BUCKHANNON — The West Virginia Supreme Court of Appeals has sided with St. Joseph’s Hospital and ruled that Stonewall Jackson Memorial Hospital in Weston must have a certificate of need to build a new hospital off of I-79.

In a unanimous decision last week, the court reversed and remanded the decision made by the Intermediate Court of Appeals of West Virginia (ICA) that stated Stonewall Jackson Memorial Hospital did not need to obtain a certificate of need to build a new hospital. Stonewall had plans to build and move into “a new, state-of-the-art” hospital on Staunton Drive near the intersection of I-79 and U.S. Highway 33, about four miles from its current site.

The ICA had initially sided with the West Virginia Health Care Authority, who, in 2023, found that no certificate of need was required for Stonewall’s construction plans. Certificates of need are, according to the Health Care Authority, a “regulatory element” used by the Authority to control healthcare costs, improve the quality and efficiency of the healthcare system, encourage collaboration and develop a system of healthcare delivery which makes health services available to all state residents.

According to the court, it was the Authority’s belief that, despite the hospital’s proposal to construct a new health care facility, the Authority had an “unwritten guideline that a certificate of need is unnecessary if a healthcare provider is merely ‘relocating’ from an existing building to a newly constructed one.”

In the Opinion of the Court written by Chief Justice William R. Wooton, the Supreme Court ruled that both the Authority and the ICA were wrong in their decisions.

“As set forth below, we find that both the Authority and the ICA erred in their interpretation of West Virginia’s certificate of need statutes and that their respective decisions must be reversed,” Wooton said in the Opinion of the Court. “…the Legislature has mandated that health care entities must seek a certificate of need for the construction of a new hospital building. Accordingly, we remand the case to the Authority for further proceedings consistent with the clear language of the statute.”

This decision is a victory for the petitioner, St. Joseph’s Hospital, who argued that Stonewall is required to obtain a certificate of need from the West Virginia Health Care Authority because “West Virginia law mandates that healthcare providers obtain such a certificate for ‘[t]he construction… of a health care facility.'”

Since 2014, St. Joseph’s has been designated a “critical access hospital,” (CAH) and to preserve its status as such it “must operate its rural facility further than 15 mountainous miles from other hospitals.” If Stonewall opened a hospital in the new location near I-79, they would then only be 12 “mountainous miles” away from St. Joseph’s.

According to the Opinion of the Court, the fight between the two hospitals began in 2021 when Stonewall first applied to the Authority for a certificate of need and St. Joseph’s intervened by arguing they would lose their CAH status. In 2022, the Authority, and later the ICA, sided with St. Joseph’s and denied Stonewall the certificate of need.

In 2023, however, the court cites that the West Virginia Legislature adopted amendments to the statutes governing the certificate-of-need process, one of which altered the definition of the phrase “capital expenditure.”

“Specifically, prior to the 2023 amendments, a certificate of need was required for certain specified capital expenditures made by or on behalf of a health care facility which exceeded $5 million,” Wooton wrote. “After the 2023 amendments, a certificate of need was required only for certain specified capital expenditures exceeding $100 million.”

The issue of the state legislature and certificates of need has been a topic of concern for Upshur County in the past year. During his annual State of the City address in February, Buckhannon Mayor Robbie Skinner called on residents to speak out against the possible abolishment of the certificate of need program.

“This legislation acts as a checks-and-balance system, and is fair to all hospitals regardless of size or location,” Skinner said during his State of the City address. “This law has been in effect for decades in West Virginia, and it must remain. The Certificate of Need process is protecting rural hospitals like ours… If it is repealed, St. Joseph’s Hospital as we know it today may cease to exist.”

After the 2023 amendments, Stonewall filed a “request for a determination of reviewability” (RDOR) with the Authority which, if approved, would exempt the hospital from having to get a certificate of need. According to the court, Stonewall argued that, because their project was expected to cost less than $100 million, the Authority should rule that a certificate of need was no longer required because of the new amendments. St. Joseph’s stepped in again, arguing that Stonewall still needed a certificate of need despite the new amendments.

After this, the Authority decided that Stonewall no longer needed a certificate of need, the court states. Although St. Joseph’s tried to appeal the Authority’s decision through the ICA, the ICA sided with the Authority.

The Supreme Court of Appeals says in the Opinion of the Court that the Authority had since altered its position and agreed with St. Joseph’s that the Authority and the ICA made mistakes in their decisions.

“In the ICA proceedings, the Authority argued that its unwritten guideline was a fair interpretation of Section 8(a)(1),” Wooton writes. “But to this Court, the Authority admits that it erred, stating that while its unwritten guideline might have reflected a good-faith effort to reasonably apply the certificate-of-need statutes, that guideline does not have an appropriate statutory basis.”

In their discussion, the Supreme Court of Appeals stated multiple times that the phrasing in the necessary section that defines certificate of need is clear and should not have been misinterpreted.

“…It is undisputed that Stonewall’s plans include the erection of a new hospital building for the provision of health services for its patients,” Wooton writes. “Section 8(a)(1), by its clear and unambiguous terms, required Stonewall to seek a certificate of need from the Authority for its new hospital project. Both the Authority and the ICA erred by finding Section 8(a)(1) to be ambiguous and by applying the Authority’s unsupportable, unwritten guideline that the relocation of services from an old building to a newly erected one is exempt from the certificate-of-need requirement.”

On Thursday, the Supreme Court of Appeals also dismissed a petition from Stonewall that asked the court to issue a writ of prohibition and a writ of mandamus against the Authority. Stonewall issued the petition against the Authority for “improperly” halting their consideration of the hospital’s construction project after St. Joseph’s filed a motion in the Supreme Court to “stay the hospital construction proceedings.”

The justices all agreed that, their decision that Stonewall was required to get a certificate of need afterall, made the petition a moot point.

“An examination of the particular facts of this case reveals that the issues raised in the petition are now moot,” The court said in its decision. “The stay order upon which the Authority based its decision has now been lifted and we need not consider petitioner’s arguments about the reach and effect of that stay or the Authority’s interpretation thereof. Thus, we dismiss the petition.”