Medical Services to Spouse Presumed Reasonable and Necessary

September 13, 2013 in Medical and Healthcare, Ohio Courts by Brad Council

The matter of Orchard Villa v. Irene Suchomma came before the Court of Appeals, Sixth Appellant District, in Lucas County Ohio on July 19, 2013.  The trial court found Ms. Suchomma to be liable for her deceased husband’s medical expenses.

In June, 2009, Joseph Suchomma signed a contract with appellee Orchard Villa to recuperate from a recent leg amputation. The contract contained a private pay provision.    His stay at Orchard Villa lasted until January, 2010.  Shortly after his release, Mr. Suchomma was diagnosed with leukemia and died on April 20, 2010. Prior to his death, Mr. Suchomma utilized Medicare Parts A and B and private insurance but had an outstanding balance of $20,692.80.  Orchard Villa then sued Mrs. Suchomma for the balance when she refused to pay.  The trial court agreed that Mrs. Suchomma was responsible for the outstanding balance.

The appellant asserts that the trial court erred by citing Rev. Code §3103.03 which provides that …  “(A) Each married person must support the person’s self and spouse out of the person’s property or by the person’s labor. If a married person is unable to do so, the spouse of the married person must assist in the support so far as the spouse is able. …”  The appellate court found that there was not sufficient evidence to indicate that Mrs. Suchomma was unable to pay the debt to Orchard Villa thereby upholding the trial court’s ruling.  The appellate court cites Kincaid, 48 Ohio St.3d at 80, 549 N.E. 2d 517 stating that the determination of a spouse’s ability to provide financially for one’s spouse “is a matter to be decided with the sound discretion of the trial court.”  Upon review, the appellate court did not find any abuse of that discretion. While the court admits that Mrs. Suchomma’s resources are limited, they believe that her sole ownership of the marital home as well as survivor benefit and her own income that she has is more than capable of aiding in her husband’s support as outlined in Rev. Code §3103.03. 

In her appeal, Mrs. Suchomma also contends that the service(s) provided by Orchard Villa were not in good faith as required the Rev. Code §3103.03 (C) which states:

 If a married person neglects to support the person’s spouse in accordance with this section, any other person, in good faith, may supply the spouse with necessaries for the support of the spouse and recover the reasonable value of the necessaries supplied from the married person who neglected to support the spouse unless the spouse abandons that person without cause.

The trial court record contains documentation that supports the fact that despite accumulating past-due balances, Orchard Villa continued to provide the same level of care throughout his stay there.  As such, the appellate court agreed with the trial court.

Mrs. Suchomma further contended that the balance due is not equivalent to the reasonable value of the services rendered.  Wagner v. McDaniels, 9 Ohio St.3d 184, 459 N.E.2d 561 (1984) states, “proof of the amount paid or the amount of the bill rendered and of the nature of the services performed constitutes prima facie evidence of the necessity and reasonableness of the charges.”  Orchard Villa provided all the bills and documentation to support the reasonableness of the services while Mrs. Suchomma provide only an assertion of the contract rate being unequal to reasonable value.  Further, Mr. Suchomma extended his stay by ten days without arguing the reasonableness of the contract rate.  The appellate court upheld the ruling of the trial court on this issue as well.

The Full Text of the Opinion May Be Found At:  http://www.supremecourt.ohio.gov/rod/docs/pdf/6/2013/2013-ohio-3186.pdf

Many thanks to Kim Goldwasser for her contributions to this article.  Kim is a paralegal with Slovin & Associates Co., L.P.A.