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MORAVIAN MANORS v. COMMONWEALTH PENNSYLVANIA (02/25/87)

decided: February 25, 1987.

MORAVIAN MANORS, INC., PETITIONER
v.
COMMONWEALTH OF PENNSYLVANIA, INSURANCE DEPARTMENT, RESPONDENT



Appeal from the Order of the Pennsylvania Insurance Commissioner in the case of In Re: The Determination and Designation of Moravian Manors, Inc. as a Continuing Care Provider, No. M85-5-1.

COUNSEL

Robert W. Hallinger, Barley, Snyder, Cooper & Barber, for petitioner.

Jean M. Callihan, Assistant Counsel, with her, M. Hannah Leavitt, Chief Counsel, for respondent.

Matthew M. Strickler, with him, Mary E. Bates, Ballard, Spahr, Andrews & Ingersoll, for intervenors.

Judges MacPhail, Doyle and Colins, sitting as a panel of three. Opinion by Judge Colins.

Author: Colins

[ 104 Pa. Commw. Page 207]

Moravian Manors (petitioner),*fn1 a non-profit corporation operating a retirement community, appeals an order

[ 104 Pa. Commw. Page 208]

    of the Insurance Commissioner (Commissioner) affirming the determination of staff that petitioner is a continuing care provider subject to the provisions of the Continuing Care Provider Registration and Disclosure Act (Act), Act of June 18, 1984, P.L. 391, 40 P.S. §§ 3201-3225. We must determine whether the Commissioner's decision manifests an error of law, an abuse of discretion or whether any findings of fact are unsupported by substantial evidence. See Section 704 of the Administrative Agency Law, 2 Pa. C.S. § 704.

The pertinent facts are not in dispute. Petitioner operates a retirement community consisting of a skilled and intermediate care nursing home, and independent cottages and apartments. Upon admission to the facility, residents enter into a residence agreement (contract or agreement) with petitioner and pay an entrance fee*fn2 ranging from $79,000 for the right to occupy an apartment and $85,000 for accommodations in a cottage. Residents are then required to pay a monthly maintenance charge of $200 to $250, again dependent upon the type of accommodations. This monthly fee covers maintenance of grounds, building exteriors and common areas, snow and trash removal and consultation with a nurse on health care matters. Petitioner provides a communal dining room where residents may purchase meals at their discretion.*fn3 Residents may also, at their

[ 104 Pa. Commw. Page 209]

    discretion, avail themselves of the community health care facility on a fee-for-service basis. Residents and non-residents of the community are billed for nursing and health services at the same rate. The agreement also contains the following provision: "Health Center facilities and residential living will continue to be available to a resident even if he, she or they are financially unable to pay such charges, provided that resident provides documentation to [petitioner] of such financial inability to pay."

On April 15, 1985, petitioner was notified that it had been determined to be a continuing care provider and was directed to apply for a certificate of authority as required by Section 4 of the Act, 40 P.S. § 3204.*fn4 Petitioner appealed this determination to the Commissioner and, after ...


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