Beatitudes Campus, ALJ Ruling 2026-1 (HHS CRD October 17, 2025)

RULING

For the reasons set forth below, I find that Beatitudes Campus (hereby referred to as "Petitioner"), is not entitled to an Administrative Law Judge (ALJ) review of determinations made as a result of the May 20, 2025 survey at Petitioner's facility. Therefore, CMS's Motion to Dismiss is granted and this case is dismissed pursuant to 42 C.F.R. § 498.70.

I.  Factual and Procedural History

Petitioner is a skilled nursing facility located in Phoenix, Arizona, that participates in the Medicare program.

On May 20, 2025, the Arizona Department of Health Services (state agency) conducted an abbreviated survey at Petitioner's facility and determined that the facility was not in substantial compliance with federal requirements.  CMS Ex. 1.  By letter dated June 17, 2025, the state agency notified Petitioner that the most serious deficiency found during the survey constituted no actual harm with potential for more than minimal harm.  A plan of correction was required by June 27, 2025.  Id.  The letter also provided information on

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Petitioner's appeal rights.  On June 26, 2025, an offsite revisit was conducted, and it was determined that there were no deficiencies of participation requirements in Petitioner's facility.  CMS Ex. 2.

On June 25, 2025, Petitioner requested a hearing to contest the findings in the statement of deficiencies (CMS 2567).  On August 11, 2025, CMS filed a Motion to Dismiss, acknowledging that the letter issued by the state agency erroneously advised Petitioner of its appeal rights.  However, CMS maintains that Petitioner is not entitled to a hearing because no remedies were imposed or effectuated as a result of the May 20, 2025 survey at Petitioner's facility.  To date, Petitioner has not filed a reply to CMS's Motion to Dismiss.

On September 16, 2025, CMS moved to stay the proceedings pending the outcome of the Motion to Dismiss.  Petitioner did not oppose the Motion to Stay, which was granted on September 17, 2025.

II.  Discussion

The hearing rights of a long-term care facility are established by federal regulations at 42 C.F.R. Part 498.  A provider dissatisfied with an initial determination is entitled to further review, but administrative actions that are not initial determinations are not subject to appeal.  42 C.F.R. § 498.3(a).  The regulations specify which actions are "initial determinations" and set forth examples of actions that are not.  A finding of noncompliance that results in the imposition of a remedy specified in 42 C.F.R. § 488.406 (except the state monitoring remedy) is an initial determination for which a facility may request an ALJ hearing.  42 C.F.R. § 498.3(b)(13).  But a facility has no right to a hearing unless CMS imposes one of the specified remedies.  The Lutheran Home - Caledonia, DAB No. 1753 (2000); Schowalter Villa, DAB No. 1688 (1999); Arcadia Acres, Inc., DAB No. 1607 (1997); see San Fernando Post Acute Hosp., DAB No. 2492 at 7-8 (2012).  The remedy, not the citation of a deficiency, triggers the right to a hearing.  Schowalter Villa, DAB No. 1688; Arcadia Acres, Inc., DAB No. 1607.

Despite the state agency conducting a survey and initially identifying deficiencies, it is undisputed that no enforcement remedies were imposed.  The Board has long held that neither the Act nor the regulations provide a hearing right for a finding of noncompliance absent the imposition of an enforcement remedy specified by the regulations.  Generations at Regency Ctr., DAB No. 2950 (2019); see also San Fernando Post Acute Hosp., DAB No. 2492, at 2, 6-8 (2012) (discussing the appeal rights of facilities that receive a determination of noncompliance with Medicare participation requirements); Columbus Park Nursing & Rehab. Ctr., DAB No. 2316 at 7 (2010) (A SNF "has no right to an ALJ hearing to contest survey deficiency findings where CMS has not imposed any

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of the remedies specified at section 488.406 based on those findings, or where CMS imposed, but subsequently rescinded, any such remedies.") (and cases cited therein).

III.  Conclusion

For the reasons stated, I find that Petitioner has no right to a hearing and this case must be dismissed pursuant to 42 C.F.R. § 498.70(b).  CMS's Motion to Dismiss is hereby GRANTED.  The parties may request that an order dismissing a case be vacated pursuant to 42 C.F.R. § 498.72.