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03/31/88 Hinsdale Sanitarium & v. the Illinois Health

March 31, 1988

HINSDALE SANITARIUM & HOSPITAL, PLAINTIFF-APPELLEE

v.

THE ILLINOIS HEALTH FACILITIES PLANNING BOARD, DEFENDANT-APPELLANT



APPELLATE COURT OF ILLINOIS, FIRST DISTRICT, FOURTH DIVISION

523 N.E.2d 53, 168 Ill. App. 3d 805, 119 Ill. Dec. 585 1988.IL.468

Appeal from the Circuit Court of Cook County; the Hon. James C. Murray and the Hon. David J. Shields, Judges, presiding.

APPELLATE Judges:

PRESIDING JUSTICE JIGANTI delivered the opinion of the court. JOHNSON and LINN, JJ., concur.

DECISION OF THE COURT DELIVERED BY THE HONORABLE JUDGE JIGANTI

The plaintiff, Hinsdale Sanitarium and Hospital (Hinsdale), submitted an application to the defendant, the Illinois Health Facilities Planning Board (Board), for a certificate of need to construct a new hospital in the Romeoville-Bolingbrook area of Illinois. The Board denied Hinsdale's application. Upon administrative review, the trial court reversed that decision as being against the manifest weight of the evidence. The Board appeals.

Pursuant to the provisions of the Illinois Health Facilities Planning Act, the Board must approve a certificate of need before a hospital can be constructed. (Ill. Rev. Stat. 1975, ch. 111 1/2, par. 1152.) Under the Board's rules, a certificate of need will be given if the applicant establishes that the proposed hospital is needed and that the proposed hospital is both financially and economically feasible. Need can be established by consulting the State Bed Plan, an analysis of computed bed needs issued by the Board, to determine whether it lists a need in the area encompassing the site of the proposed hospital. If the State Bed Plan does not indicate a need, then an applicant must establish that it is entitled to a variance under the Board's rules. Because the State Bed Plan showed an excess of beds in the proposed area, Hinsdale sought to show that it was entitled to a variance under Rule 3.05.2 of the Board's rules.

On recommendation of the Regional Health Systems Agency and the staff of the Board, the Board denied Hinsdale's application. There were three reasons for the denial. First, the project did not conform with the State Bed Plan, which showed an excess of beds in the proposed area. Second, Hinsdale failed to show that it was entitled to a variance from the State Bed Plan. Third, Hinsdale failed to show the economic feasibility of the plan.

Following the initial denial by the Board, Hinsdale requested an "Appeal Fair Hearing" pursuant to the Illinois Health Facilities Planning Act. After receiving testimony and documentary evidence, the hearing officer issued a report which recommended that the Board's staff reexamine the issue of economic feasibility. Significantly, the hearing officer did not recommend a reexamination of the issue of need. Upon further review, the Board again denied Hinsdale's application. The basis of this decision was essentially the same as in the initial denial.

The Board's determination that Hinsdale did not establish that it was entitled to a variance or that the project was economically feasible may be reversed by a reviewing court if the findings of the Board are against the manifest weight of the evidence. (Northwest Hospital v. Illinois Health Facilities Planning Board (1978), 59 Ill. App. 3d 221, 227, 375 N.E.2d 1327, 1332.) A review of the record in the instant case leads us to the Conclusion that the trial court was correct in ruling that the Board's decision to deny the plaintiff's application was not supported by the record. A Discussion of the evidence which supports our holding follows.

To establish entitlement to a variance under Rule 3.05.2, Hinsdale must establish that the proposed service area is medically underserved and that alternative health care facilities are not available, not accessible, or not acceptable.

Factors to consider in determining if the proposed service area is medically underserved are: (1) unfavorable physician/patient ratio; (2) unfavorable time or distance to the nearest physician or hospital; (3) hospitalization rates reflecting an unfavorable situation; (4) existence of factors adversely affecting medical care, such as unfavorable infant-mortality rate, size of indigent population, lack of medical services for the poor, advanced age of physicians and socio-economic barriers to health care.

Regarding the factor of unfavorable ratio of physicians to population, an expert testified that the ratio of physicians to population of the Romeoville-Bolingbrook area had reached a critical level, as it had fallen below the minimum Federal guidelines for acceptable or even minimal care. The Board presented no evidence to the contrary and conceded that the physician/patient ratio is below average. Further, uncontradicted testimony was heard to show that the construction of the proposed hospital would help to alleviate the unfavorable ratio problem.

Regarding the factor of unfavorable time or distance to the nearest physician or hospital, uncontradicted evidence was presented showing that the residents of the Romeoville-Bolingbrook area must travel approximately 30 minutes or more, even under good conditions, to seek health care. Evidence was also presented which showed that residents of the Romeoville-Bolingbrook area often encounter difficulty in getting to or being transported to surrounding ...


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