Ahr v. Bradley

665 S.W.2d 626, 1983 Mo. App. LEXIS 3787
CourtMissouri Court of Appeals
DecidedNovember 15, 1983
DocketNo. WD34182
StatusPublished
Cited by1 cases

This text of 665 S.W.2d 626 (Ahr v. Bradley) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ahr v. Bradley, 665 S.W.2d 626, 1983 Mo. App. LEXIS 3787 (Mo. Ct. App. 1983).

Opinion

DIXON, Judge.

The Missouri Department of Mental Health appeals from the award of the trial court of $1,500.00 on the Department’s claim against the estate of Elsie Bradley in the amount of $3,537.80 for expenses incurred in the care of Mrs. Bradley by Fulton State Hospital. The issue on appeal is the effect to be given the language of Section 630.220, RSMo Supp.1982, “all sums due ... the department on account of any patient ... the account therefor, certified by the head of the facility ... shall be prima facie evidence of the amount due.”

Elsie Bradley was admitted voluntarily to Fulton State Hospital on September 18, 1981, and remained there through December 8, 1981. From September 28 to November 10, the costs incurred by Mrs. Bradley were paid by Medicare. In a November 9, 1981, letter, Dr. Jerry Wessel, Physician Advisor of the Utilization Review Committee at the hospital, notified Truby Koenig, Mrs. Bradley’s cousin, that a state review board had determined that it was no longer necessary for Mrs. Bradley to remain in the General Medical and Surgical Unit (GM & S Unit) because she was receiving only custodial care. The letter also noted that “this determination [by the review board] only means that Medicare and/or Medicaid benefits will not be provided beyond 10 November 1981.” Soon after receiving the letter, Mrs. Koenig gave it to Elizabeth Zaner, the guardian of Elsie Bradley.

On November 12, 1981, the hospital sent to Mrs. Zaner a document titled “Notice of Costs.” Zaner signed the Notice on November 18 and returned it to the hospital. The “Notice of Costs” included the following:

The charges for care and treatment for Elsie Bradley a patient of Fulton State
(name of patient) (DMH
Hospital , receiving care and treatment at Fulton State Hospital_has
Facility) (DMH Facility, Nursing Home, etc.)
been determined to be $ 5.25 per day (effective 11-11-81) after applying the
(Day, Month, Service)
Standard Means Test (Section 202.330 RSMo.1). The cost for care and treatment is
$61.03 per_day_.
(Day, Month, Service)
The difference between the costs of care and treatment and the amounts received in payment may be claimed against the patient’s estate at death by the Department of Mental Health. This is required by Section 473.398 RSMo.
The amount charged for care and treatment may be adjusted from time to time because the costs of care and treatment or the financial resources available to the patient may change. The cost of care and treatment is recomputed annually. The cost of care and treatment is subject to change due to changes in the level of care and treatment or the recomputation of costs. If at any time you have any questions regarding the amounts being charged and/or the cost of care and treatment, please contact the Accounting Office at Fulton State Hospital .
(DMH Facility)

Mrs. Bradley was discharged from the hospital on December 8, 1981, and died on January 14, 1982.

On February 1, 1982, the hospital certified Mrs. Bradley’s account to the Office of [628]*628the Attorney General for collection. A claim for $3,579.80 was filed in the probate division of the Randolph County Circuit Court. At the hearing the Department’s attorney orally amended the claim to $3,537.80 to reflect a $42.00 payment made on the account after the account had been certified.

At the hearing the Department introduced the Certificate of Account of Mrs. Bradley, which had been properly certified by the superintendent of the hospital. The Department’s only witness was Jean Sabo, a State of Missouri resource investigator. Mrs. Sabo explained the formula for determining the certified amount, the Standard Means Test and the account certification process. She also testified about the differences in treatment and the costs between the GM & S Unit and the other units at the hospital. Finally, Mrs. Sabo stated that Medicare had refused to continue paying for Mrs. Bradley’s care as of November 10 because under Medicare standards Mrs. Bradley no longer required the care provided in the GM & S Unit.

The estate presented two witnesses. Basil Bradley, the cousin of Mrs. Bradley’s late husband, testified that he had visited Mrs. Bradley in the hospital on about four to six occasions. He stated that on each visit she appeared to have no serious mental problems.

Mrs. Elizabeth Zaner, the Public Administrator of Randolph County and Mrs. Bradley’s guardian, testified generally about nursing home costs in the area. She also stated that the two bills from the hospital that she paid had noted that Mrs. Bradley was receiving only custodial care. Mrs. Zaner testified that she relied on the Notice of Costs in concluding that Mrs. Bradley was only being charged the $61.03 per diem rate beginning November 11 instead of the per diem charge of $131.60. Had she known of the higher charge, Mrs. Zaner would have moved Mrs. Bradley to a different care center in the area that charged a lower rate.

On August 9, 1982, the Probate Division awarded the Department $1,500.00 on its claim.

The issue before this court is the effect of the certificate as prima facie proof. The Department argues that the prima facie case established by the Certificate of Account was not properly rebutted and therefore, under Sections 473.398, 630.205, and 630.220, RSMo Supp.1982, the Department is entitled to a judgment for the full amount of its claim. The estate argues that the amount of the Department’s claim is unreasonable in light of the Notice of Costs and the letter of Dr. Wessel. The Estate also asserts that the evidence, presented at the hearing, is sufficient to rebut the prima facie case and support the $1,500.00 award of the trial court.

The Department cites State v. Siecke, 472 S.W.2d 367 (Mo. banc 1971), in support of its position. In Siecke the court addressed the question of whether the state’s certificate of account was sufficient evidence to require a verdict for the amount in the certificate when no evidence was offered to challenge the state’s claim. In that case the state was proceeding under a similar statute, Section 191.130, RSMo 1969, which, like Section 630.220, stated that the certificate was “prima facie evidence of the amount due.” The court cited only part of the definition of prima facie evidence noted in State ex rel. State Dept, of Public Health & Welfare v. Ruble, 461 S.W.2d 909, 913 (Mo.App.1970), which stated that

“Prima facie evidence” means such evidence which, in law, is sufficient to satisfy the burden of proof to support a verdict ... when not rebutted by other evidence. Prima facie evidence, however, is not conclusive evidence, and while it suffices to support a judgment upon a fact so established, it does not require or demand a verdict for the party whose contention it supports.

(emphasis added). The Siecke

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Related

Downs v. Director of Revenue
791 S.W.2d 851 (Missouri Court of Appeals, 1990)

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Bluebook (online)
665 S.W.2d 626, 1983 Mo. App. LEXIS 3787, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ahr-v-bradley-moctapp-1983.