St. Luke's Episcopal-Presbyterian Hosp. v. Underwood

• Decision Date: 16 December 1997
• Docket Number: No. 71758,EPISCOPAL-PRESBYTERIAN,71758
• Citation: 957 S.W.2d 496
• Parties: ST. LUKE'SHOSPITAL, Plaintiff/Appellant, v. Melvin UNDERWOOD and Shirley Underwood, Defendants/Respondents.
• Court: Missouri Court of Appeals

Page 496

957 S.W.2d 496

ST. LUKE'S EPISCOPAL-PRESBYTERIAN HOSPITAL, Plaintiff/Appellant, v. Melvin UNDERWOOD and Shirley Underwood, Defendants/Respondents.

No. 71758.

Missouri Court of Appeals,

Eastern District,

Northern Division.

Dec. 16, 1997.

Gary Underwood, Newton G. McCoy, St. Louis, for plaintiff/appellant.

E. Rex Bradley, Louisiana, for Shirley Underwood.

William C. McIlroy, Bowling Green, for Melvin Underwood.

CRANDALL, Judge.

Plaintiff, St. Luke's Episcopal-Presbyterian Hospital (hospital), appeals from the judgment of the trial court, entered in a court-tried case, in favor of defendants, Melvin Underwood and Shirley Underwood, at the close of the hospital's evidence, in an action to collect the unpaid balance of a hospital bill. We reverse and remand for a new trial.

The evidence established that defendant, Melvin Underwood (patient), was admitted to the hospital's emergency room on May 16, 1993 and underwent heart by-pass surgery on May 18. He alone signed agreements to authorize treatment and to pay for the services rendered by the hospital. He remained in the hospital until June 7, 1993. The bill for services rendered by the hospital totaled $112,673.58.

In February 1994, the hospital brought the present action against patient and patient's wife, Shirley Underwood (wife), to collect the unpaid balance of patient's account, $108,299.08, plus interest. The action was in two counts: Count I was on account; Count II was based upon written agreement to pay. Under Count I, the hospital alleged that wife, as patient's spouse, was jointly and severally liable for the necessaries provided to patient. In an affidavit attached to the hospital's petition the director of patient accounts stated that the services rendered were "necessary" and that the amount charged was "reasonable."

At trial, defendants moved for directed verdict at the close of the hospital's evidence on the basis that the hospital failed to prove that the services rendered were medically necessary and that the charges were reasonable. The trial court entered judgment in favor of defendants, stating that it was granting defendants' motion for directed verdict.

Before addressing the points on appeal, we consider the propriety of a directed verdict in a court-tried case. In a court-tried case, there is no verdict. Ford Motor Credit Co. v. Freihaut, 871 S.W.2d 129, 130 (Mo.App. E.D.1994). A motion for directed verdict is treated as submitting the issues on the merits. Id. Appellate review is therefore guided by the principles enunciated in Murphy v. Carron, 536 S.W.2d 30, 32 (Mo. banc 1976). The judgment of the trial court will be upheld unless there is no substantial evidence to support it, unless it is against the weight of the evidence, or unless it erroneously declares or applies the law. Id.

In its first point, the hospital contends the trial court erred in entering judgment in favor of defendants at the close of its evidence on the basis that the hospital did not prove the charges for the services rendered to patient were reasonable. It argues that had the trial court permitted the credit assistant to testify, her testimony would have provided sufficient proof of the reasonableness of the charges. When the hospital's counsel attempted to elicit testimony from the credit assistant that the charges were reasonable, the trial court sustained defendants' objections to the testimony on the ground that such testimony was beyond the expertise of the witness.

An action on account is an action based on contract. Massac Environmental Technologies, Inc. v. Futura Coatings, Inc., 929 S.W.2d 318, 320 (Mo.App. E.D.1996). Because the case before us is an action on account, the requisite elements to be proven are that patient requested that the hospital provide the services, patient accepted the services, and the hospital's charges were reasonable. See id. Here, the only element challenged by patient is the reasonableness of the charges for the services rendered by the hospital.

As to the issue of the reasonableness of the hospital's charges, the credit assistant testified that she had worked for the hospital for seven years and dealt with bills as part of her duties, which included the collection of accounts. She stated that the information contained in the hospital statement was recorded in the regular and ordinary course of the hospital's business as the services were provided to the patient. She testified that she was familiar with the method by which the hospital established its charges; namely, the hospital used a periodic survey of hospitals within the area to determine if its charges were in line with those of other hospitals. The credit assistant was qualified to testify on the issue of the reasonableness of the charges. See, e.g., Heartland Health Systems, Inc. v. Chamberlin, 871 S.W.2d 8 (Mo.App. W.D.1993) (Heartland's financial representative was permitted to testify that she was familiar with the charges in the medical industry for services of the same type as those rendered to defendants); Cardinal Glennon Children's Hosp. v. Clardy, 833 S.W.2d 44 (Mo.App. S.D.1992) (testimony of the supervisor of patient accounts sufficient to prove charges were reasonable); Board of Trustees of North Kansas City Memorial Hosp. v. Conway, 675 S.W.2d 36 (Mo.App.1984) (supervisor of credit and collection at the hospital was qualified to express an opinion on the reasonableness of the hospital's charges).

The trial court erred in excluding the credit assistant's testimony. If such testimony had been admitted, the hospital could have established the essential element of the reasonableness of the charges for the services...