Cal. Dep't of Health Care Servs. v. Ehrenberg (In re Ridgecrest Healthcare, Inc.)

The Trustee responds that "the QA Fee, if an excise tax, is clearly and unequivocally not 'on a transaction[.]' " (Dkt. 15, Appellee's Br. at 15) (capitalization omitted). Because "[s]killed nursing facilities provide long-term care to their patients, and do[ ] not engage in one-time or discrete transactions *829 with their patients[,]" the Trustee asserts that "QA Fees are not assessed on any discrete activity or transaction involving any particular patient, care or service." ( Id. at 19). According to the Trustee, DHS "wants to squeeze the QA Fee into an excise tax 'on a transaction,' but fails to identify what the transaction is." ( Id. ). The Trustee's assertions are unpersuasive.

During the hearing on the claim objection following remand, DHS's counsel explained that QA Fees were imposed on a "per bed" 5 basis:

(BK Dkt. 519, January 4, 2017, Hearing Tr. at 23-24).

DHS's characterization of QA Fees as being imposed on a "per bed, per patient day" basis was essentially uncontested. Indeed, the Trustee agreed with this characterization. ( See BK Dkt. 480, Trustee's Opening Supp. Br. at 4) (describing QA Fees as "recurring monthly charges which are based on a facility specific…