dismissal stated that "a new notice of appeal will be filed when a proper representative, such as an estate administrator, has been appointed to bring such appeal on behalf of the late Mr. Adams." In October 2019, Jared B. Chamberlain filed a request in the Adams County Probate Court to be appointed the special administrator of Adams's estate.

{¶ 5} Approximately one month later, appellant and Jared B. Chamberlain filed a notice of appeal from the administrative decision that denied Adams's Medicaid application. Appellant and Chamberlain alleged that they brought their appeal under R.C. 5101.35(E)(3) and claimed that this statute permits an appeal when a proper representative has been appointed to bring an appeal on a decedent's behalf. Appellant alleged that it had standing to appeal the administrative order because the order injures its pecuniary interests. Chamberlain asserted that he had standing to pursue the appeal as the estate administrator-in-waiting. Chamberlain alleged that once the probate court appointed him the special administrator, he will have standing to appeal.

{¶ 6} On November 20, 2019, appellee filed a motion to dismiss the administrative appeal for lack of jurisdiction. Appellee claimed that neither appellant nor Chamberlain had standing to appeal when neither had been appointed to administer Adams's estate at the time the notice of appeal had been filed.

{¶ 7} Appellant responded and claimed that it had standing as Adams's authorized representative. Appellant asserted that Adams's guardian, Thomas Grennan, designated appellant to act as Adams's authorized representative to pursue Medicaid benefits.

{¶ 8} Appellee responded, however, that even if appellant had been designated Adams's authorized representative while living, that does not mean that appellant could represent Adams's interest in an administrative appeal following Adams's death. Instead, appellee claimed that after Adams died, only a personal representative could represent Adams's interest on appeal.

{¶ 9} On December 2, 2019, the Adams County Probate Court appointed Chamberlain the special administrator of Adams's estate. On December 18, 2019, the trial court dismissed the administrative appeal due to a lack of subject matter jurisdiction. This appeal followed.

{¶ 10} In its sole assignment of error, appellant asserts that the trial court incorrectly dismissed its administrative appeal. In particular, appellant contends that the court wrongly determined that appellant lacked standing to appeal the administrative decision. Appellant argues that it has standing under R.C. 119.12 because the administrative decision adversely affects its pecuniary interests. Appellant claims that if the administrative decision is allowed to stand, appellant will not be paid for the medical services provided to Adams.

{¶ 11} Appellee responds that the trial court correctly determined that appellant does not have standing to appeal the administrative denial of Adams's Medicaid application. Appellee asserts that appellant was not appellant's personal representative and, thus, could not represent Adams's interests. Appellee argues that only an "appellant" as defined in R.C. 5101.35(A)(2) may appeal an administrative decision to the common pleas court.

{¶ 12} Appellee further asserts that appellant cannot claim a right to appeal under R.C. 119.12. Appellee argues that R.C. 5101.35(A)(2), not R.C. 119.12, defines who may appeal an administrative decision to a common pleas court. Appellee further contends that even if R.C. 119.12 were the authorizing statute, appellant is not a "party" as defined in R.C. 119.01(G).

{¶ 13} In reply, appellant agrees that R.C. 5101.35 governs its right to appeal. Appellant claims that Adams designated appellant as Adams's authorized representative and this designation means that appellant could represent Adams's interest in an appeal to the common pleas court.

{¶ 14} A motion to dismiss based on a lack of standing involves a question of law that an appellate court will review independently and without deference to the trial court. See Bank of America v. Stevens, 4th Dist. Hocking No. 16CA24, 2017-Ohio-9040, 2017 WL 6398844, ¶ 23, citing Moore v. Middletown, 133 Ohio St.3d 55, 2012-Ohio-3897, 975 N.E.2d 977, ¶ 20.

{¶ 15} In general, "standing relates to a party's right to make a legal claim or seek judicial enforcement of a legal duty or right." Albanese v. Batman, 148 Ohio St.3d 85, 2016-Ohio-5814, 68 N.E.3d 800, ¶ 24, citing Ohio Pyro, Inc. v. Ohio Dept. of Commerce, 115 Ohio St.3d 375, 2007-Ohio-5024, 875 N.E.2d 550, ¶ 27, citing Black's Law Dictionary 1442 (8th Ed.2004). Thus, "[s]tanding is a threshold question for [a] court to decide in order for it to adjudicate the action." State ex rel. Jones v. Suster, 84 Ohio St.3d 70, 77, 701 N.E.2d 1002 (1998). Additionally, whether a party has "'standing is to be determined as of the commencement of suit.'" Fed. Home Loan Mortg. Corp. v. Schwartzwald, 134 Ohio St.3d 13, 2012-Ohio-5017, 979 N.E.2d 1214, ¶ 24, quoting Lujan v. Defenders of Wildlife, 504 U.S. 555, 570-571, 112 S.Ct. 2130, 119 L.Ed.2d 351 (1992), fn. 5. We further note that the party seeking to appeal bears the burden to demonstrate standing to appeal.

{¶ 16} Standing to appeal an administrative decision is not automatic. Indeed, "the right to appeal is neither inherent nor inalienable." Willoughby Hills v. C. C. Bar's Sahara, Inc., 64 Ohio St.3d 24, 26, 591 N.E.2d 1203 (citation omitted); accord Midwest Fireworks Mfg. Co. v. Deerfield Twp. Bd. of Zoning Appeals, 91 Ohio St.3d 174, 2001-Ohio-24, 743 N.E.2d 894, 2001 WL 293189 (2001). Thus, "[i]n the absence of constitutional or statutory authority," a person or entity may not "seek appellate review of the order of an administrative determination." Willoughby Hills, 64 Ohio St.3d at 26. Parties seeking to appeal an administrative decision "'must meet strict standing requirements in order to satisfy the threshold requirement for the * * * tribunal to obtain jurisdiction.'" Victoria Plaza Liab. Co. v. Cuyahoga Cty. Bd. of Revision, 86 Ohio St.3d 181, 183, 712 N.E.2d 751 (1999), quoting State ex rel. Tubbs Jones v. Suster, 84 Ohio St.3d 70, 77, 701 N.E.2d 1002, fn. 4 (1998); accord Cincinnati City School Dist. Bd. of Edn. v. Testa, 142 Ohio St.3d 138, 2014-Ohio-4647, 28 N.E.3d 1194, ¶ 13, citing Am. Restaurant & Lunch Co. v. Glander, 147 Ohio St. 147, 70 N.E.2d 93 (1946), paragraph one of the syllabus (stating that "adherence to the conditions * * * imposed [in the statute] is essential to the enjoyment of the right conferred").

{¶ 17} In the case sub judice, appellant sought to appeal the ODJFS's administrative decision to deny Adams's medicaid application. R.C. 5101.35 governs administrative appeals from the ODJFS and provides:

(E) An appellant who disagrees with an administrative appeal decision of the director of job and family services or the director's designee issued under division (C) of this section may appeal from the decision to the court of common pleas pursuant to section 119.12 of the Revised Code. The appeal shall be governed by section 119.12 of the Revised Code except that:

* * * *

(3) The appellant shall mail the notice of appeal to the department of job and family services and file notice of appeal with the court within thirty days after the department mails the administrative appeal decision to the appellant. For good cause shown, the court may extend the time for mailing and filing notice of appeal, but such time shall not exceed six months from the date the department mails the administrative appeal decision. Filing notice of appeal with the court shall be the only act necessary to vest jurisdiction in the court.

{¶ 18} The statute thus gives an "appellant" the right to appeal an administrative decision from the ODJFS. R.C. 5101.35(A)(1)(a)(i).

{¶ 19} Determining whether the appellant in the case sub judice, Saber Health Care, fits the definition of "appellant" under R.C. 5101.35(A)(2) requires us to ascertain the...