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Fairfax Nursing Home, Inc. v. U.S. Dep’t of Health and Human Services

United States Court of Appeals for the Seventh Circuit
300 F.3d 835 (2003)


Facts

Fairfax Nursing Home (Fairfax) (defendant) was a skilled nursing facility under the regulation of the Centers for Medicare and Medicaid Services, a division of the U.S. Department of Health and Human Services (HHS) (plaintiff). If violations of Medicare regulations were found, the state could recommend the imposition of civil monetary penalties (CMPs). Over a 105-day period, Fairfax violated 42 C.F.R. § 483.25(k) relating to the provision of respiratory care to residents dependent on ventilators on five occasions. In three of the violations, negligent care by Fairfax employees resulted in the deaths of the three residents. In the other two cases, Fairfax employees failed to follow policies and procedures that threatened the health of its residents. Thereafter, CMS imposed a $3,050 CMP for each of the 105 days Fairfax was not in compliance with HHS regulations. Fairfax appealed the fine to an administrative law judge (ALJ) who found that the amount was reasonable and noted that Fairfax had failed to substantially comply with the regulations governing the proper care of ventilator-dependent residents. Fairfax then appealed to the Department Appeals Board of the HHS, which affirmed the ALJ’s decision. Fairfax thereafter appealed to the court of appeals.

Rule of Law

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Issue

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Holding and Reasoning (Ripple, J.)

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  • A “yes” or “no” answer to the question framed in the issue section;
  • A summary of the majority or plurality opinion, using the CREAC method; and
  • The procedural disposition (e.g. reversed and remanded, affirmed, etc.).

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