The opinion
If this opinion indicates that it is “FOR PUBLICATION,” it is subject to
revision until final publication in the Michigan Appeals Reports.
STATE OF MICHIGAN
COURT OF APPEALS
In re JUSTIN PAUL DI REZZE, M.D.
DEPARTMENT OF LICENSING AND UNPUBLISHED
REGULATORY AFFAIRS, September 17, 2025
10:22 AM
Petitioner-Appellee,
V No. 370615
LARA
Bureau of Professional Licensing
JUSTIN PAUL DI REZZE, M.D., LC No. 22-004852
Respondent-Appellant.
Before: K. F. KELLY, P.J., and PATEL and FEENEY, JJ.
PER CURIAM.
In this professional-discipline action, respondent appeals as of right a final order of the
Board of Medicine’s Disciplinary Subcommittee (DSC), part of the Bureau of Professional
Licensing (BPL) in the Department of Licensing and Regulatory Affairs (LARA), placing him on
probation for a period of one day to six months, requiring him to complete 10 hours of continuing
education, and imposing a fine of $2,500, for violating MCL 333.16221(a).1 We affirm.
I. FACTS
Respondent is a physician licensed to practice medicine in Michigan, and, at the relevant
time, served as the medical director of Wellbridge of Grand Blanc (Wellbridge), a nursing and
1
MCL 333.16221(a) authorizes the DSC to impose sanctions, under MCL 333.16226, for “a
violation of general duty,” defined in part as “negligence or failure to exercise due care, including
negligent delegation to or supervision of employees or other individuals, whether or not injury
results . . . .”
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rehabilitation facility. This disciplinary action arose from respondent’s treatment of patient AH,2
an elderly man who had been hospitalized for a urinary-tract infection and sepsis immediately
before his admission at Wellbridge; AH was weak, could not walk, needed help with day-to-day
activities, and suffered from diabetes, hyperlipidemia, and hypertension. AH was admitted at
Wellbridge on the evening of March 14, 2019, but on March 25, 2019, at his family’s insistence,
AH was transported to Ascension Genesys Hospital (Ascension), then, that same night, to the
emergency department at the University of Michigan (UM) Hospital in Ann Arbor, where he was
admitted.
A. COMPLAINT
In May 2019, members of AH’s family filed a complaint with the BPL, and an investigation
into respondent’s treatment of AH at Wellbridge was conducted. In January 2020, petitioner
served an administrative complaint on respondent. Petitioner alleged that AH had been
hospitalized for sepsis, following a urinary-tract infection, before he was transported to Wellbridge
“for rehabilitation and care.” Petitioner asserted that, upon admission to Wellbridge, AH had three
pressure ulcers, or bedsores—two on his coccyx and one on his left heel, “all noted and present at
the time of admission to the facility.” Petitioner also asserted that respondent completed AH’s
intake history and examined AH, but documented no rashes or ulcers and otherwise “failed to note
and document a detailed description of the patient’s current wounds,” and that, on the same day,
staff was directed to monitor AH’s left heel, but no orders addressed the wounds on his coccyx.
Petitioner also alleged that, on March 18, 2019—four days after AH’s admission to
Wellbridge—a physician’s assistant (PA) had examined AH and noted wounds on his right heel
and buttocks, but “failed to note the wound on the patient’s left heel and failed to document a
detailed description of the patient’s wounds;” and on the same day, staff was directed to monitor
and treat AH’s coccyx wounds twice daily. Petitioner also alleged that, one week later, the PA
again examined AH, and again noted the presence of wounds on the right heel and buttocks, but,
as before, “failed to note the wound on the patient’s left heel and failed to document a detailed
description of the patient’s wounds.”
Petitioner also stated that its retained expert opined that respondent “was negligent and
failed to conform to minimal standards of acceptable and prevailing practice” by: (1) failing to
properly document AH’s wounds upon admission, (2) failing to properly supervise the PA, (3)
failing to issue orders to address AH’s wounds until four days after admission, (4) discontinuing
AH’s use of an external catheter, and (5) failing to order “multiple modalities” to care for AH’s
wounds. In Count I, petitioner alleged that respondent’s conduct violated general duty by way of
“negligence or failure to exercise due care, including negligent delegation to or supervision of
employees or other individuals,” in violation of MCL 333.16221(a). In Count II, petitioner alleged
that respondent’s conduct demonstrated incompetence, in violation of MCL 333.16221(b)(i).
B. ADMINISTRATIVE LAW JUDGE HEARING
2
Initials have been used throughout these proceedings to protect the patient’s identity.
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In October 2022, a hearing was held before an administrative law judge (ALJ), during
which the ALJ heard testimony from a BPL investigator, an expert witness from both parties, and
respondent.
The petitioner’s expert witness, Madeline Krissoff, M.D., was qualified as an expert in
internal medicine and geriatrics, including pressure wounds and ulcers. Dr. Krissoff asserted that
respondent violated the Public Health Code (PHC), MCL 333.1101 et seq., by failing to diagnose
and treat AH’s wounds, leading to a decline in his condition and resulting in his admission to the
UM Hospital. Dr. Krissoff stated that a reasonably prudent medical doctor would have seen and
documented AH’s pressure ulcers during his history and physical (H & P). Dr. Krissoff also stated
that the first reference to treatment of AH’s coccyx wounds was not made until four days after AH
arrived at Wellbridge, and AH’s care plan was generated by the nursing staff with no indication
that a doctor had any input into it. Dr. Krissoff further testified that the “progress notes” created
by the PA, and signed by respondent, noted a wound on AH’s buttock, but also noted a wound on
his right heel rather than his left heel. Dr. Krissoff opined that, if a physician signs a PA’s note as
an author, the physician has the responsibility to ensure that the note is accurate.
The respondent’s expert witness, Iris Boettcher, M.D., was qualified as an expert in internal
and geriatric medicine. Dr. Boettcher acknowledged that respondent’s documentation of his initial
assessment of AH “could have been better,” but stated that “it was certainly within the minimal
standard of care.” She testified that a skilled nursing facility, such as Wellbridge, provides “team-
based care,” in which the physician “is responsible for writing the orders and care plan oversight.”
In her opinion, respondent exercised appropriate oversight and issued appropriate orders for AH’s
care plan. Dr. Boettcher did not believe that AH’s condition worsened during his stay at
Wellbridge. She also stated that she had no concerns regarding respondent’s oversight in this case,
explaining that, although there was an error regarding the location of a heel wound, it had no
significant impact on the overall care the PA provided, which met the “minimal standards.”
Respondent testified that he was the medical director and sole attending physician at
Wellbridge, as well as the chief executive officer of Theoria, which he described as “a post-acute
care health technology, as well as medical management organization.” As for AH’s arrival at
Wellbridge, respondent testified that he was completing his rounds at 9:00 or 10:00 p.m. when a
nurse asked him to evaluate a “new arrival.” He described AH as extremely sick, with multiple
comorbidities, and stated that, when he examined AH, he focused on the chief complaint for which
he was admitted to Ascension, and made sure that AH had appropriate antibiotics and sepsis
screening. Respondent added that he was not notified of AH’s transfer beforehand, there was no
documentation that AH had any wounds, and he was unaware of any wounds when he completed
AH’s H & P. Respondent agreed that his skin inspection revealed “ ‘no rashes or ulcers’ ” and
begrudgingly admitted that he had failed to note and document a detailed description of the
patient’s current wounds. Nevertheless, he testified that he was notified of AH’s wounds five
hours later—due to the care plan he had put into place—and he and the Wellbridge staff generated
and implemented an appropriate care plan. Respondent denied that AH’s family was displeased
with the care he received at Wellbridge, asserting that it was only AH’s wife who requested a
transfer against medical advice. Respondent further asserted that he had not reviewed the PA’s
progress notes and had no legal responsibility to do so. He explained that the electronic health-
records (EHR) software used by Wellbridge was subpar, and his apparent signature on the PA’s
notes was added by a “glitch” in the interface of the two software systems.
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C. ALJ DECISION
In June 2023, the ALJ issued a lengthy proposal for decision (PFD). Addressing the
allegation that respondent failed to document ulcers or rashes at the time that AH was admitted,
the ALJ found the testimony of Dr. Krissoff more credible than that of respondent and his expert,
Dr. Boettcher, and concluded that petitioner “has shown, by a preponderance of the evidence, that
Respondent violated MCL 333.16221(a) by failing to visualize and document the rash and pressure
ulcers during his March 14, 2019, examination of patient A.H.”3 Addressing the allegation of
improper supervision, the ALJ found that petitioner “has proven by a preponderance of the
evidence that Respondent violated MCL 333.16221(a) by failing to properly supervise [the
pertinent] physician’s assistant . . . as alleged in the Administrative Complaint.”
Addressing Count I of the complaint, the ALJ concluded that petitioner “has proven by a
preponderance of the evidence that [respondent’s] failure to visualize or document A.H.’s pressure
ulcers, and his failure to properly supervise [the] physician assistant . . . constitute negligence
within the meaning of MCL 333.16221(a).” Addressing Count II, the ALJ concluded that,
although petitioner had proven that respondent “violated a general duty and was negligent in
certain respects,” the evidence did not “support a conclusion that his violations of the standard of
care [rose] to the level of a [sic] ‘incompetence’ within the meaning of MCL 333.16221(b)(i).”
Thereafter, respondent filed objections to the PFD.
D. DSC ORDER
In its final order, the DSC accepted the ALJ’s findings of fact and conclusions of law and
placed respondent on probation “for a minimum of one (1) day, and not to exceed six (6) months,
commencing on the effective date of this Order.” The terms of probation included completion of
10 hours of continuing education and compliance with the PHC. The DSC also fined respondent
$2,500, to be paid within six months. Respondent moved for reconsideration, which the DSC
denied. Respondent now appeals.
II. PRESERVATION AND STANDARD OF REVIEW
Because these issues were specifically raised before, and addressed by, the ALJ and the
DCS, they are preserved for appellate review. See Meier v Pub Sch Employees’ Retirement Sys,
343 Mich App 571, 579-580; 997 NW2d 719 (2022); In re Sangster, 340 Mich App 60, 71-72;
985 NW2d 245 (2022).
“Rulings by disciplinary boards or subcommittees are reviewed on appeal solely under
Const 1963, art 6, § 28.” In re Sangster, 340 Mich App at 66. Const 1963, art 6, § 28 states that
appellate review of these rulings includes, “as a minimum, the determination whether such final
decisions, findings, rulings and orders are authorized by law; and, in cases in which a hearing is
required, whether the same are supported by competent, material and substantial evidence on the
3
The ALJ further found that petitioner failed to establish that: (1) respondent violated MCL
333.16221(a) by failing to provide treatment to AH’s coccyx wound before March 18, 2019,
discontinuing the use of the external catheter, or failing to provide multiple modalities of treatment
for AH’s wounds; or (2) AH was transferred to the UM Hospital for sepsis or infected ulcers.
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whole record.” Within this context, “a decision is not ‘authorized by law’ when it is in violation
of a statute or a constitutional provision, in excess of an agency’s statutory authority or jurisdiction,
made upon unlawful procedure that results in material prejudice, or when it is arbitrary and
capricious.” In re Sangster, 340 Mich App at 67.
We “must review the entire record, not just the portions that support an agency’s findings,
when assessing whether the agency’s decision was supported by competent, material, and
substantial evidence on the whole record. ‘Substantial evidence’ means evidence that a reasonable
person would find acceptably sufficient to support a conclusion.” Id. (citation omitted).
Administrative findings of fact and conclusions of law premised primarily on credibility
determinations will generally not be disturbed, and “[a] reviewing court may not set aside factual
findings supported by the evidence merely because alternative findings could also have been
supported by evidence on the record or because the court might have reached a different result.”
Id. (quotation marks and citation omitted). We “must generally defer to an agency’s administrative
expertise.” Id. (quotation marks and citation omitted). Therefore, “it does not matter that the
contrary position is supported by more evidence, that is, which way the evidence preponderates,
but only whether the position adopted by the agency is supported by evidence from which
legitimate and supportable inferences were drawn.” Id. (quotation marks and citation omitted;
alteration in original).
Respondent’s due-process argument presents a constitutional question which we review de
novo. See Shahid v Dep’t of Health & Human Servs, 333 Mich App 267, 273; 963 NW2d 638
(2020).
III. STANDARD OF CARE
Respondent first argues that the DSC’s conclusion that he violated the standard of care by
failing to discover or document AH’s pressure injuries was not supported competent, material, and
substantial evidence on the whole record. We disagree.
Under MCL 333.16231(1), a person or governmental entity who believes that a violation
of article 15 of the PHC has occurred may submit a written allegation to LARA. MCL 333.16221
provides that LARA “shall investigate any allegation that 1 or more of the grounds for disciplinary
subcommittee action under this section exist . . . .” LARA may issue a formal complaint, MCL
333.16231(6)(a), and, after an investigation, must provide a copy of the complaint to the
appropriate disciplinary subcommittee, MCL 333.16221. Grounds for action by a disciplinary
subcommittee include “a violation of general duty, consisting of negligence or failure to exercise
due care, including negligent delegation to or supervision of employees or other individuals,
whether or not injury results . . . .” MCL 333.16221(a). Under MCL 333.16231a(1) and (2), if
the parties cannot reach agreement, a hearing must be held before a hearings examiner, who “shall
determine if there are grounds for disciplinary action,” and “prepare recommended findings of fact
and conclusions of law for transmittal to the appropriate disciplinary subcommittee.” If the
disciplinary subcommittee finds ground for action under MCL 333.16221(a), it “shall impose” one
or more sanctions, including “probation, limitation, denial, suspension, revocation, permanent
revocation, restitution, or fine.” MCL 333.16226(1).
In this case, the parties do not dispute that AH suffered from three pressure wounds upon
his arrival at Wellbridge. Wellbridge records establish the AH suffered from wounds on his coccyx
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and left heel at the time of his admission.4 Respondent admitted that the wounds existed at the
time he examined AH. He also admitted that when he examined AH, he did not turn him over or
examine his heel. Yet the H & P he authored following the examination stated, “Skin: Inspection:
No rashes or ulcers.”
Petitioner’s expert, Dr. Krissoff, testified that a reasonably prudent medical doctor in
respondent’s situation would have a duty to examine the patient’s skin and to document any
wounds found. She added that, if the doctor was unable to turn the patient for further examination,
a reasonable physician would document that limitation. Dr. Krissoff further testified that a
reasonable and prudent physician would have seen and documented the wound on AH’s left heel,
and that respondent’s failure to do so was not excused by the nursing staff’s subsequent
documentation. In her opinion, a reasonably prudent medical doctor would have observed and
documented AH’s pressure ulcers. Conversely, respondent’s expert, Dr. Boettcher, testified that
although respondent’s failure to document those ulcers was an oversight or a mistake, it did not
violate the standard of care.
The ALJ found Dr. Krissoff’s testimony “more credible” on this issue, and also noted Dr.
Boettcher’s testimony that that the failure to document the wounds was a “mistake.” The ALJ
specifically credited Dr. Krissof’s testimony that respondent should have observed and described
the wounds, should have documented the parts of AH’s body that he actually observed, and should
have requested assistance or documented that he was unable to view the buttocks. The ALJ found
that respondent’s failure to do so was not excused by the subsequent examination that the nurses
completed. The ALJ concluded that “Petitioner has shown, by a preponderance of the evidence,
that Respondent violated MCL 333.16221 (a) by failing to visualize and document the rash and
pressure ulcers during his March 14, 2019, examination of patient A.H.” We are satisfied that this
conclusion was supported by competent, material, and substantial evidence.
“ ‘Competent evidence’ is defined as ‘[t]hat which the very nature of the thing to be proven
requires . . . .’ ” Goff v Bil-Mar Foods, Inc, 454 Mich 507, 514 n 5; 563 NW2d 214 (1997)
(alteration in original), overruled in part on other grounds by Mudel v Great Atlantic & Pacific
Tea Co, 462 Mich 691; 614 NW2d 607 (2000), quoting Black’s Law Dictionary (6th ed).
“Material” means “ ‘[i]mportant; more or less necessary; having influence or effect . . . .’ ” Goff,
454 Mich at 514 n 5 (alteration in original), quoting Black’s Law Dictionary (6th ed). “Substantial”
means “ ‘[o]f real worth and importance; of considerable value; . . . actually existing; real; . . . not
illusive; solid; true; veritable.’ ” Goff, 454 Mich at 514 n 5 (alteration in original), quoting Black’s
Law Dictionary (6th ed). In In re Sangster, 340 Mich App at 67 (citation omitted), this Court
described substantial evidence as “evidence that a reasonable person would find acceptably
sufficient to support a conclusion. This may be substantially less than a preponderance of
evidence, but does require more than a scintilla of evidence.”
We conclude that the testimony of Dr. Krissoff and the documentary evidence clearly
constituted “competent evidence” supporting the conclusion that respondent violated the standard
of care. This evidence was also material in that it was important, necessary, and clearly influenced
4
The wounds were noted on a skin and wound evaluation that was performed by nurses on the
date of AH’s admission.
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the ALJ’s conclusion. This evidence was also substantial in that a reasonable person could find it
sufficient to support the ALJ’s conclusion. Petitioner’s arguments to the contrary lack merit.
Although the evidence might also have supported a finding in respondent’s favor, whether a
contrary position had evidentiary support is irrelevant if the agency’s decision was supported by
legitimate and supportable inferences drawn from the evidence. Id. In this case, the agency’s
decision was supported by such evidence.
Moreover, administrative findings of fact and conclusions of law premised primarily on
credibility determinations will generally not be disturbed and, as noted, “[a] reviewing court may
not set aside factual findings supported by the evidence merely because alternative findings could
also have been supported by evidence on the record or because the court might have reached a
different result.” Id. (quotation marks and citation omitted). Because the ALJ’s conclusion was
premised largely on a credibility evaluation of the witnesses, the DSC had a reasonable basis for
adopting that conclusion. See id.
Respondent also objects to the ALJ’s conclusions that, “[e]ven if [respondent] had no duty
to perform a skin assessment, having undertaken that task, he falsely documented that A.H. had
no skin rashes or ulcers,” and that, “by documenting that A.H. had no wounds when there were
wounds, Respondent violated the standard of care.” Citing Merriam-Webster’s Collegiate
Dictionary (11th ed), respondent argues that to do an act “falsely” requires that it be done
“deceitfully, dishonestly, or deceptively,” which there is no evidence of in this case. But an act
need not necessarily be done deceitfully, dishonestly, or deceptively to be false. Rather, “false”
can also simply mean untrue, wrong, or erroneous, and “[w]hat is false can be so by intent, by
accident, or by mistake.” Black’s Law Dictionary (12th ed).
Respondent’s defense is largely premised on the assertion that AH suffered no harm during
his stay at Wellbridge. But as noted, a disciplinary subcommittee may find a violation of general
duty “whether or not injury results.” MCL 333.16221(a). Because the ALJ’s findings of fact and
conclusions of law were supported by competent, material, and substantial evidence on the whole
record, the DSC did not err by adopting the PFD, including the ALJ’s conclusion that respondent’s
failure to discover or document AH’s pressure ulcers constituted negligence within the meaning
of MCL 333.16221(a).
IV. NEGLIGENT SUPERVISION
Respondent further argues that the DSC’s conclusion that he was liable for negligent
supervision of the PA was neither authorized by law nor supported by competent, material and
substantial evidence on the whole record. We disagree.
A PA may only operate under a practice agreement with a participating physician. MCL
333.17047(1). The practice agreement must include, inter alia, “[a] process between the
physician’s assistant and participating physician for communication, availability, and decision
making when providing medical treatment to a patient.” MCL 333.17047(2). Before March 22,
2017, a PA was authorized to “provide medical care services only under the supervision of a
physician or properly designated alternative physician, and only if those medical care services are
within the scope of practice of the supervising physician and are delegated by the supervising
physician.” MCL 333.17076(1), as amended by 2011 PA 210. But as amended by 2016 PA 379,
MCL 333.17076(1) now provides that a PA “may make calls or go on rounds in private homes,
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public institutions, emergency vehicles, ambulatory care clinics, hospitals, intermediate or
extended care facilities, health maintenance organizations, nursing homes, or other health care
facilities in accordance with a practice agreement.” As amended, MCL 333.17076 contains no
reference to “supervision” by a physician. Moreover, MCL 333.17049(2) provides as follows:
Notwithstanding any law or rule to the contrary, a physician is not required
to countersign orders written in a patient’s clinical record by a physician’s assistant
with whom the physician has a practice agreement. Notwithstanding any law or
rule to the contrary, a physician is not required to sign an official form that lists the
physician’s signature as the required signatory if that official form is signed by a
physician’s assistant with whom the physician has a practice agreement.
In this case, respondent testified that his practice agreement with the PA required him to
be available to her and audit at least 10 of her notes every six months. Respondent explained as
follows: “I have responsibility to provide oversight with her, but it’s not to review every single
note, to review every single care plan, to review every single order. That’s not my responsibility,
nor is it legally required of me.” But he also testified that: (1) he met with her more frequently,
perhaps every day or two; (2) he would randomly spot check 10 or 15 of her notes to ensure that
her documentation was appropriate; and (3) had he reviewed her progress notes in this case, he
would have told her that she documented the wrong foot, explained how to correct the error, and
perhaps implemented a performance-improvement plan for the next 30 days. By his own
testimony, then, by entering into the practice agreement, respondent had assumed, at a minimum,
a limited contractual duty to “provide oversight” and supervise the PA. For the reasons discussed
next, we conclude that the DSC did not exceed its authority by adopting the ALJ’s determination
that respondent negligently supervised the PA.
The PA’s relevant progress notes both: (1) erroneously indicated that AH had a wound on
his right heel, rather than his left heel; and (2) contained the following notation: “Author: Justin
Di Rezze Physician – Physician [e-SIGNED].” Dr. Krissoff testified that when a physician’s
signature appears on a progress note, the physician thereby represents that the note is accurate:
“It’s understood that that would be the case that the record was reviewed and agreed with and
signed, co-signed.” The ALJ found Dr. Krissoff’s testimony credible on this issue, and quoted the
following passage from Dr. Krissoff’s report:
[Respondent’s] care of this patient shows evidence of negligence or failure to
exercise due care, in that not only did he not visualize the wounds, he did not prop-
erly supervise his physician’s assistant. From the records of [the PA’s] progress
notes dated March 18, 2019, and March 22, 2019, it is not clear whether she visual-
ized the wounds either. In the March 18, 2019, visit, she only stated “right heel
wound and buttock wound” without any description of size, evidence of infection,
or other detail. In the documentation of the March 22, 2019, visit, there is also
nothing to suggest that she actually visualized the wounds. She states, “no wound
changes per staff” suggesting that she got her information on the wounds from staff,
not from direct visualization.
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The progress notes, along with Dr. Krissoff’s testimony and report, constituted competent,
material, and substantial evidence supporting the ALJ’s conclusion that respondent failed to
properly supervise the PA. Although the evidence might also support a finding in respondent’s
favor, whether the evidence might have supported a contrary position is irrelevant if the agency’s
decision was supported by legitimate and supportable inferences drawn from the evidence. In re
Sangster, 340 Mich App at 67. In this case, the agency’s decision was supported by such evidence.
The ALJ considered respondent’s testimony that he did not review, sign, or otherwise adopt
the PA’s notes and that the appearance of his signature was a result of the integration of medical
records. Nevertheless, the ALJ found petitioner’s argument “persuasive and supported by the
evidentiary record,” explaining that “Dr. Krissoff credibly testified that [respondent’s] signature
indicates that he bears a responsibility for the note’s accuracy.” The ALJ concluded that “as the
attending physician and medical director, he cannot now disavow the WellBridge records, which
indicate that he did sign them.”
The ALJ clearly found Dr. Krissoff’s testimony on this issue more persuasive than
respondent’s. Because the ALJ’s conclusion was premised largely on a credibility evaluation of
the witnesses, the DSC had a reasonable basis for adopting that conclusion. See id.
On appeal, respondent argues that his signature only appeared on the PA’s notes as a result
of the production of records for this proceeding. But this assertion is undercut by respondent’s
following testimony at the hearing: “And you know, much to [opposing counsel’s] dismay, the e-
signature is actually one of the problems that we brought up multiple times.” If the issue arose
only in the course of gathering records for this proceeding, there would have been no need to raise
the issue multiple times before this proceeding commenced.
Respondent also argues that the ALJ proceedings violated his right to due process, under
the state and federal Constitutions,5 because he had no notice before the first day of the hearing of
the “specific charges” that: (1) he reviewed and signed the PA’s erroneous notes, (2) he developed
a software system that provided a false impression that he adopted the PA’s notes, or (3) these acts
violated the PHC. “Due process and the Administrative Procedures Act require that a party in a
contested case be given timely and adequate notice detailing the reasons for the proposed
administrative action.” Hardges v Dep’t of Social Servs, 177 Mich App 698, 702; 442 NW2d 752
(1989). We conclude that given the specificity of the complaint, the ALJ correctly rejected
respondent’s due-process argument.
As an initial consideration, the ALJ did not conclude that respondent violated the PHC
simply by signing or otherwise adopting the PA’s notes. The portion of the PFD respondent cites
in support of this argument presents a quotation of petitioner’s argument on this issue, not a finding
of the ALJ. Although the ALJ found petitioner’s argument persuasive, it did so only with regard
to the negligent supervision of the PA, and respondent was never charged with violating the PHC
by signing or adopting the notes. Indeed, the ALJ clearly stated, when finding that the PA had
erroneously documented a wound on AH’s right heel, “this allegation, standing alone, does not
prove that [respondent] violated the Code based on [the PA’s] errors,” but that “this allegation is
5
US Const, Am XIV, § 1; Const 1963, art 1, § 17.
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relevant to the issue of whether [respondent] improperly supervised [the PA] . . . .” Moreover, the
issue of respondent’s signature only grew in importance because respondent vehemently denied
having signed or otherwise reviewed the PA’s notes, and petitioner’s argument, as quoted by the
ALJ, was a response to respondent’s denial rather than a new, specific charge.
The ALJ correctly concluded that negligent supervision was properly raised. Paragraphs
9 and 11 of the complaint clearly alleged that the PA had examined AH twice, each time
erroneously noting a wound on his right heel, while failing to document a wound on his left heel
or provide a detailed description of his wounds. The complaint alleged a failure to properly
supervise the PA as follows:
Respondent failed to properly supervise [the PA] who examined the patient on
March 18, 2019, and March 25, 2019. In both assessments, [the PA] noted the heel
wound was on the patient’s right heel, rather than the patient’s left heel where the
wound was actually located. [The PA] failed to document a detailed description of
the wounds and there is nothing in [the PA’s] documentation that suggests [the PA]
visualized and examined the wounds.
Count I of the complaint alleged a violation of a general duty, under MCL 333.16221(a),
“including negligent delegation to or supervision of employees or other individuals, whether or
not injury results . . . .” Accordingly, any reasonable person would know that petitioner was
advancing a claim of negligent supervision in its complaint.
Affirmed.
/s/ Kirsten Frank Kelly
/s/ Sima G. Patel
/s/ Kathleen A. Feeney
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