Appeal from the Order of the Department of Public Welfare in the case of Appeal Of: Western Reserve Convalescent Home of Erie, Pennsylvania, Re: File No. 23-83-378.
Benjamin B. Wechsler, II, for petitioners.
William D. Lenahan, for respondents.
Judges MacPhail, Doyle and Barry, sitting as a panel of three. Opinion by Judge MacPhail.
[ 96 Pa. Commw. Page 447]
Gus Romagni, Stanley Gottsegen, and Lawrence Tucker, successors-in-interest to the Western Reserve Convalescent Home of Erie (Petitioner) appeal from an order of the Department of Public Welfare (DPW) which held that Petitioner did not file a timely final cost report and that DPW properly determined Petitioner's final cost settlement. We reverse and remand.
Petitioner, a participant in the Medical Assistance Program administered by DPW, changed ownership effective January 1, 1983. This change of ownership required a final cost report to be filed within thirty days. 55 Pa. Code § 1181.73(a). By letter dated January 28, 1983, Petitioner requested an extension for filing their MA-11 Cost Report until March 31, 1983, stating that the Commonwealth's final closing statements and additional accounting information necessary to prepare an accurate report were not yet available. A second request
[ 96 Pa. Commw. Page 448]
dated March 31, 1983 requested an extension until April 30, 1983, stating that additional accounting procedures were necessary to prepare an accurate report. DPW did not respond to either request. Petitioner filed its final cost report on April 29, 1983.
DPW returned the MA-11 filed by Petitioner on May 23, 1983 for Petitioner to make various corrections.*fn1 On June 27, 1983, Petitioner submitted a corrected MA-11 report. By letter dated November 28,
[ 96 Pa. Commw. Page 4491983]
, DPW notified Petitioner that its cost report for the fiscal period ending December 31, 1982 had been audited by the Division of Nursing Home Audits. DPW refused to consider Petitioner's final cost report, contending that it had been untimely filed under 55 Pa. Code § 1181.73(a). Therefore, instead of using Petitioner's MA-11, DPW calculated Petitioner's final settlement based on the last final per diem rate for which DPW had audited costs for Petitioner. 55 Pa. Code § 1181.73(b).
Petitioner timely appealed the results of the audit to the Office of Hearings and Appeals (OHA). A fair ...