Holsopple v. Village Green-Trilogy Health Servs., L.L.C.

2023 Ohio 3729
CourtOhio Court of Appeals
DecidedOctober 13, 2023
Docket2023-CA-7
StatusPublished

This text of 2023 Ohio 3729 (Holsopple v. Village Green-Trilogy Health Servs., L.L.C.) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Holsopple v. Village Green-Trilogy Health Servs., L.L.C., 2023 Ohio 3729 (Ohio Ct. App. 2023).

Opinion

[Cite as Holsopple v. Village Green-Trilogy Health Servs., L.L.C., 2023-Ohio-3729.]

IN THE COURT OF APPEALS OF OHIO SECOND APPELLATE DISTRICT DARKE COUNTY

MARILYN K. HOLSOPPLE, POWER : OF ATTORNEY FOR MARCEIL : JOHNSTON : C.A. No. 2023-CA-7 : Appellant : Trial Court Case No. 23-CVI-001-0050 : v. : (Civil Appeal from Municipal Court) : VILLAGE GREEN-TRILOGY HEALTH : SERVICES, LLC :

Appellee

...........

OPINION

Rendered on October 13, 2023

MARILYN K. HOLSOPPLE, Appellant, Pro Se

PATRICK L. OJEIL, Attorney for Appellee

.............

TUCKER, J.

{¶ 1} Marilyn K. Holsopple appeals pro se from the trial court’s entry of judgment

against her on a small-claims complaint seeking to recover $5,680 from defendant-

appellee Village Green-Trilogy Health Services, LLC (“Village Green”).

{¶ 2} Holsopple filed the lawsuit purportedly in her capacity as power of attorney -2-

for her elderly mother, Marceil Johnston. The basis of the lawsuit was that Village Green

should have billed Medicare for the cost of Johnston’s stay at Village Green’s facility and

should have reimbursed Holsopple for her payment of the bill. Following a bench trial, the

trial court found Holsopple responsible for the bill because she had agreed to a private-

pay arrangement.

{¶ 3} On appeal, Holsopple contends Village Green misrepresented the nature of

the service it provided, fraudulently billed for a service it was not licensed to provide, and

committed elder abuse by having Johnston sign a document. The essence of her

argument is that “if Village Green held the proper license, Medicare could have been billed

and Medicare would have paid” the amount at issue. See Appellant’s Brief at 4.

{¶ 4} We conclude that the trial court correctly found Holsopple obligated to pay

the disputed bill. Holsopple also failed to prove any misrepresentation, fraud, or elder

abuse relieving her of her obligation under the private-pay agreement. Accordingly, the

trial court’s judgment will be affirmed.

I. Background

{¶ 5} Johnston stayed at Village Green’s skilled-care facility from July 21, 2021,

through September 10, 2021. Medicare covered the cost of this stay. On September 11,

2021, she was transferred to Village Green’s assisted-living facility, where she remained

through October 6, 2021. Village Green represented that Medicare would not pay for this

portion of Johnston’s stay, and Holsopple personally signed a private-pay agreement

acknowledging her responsibility to pay the bill. Holsopple then wrote a check to Village

Green to pay for her mother’s stay. The check was drawn on a joint checking account in -3-

the name of Holsopple and Johnston.

{¶ 6} After Holsopple paid the bill for her mother’s stay in the assisted-living facility,

she began asking Village Green to seek reimbursement through Medicare. Holsopple

insisted that “short-term rehab” stays were covered by Medicare. At Holsopple’s request,

Village Green eventually submitted the bill to Medicare, which denied coverage. At trial,

Holsopple testified that Medicare denied the claim because Village Green had billed it

incorrectly. She also testified about her belief that Village Green was not licensed to

provide short-term rehabilitation services. Holsopple asserted that Medicare would have

paid if Village Green had been licensed. In the absence of such a license, she argued

that Village Green had committed fraud.

{¶ 7} Village Green representative Gwen Huffaker also testified at trial. She

explained that Village Green operated a licensed skilled-care facility that was covered by

Medicare and a “residentially licensed” assisted-living facility known as “Assisted Almost

Home” that was not covered by Medicare. Huffaker testified that on September 11, 2021,

Johnston was transferred from the skilled-care facility to the assisted-living facility. At that

time, Johnston signed a notice of Medicare non-coverage. In addition, Holsopple signed

a self-pay agreement and later paid for her mother’s stay with a check.

{¶ 8} Huffaker testified that she could not bill Johnston’s assisted-living stay as

“Medicare covered” because it was not, and doing so would constitute insurance fraud.

Huffaker explained that she had billed the assisted-living stay as “non-covered” because

Holsopple had insisted that her private supplemental insurance would cover the expense

if Huffaker submitted it to Medicare. Huffaker’s own understanding was that if Medicare -4-

would not pay, then supplemental insurance would not pay either.

{¶ 9} On cross-examination, Huffaker testified that Village Green had no

mechanism to bill Medicare for an assisted-living stay because it was not covered by

Medicare. For that reason, Huffaker submitted the bill to Medicare as non-covered, and

Medicare denied payment. It appears that Holsopple’s supplemental insurance did not

pay the bill either. Finally, Huffaker clarified that Village Green did offer Medicare-covered

short-term “rehab stays” in its licensed skilled-care facility. She reiterated that Johnston

was in the residential assisted-living facility, not the skilled-care facility, during the time in

question.

{¶ 10} The trial court entered judgment in favor of Village Green, reasoning:

Based on the evidence provided to the Court and testimony of the

parties, the Court finds that Marilyn Holsopple is properly before the Court

as Power of Attorney for Marceil Johnston. Marceil was a patient/resident

at Village Green initially in a skilled nursing bed then moved to assisted

living. Plaintiff agreed to the private pay requirement of the move to assisted

living at the rate of $168.00, and [was] notified that the bed that Marceil was

moved to would not be covered by Medicare. All invoices were paid in full

by Plaintiff to Defendant. Plaintiff brings this lawsuit for her money back

alleging Defendant failed to bill Medicare properly for the assisted living bed

and Plaintiff was wrongly charged.

The Court finds that the notification of the move to assisted living was

proper and that the agreement to private pay the daily rate of $168.00 is -5-

enforceable. Defendant cannot change the status of Marceil’s stay to

something covered by insurance when all parties were aware of the private

pay status at the time of transition.

Therefore, the Court finds that Plaintiff failed to meet her burden of

proof by the preponderance of the evidence that monies are due from

Defendant. * * *

March 15, 2023 Judgment Entry at 1.

{¶ 11} On April 18, 2023, we issued a show-cause order questioning whether the

present appeal should be dismissed on the basis that it had been filed by Holsopple, a

non-lawyer, on behalf of her mother. Holsopple responded by arguing that she was

proceeding pro se despite her reference to acting as power of attorney.

{¶ 12} Having reviewed the record, we note that Holsopple signed the private-pay

agreement in her own capacity, obligating herself to pay for her mother’s stay at Village

Green. Holsopple subsequently paid the bill with a check drawn on a joint checking

account she shared with her mother. Under these circumstances, we are persuaded that

Holsopple in fact is acting pro se on appeal and asserting a personal right to

reimbursement from Village Green. Finding our show-cause order satisfied, we will

proceed to the merits of the appeal.

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2023 Ohio 3729, Counsel Stack Legal Research, https://law.counselstack.com/opinion/holsopple-v-village-green-trilogy-health-servs-llc-ohioctapp-2023.