In Millcreek Manor v. Department of Public Welfare, 796 A.2d 1020 (Pa. Cmwlth. 2002), Millcreek, a nursing home, petitioned for review of a decision of a Department of Public Welfare Hearing Officer who denied Millcreek's appeal from a decision of DPW's Long Term Care Programs Bureau. One of the issues that Millcreek raised on appeal was that the hearing officer failed to conduct a de novo hearing as required by DPW's regulations. The Court agreed with Millcreek because the hearing officer improperly reviewed the prior decision under an "abuse of discretion" standard. The Court stated that: By reviewing DPW's actions for an abuse of discretion, the hearing officer was clearly conducting an appellate review of DPW's actions rather than acting as an independent fact finder in a de novo proceeding. In conducting a de novo review, the hearing officer of the Bureau, as the reviewing tribunal, is in effect substituted for the LTC Bureau, the prior decision-maker, and must re-decide the case. Id. at 1030. Accordingly, the Court vacated the decision of the hearing officer and remanded the case for a de novo hearing and the issuance of a proper adjudication. In Millcreek Manor, the Court stated that: In conducting a full evidentiary hearing, the administrative hearing officer is conducting a de novo review of the matter. "De novo" review entails, as the term suggests, full consideration of the case anew as if it was not heard before and no decision had been previously rendered. Commonwealth v. Krut, 311 Pa.Super. 64, 457 A.2d 114 (1983). The reviewing body is in effect substituted for the prior decision-maker and redecides the case. D'Arciprete v. D'Arciprete, 323 Pa.Super. 430, 470 A.2d 995, 996 (1984). In conducting a hearing de novo, the tribunal hears the matter in its original, not appellate, jurisdiction. In re Involuntary Commitment of Barbour, 1999 PA Super 162, 733 A.2d 1286, 1288 (Pa.Super.1999). The difference between de novo review and appellate review is significant. Under de novo review, the reviewing tribunal conducts an independent fact-finding proceeding in which new evidence is taken and all issues are determined anew. Under appellate review, the reviewing tribunal examines the record to determine whether the agency's findings are reasonably supported by substantial evidence; the administrative order being reviewed carries a presumption of validity. Id. at 1029.