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Adoni Health Institute v. Delaware Board of Nursing

Superior Court of Delaware

August 9, 2018

ADONI HEALTH INSTITUTE, Appellant,
v.
DELAWARE BOARD OF NURSING, Appellee.

         Upon appeal from the Delaware Board of Nursing: AFFIRMED.

          OPINION

          John A. Parkins, Jr., Judge

         This is Adoni Health Institute's second appeal from the Delaware State Board of Nursing.[1] In 2015, the Board revoked

         Adoni's conditional approval to operate its practical nursing program. On appeal in 2016, this court reversed all of the Board's factual findings except one, and remanded the matter to the Board with instructions to decide one remaining issue: whether the fact that the school misstated the duration of its curriculum warranted the Board's withdrawal of the school's conditional approval to operate. On remand, the Board considered evidence that was not previously considered in its original 2015 hearing, but was related to the duration of the school's curriculum. The Board issued a decision in September 2017, holding that Adoni's misstatement of its curriculum length warranted revocation of its approval. Adoni appealed to this court arguing, among other things, that the Board erred as a matter of law by reopening the factual record. For the reasons that follow, the Board's decision should be AFFIRMED.

         I. BACKGROUND

         The underlying facts of this case are described in some detail in this court's July 2016 opinion, [2] and will be summarized only briefly here. In 2007, the Board granted Adoni a conditional approval to operate after determining the school did not qualify for full approval. The Board identified three deficiencies in Adoni's program: (1) substandard NCLEX exam pass rates; (2) inadequate annual reports; and (3) student complaints. Adoni implemented an action plan intended to revamp its program, and in July 2012 the Board approved Adoni's action plan. Under the plan, continued approval for the school to operate hinged on the success of the 2012 cohort on the NCLEX, that is, approval hinged on only the students who started in September 2012 and participated in the revamped program. Yet, when the NCLEX results for the pre-2012 cohort continued to be poor and the school's 2014 annual report was deficient, the Board voted to withdraw its approval. A hearing was held in June 2015. On July 8, 2015, the Board issued a written opinion formally withdrawing Adoni's approval.[3]

         Adoni appealed to the Superior Court. On July 29, 2016, this court reversed the Board's decision and all but one of its factual findings. The court upheld the Board's finding that Adoni misstated the duration of its curriculum in its 2014 annual report. The court remanded the matter, holding in relevant part:

The court's decision to uphold the Board's finding concerning the misstated length of the curriculum is not sufficient, at this juncture, to sustain the Board's decision to withdraw [Adoni's] approval. Although the Board found that the faults in [the school's] 2014 Annual report, in their entirety, justified withdrawal of [Adoni's] approval, it made no finding that the misstatement of the curriculum length alone justified such an extreme measure. The court, of course, is not equipped to make that decision, and therefore the matter will be remanded to the Board for its determination of that issue.[4]

         Following the court's remand, the Board wrote a letter to Adoni in October 2016 stating its intent to schedule a hearing "in early 2017," and also requesting that Adoni produce certain information related to the school's curriculum length in preparation for the hearing. The requested documents included: (1) a list of the students in each cohort beginning in 2011 through 2016; (2) the date each student began at the school; (3) the date each student finished at the school; (4) an indication of how each student separated from the school; and (5) an indication of whether there were duplicate names in different cohorts.[5] Adoni produced the documents on December 7, 2016.

         On December 19, 2016, the Board's Practice and Education Committee reviewed the documents, determined that the documents demonstrated a long-standing pattern by Adoni of misstating its curriculum length to the Board and its students, and then recommended that the Board move forward with withdrawal of the school's approval. The Board reviewed the documents and voted to accept the Committee's recommendation to withdraw based on the misstatement of its curriculum length. The Board notified Adoni of it proposal to withdraw and later scheduled a hearing, which was postponed several times at the request of Adoni.

         On July 10, 2017, two days before the scheduled hearing, Adoni filed a motion in limine "to preclude the re-opening of the factual record on remand as contrary to the directive of the Superior Court." The Board, however, denied the motion in limine finding that, "the Court's Opinion does not state that the Board is limited to considering only the record established in the original proceeding," and emphasizing that the court "remanded the matter to the Board for proceedings consistent with the Court's Opinion."[6]

         At the July 12, 2017 hearing, the Board considered the seventeen exhibits produced by Adoni, consisting of the student enrollment dates, transcripts, and annual reports. The school also presented its own evidence. The Board heard testimony from Dr. Ola Aliu, the President of the school, and Dr. Lucille Gamberdella, former Board President who helped Adoni revamp its nursing program.

         The Board issued its decision on September 13, 2017, finding that Dr. Aliu's "multiple and varied explanations for the curriculum length" during his testimony were not credible.[7] It also found Dr. Gamberdella's testimony did not provide good cause to extend the school's conditional approval.[8] The Board held that Adoni's misstatement about the length of its curriculum in its 2014 annual report was sufficient justification to withdraw the school's conditional approval because it: 1) "reveals that [Adoni] is not operating a legitimate practical nursing education program;" 2) "exposes that the school is deceiving its students about when they will become employable;" 3) "reveals that [Adoni] has repeatedly deceived the Board about the length of its curriculum in order to obscure the fact that it's also deceiving students;" and 4) the misstatement "renders the Board wholly incapable of determining whether the school is providing adequate resources . . . ." The school again appealed the Board's decision to the Superior Court; this time on the basis that the record was improperly expanded on remand.

         II. ANALYSIS

         This court reviews the Board's decision to determine "whether it acted within its statutory authority, whether it properly interpreted and applied the applicable law, whether it conducted a fair hearing and whether its decision is based on sufficient substantial evidence and is not arbitrary."[9] Substantial evidence is "such relevant evidence that a reasonable mind might accept as adequate to support a conclusion."[10] But, this court will not weigh evidence, determine questions of credibility, or make its own factual findings.[11] Questions of law are reviewed de novo.[12] And absent an error of law, the Board's decision is reviewed for an abuse of discretion.[13]

         It is well-settled that when the Superior Court remands a matter to the Board for further proceedings, the Board must follow the court's "instruction concerning treatment of an issue on remand even if the [court] has left the ...


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