A Toledo-based nursing home provider is watching the state of West Virginia carefully these days.

HCR Manor Care owns seven nursing homes in West Virginia, as well as hundreds of homes in other states. The company, which is based in northwestern Ohio, is in the midst of a $6.3 billion buyout by the Carlyle Group, a private global investment firm.

But that sale can't go through, a company vice president said, until West Virginia's Health Care Authority decides whether to grant the company a certificate of need for its facilities.

"We are nearing completion," said Rick Rump, assistant vice president of corporate communication for HCR Manor Care. "It will be done as soon as all of the approvals are in, and right now West Virginia is the biggest hurdle."

The Health Care Authority already granted HRC a certificate of need once -- back on Oct. 19. But on Nov. 15, the Service Employees International Union Local 1199 filed an appeal asking the Health Care Authority to reconsider the company's certificate of need on the grounds it didn't meet specific requirements. It also asked the Health Care Authority to rescind the certificate while the issue was up in the air.

The Health Care Authority obliged. It temporarily rescinded the certificate and set a hearing on the matter for Dec. 14.

Rump said the HCA's decision is unprecedented both for the company and for the state agency itself.

"No other state approved a certificate of need and then stayed the process, and it's the first time in West Virginia, too. They've never granted a CON and then rescinded it," Rump said. "It's an odd precedent."

Sonia Chambers, the Health Care Authority's chairwoman, said that is not true.

"We have granted reconsiderations on a number of occasions," she said. "It's not routine, but it's not unprecedented."

Chambers said the agency decided to reconsider HCR's certificate because the SEIU presented enough preliminary evidence to call into question some of the company's answers and information on its application.

Rump said the company filed its certificate of need application Aug. 29. The Health Care Authority published the announcement of the filing and said any affected party could file paperwork asking for a hearing by Oct. 8

"No one did," Rump said. "So on Oct. 19, the WVHCA approved the transaction."

A few weeks later, three delegates hosted a press conference in the Capitol expressing concern about the transaction, saying that recent news articles about reduced staffing and several cutbacks at nursing homes that had been purchased by private investment firms made them worry about the Carlyle Group's move to buy HCR Manor Care.

Delegates Joe DeLong, D-Hancock; Don Perdue, D-Wayne, and Barbara Hatfield, D-Kanawha, said they were concerned that the Health Care Authority, which licenses all health-care related facilities in the state, had rushed through the application and approval process and granted the certificate without knowing all of the facts.

DeLong said the proposed purchase already has spurred two congressional hearings, and five states have raised the red flag over the offer.

"We really need to slow things down and look at this," DeLong, who is the House majority leader, said during the news conference. "I guess our feeling is 'What's the rush?'"

Less than a week later, SEIU, which represents about 3,000 West Virginians, filed its appeal.

The 14-page appeal set out several areas where the labor union has concerns, including possible decreased staffing at the seven nursing homes in West Virginia which all go by the name Heartland, as well as a decline in patient care, cutting back on beds available to patients covered by Medicaid and Medicare and failing to provide charity care. In addition, SEIU said HCR failed to provide information the authority requires, such as bed capacity, closing costs, transaction fees and consultant fees.

"The HCA violated its own statutory provisions by failing to have an adequate record on the critical factors that must be considered in determining whether or not to issue a CON," SEIU's attorneys wrote in the appeal. "Thus the decision was made in excess of the agency's authority, made upon unlawful procedures and is arbitrary, capricious and an abuse of discretion."

Calls made to Local 1199 and the union's attorney were not returned.

Rump said HCR answered all of the Health Care Authority's questions and filled out all of the paperwork needed to get a new certificate of need for the new owners. He said SEIU's accusations that the quality of care in the company's nursing homes would decline after the sale was complete doesn't make sense.

"It's not in our best interest to do that," he said. "Our best interest is to provide the highest quality of care we can."

He said the new owners want to make the best return on their investment, and providing shoddy care to nursing home residents isn't the way to do that. He also said that all of the state laws and regulations regarding the nursing homes will still apply regardless of who owns them.

"The state of West Virginia will make sure we are doing things right and that we are following the regulations," he said, adding, "We aren't going to be cutting staff. We aren't going to be cutting patient care. We're going to be doing the best we can to provide the best patient care. It doesn't make a lot of sense for us to do otherwise."

WHAT'S NEXT

The Health Care Authority will host a an administrative hearing on the certificate of need application filed by MCHCR-CP Holdings and HCR III Healthcare, LLC and PropCos and OpCos (Manor Care) at 9 a.m. Dec. 14 in the Authority's office at 100 Dee Drive, Charleston.