State ex rel. Eagleton v. Patrick

• Decision Date: 09 September 1963
• Docket Number: No. 1,No. 49828,49828,1
• Citation: 370 S.W.2d 254,97 A.L.R.2d 1180
• Parties: STATE of Missouri ex rel. Thomas F. EAGLETON, Attorney General, Respondent, v. Bonnie PATRICK, Appellant
• Court: Missouri Supreme Court

Page 254

370 S.W.2d 254

97 A.L.R.2d 1180

STATE of Missouri ex rel. Thomas F. EAGLETON, Attorney General, Respondent, v. Bonnie PATRICK, Appellant.

No. 49828.

Supreme Court of Missouri, Division No. 1.

Sept. 9, 1963.

Roswell Henderson, Moberly, for appellant.

Thomas F. Eagleton, Atty. Gen., Clyde Burch, Asst. Atty. Gen., Jefferson City, for respondent.

WELBORN, Commissioner.

The Attorney General of Missouri, as authorized by Sec. 198.160, ¹ commenced this action in the Randolph County Circuit Court to enjoin appellant's alleged operation in Moberly of a nursing home, without a license, required to be issued, under Chapter 198, by the State Division of Health.

The circuit court issued a temporary restraining order upon the suit being filed and, upon submission of the cause, granted a permanent injunction. After motion for a new trial had been overruled, defendant appealed to this court. The State 'in its own behalf' is a party to the action. State ex rel. Thrash v. Lamb, 237 Mo. 437, 141 S.W. 665. We have jurisdiction of the appeal. State ex rel. Collet v. Scopel, Mo.Sup., 316 S.W.2d 515.

Section 198.011 V.A.M.S., enacted in 1957 (Laws of Mo., 1957, p. 666), provides, in part, as follows:

'(1) The term 'nursing', 'convalescent' or 'boarding' home means a private home, institution, building, residence or other place, whether operated for profit or not, which provides, through its ownership or management, maintenance, personal care or nursing for three or more individuals not related to the operator, who by reason of illness, physical infirmities or advanced age are unable to care for themselves; or provides sheltered care to three or more individuals not related to the operator, which includes treatment or services which meet some need of the individual beyond the basic requirements for food, shelter and laundry. The term shall not include the following:' Certain exceptions follow, but appellant does not claim the benefit of any of them.

The defendant contended in the trial court, and, as appellant here, that she was not engaged in an operation requiring a license under this statute.

According to the agreed statement of facts upon which the case was submitted, the appellant began operating her 'home' at 1127 Henry Street, in Moberly, some time subsequent to the effective date of the 1957 licensing act, the exact date not appearing. Mrs. Patrick 'held herself out to patients and relatives as being able to provide care'. She inserted advertisements in the Moberly Monitor-Index, soliciting bed patients for her home.

Following the receipt of 'numerous' complaints that appellant was operating an unlicensed nursing home, a licensed physician and a registered nurse representing the State Division of Health, went to the home at 10:00 A.M., December 15, 1961. The appellant was not present at that time, but an employee, who was a licensed practical nurse and who was 'left in charge of the premises,' admitted the inspectors without objection upon their identifying themselves.

At the time of the inspection, there were seventeen 'patients' in the home. Five of the 'patients' had been transferred from hospitals or licensed nursing homes and were under the care of their own licensed private physicians. Three of the 'patients' had been adjudicated incompetent by the Probate Court of Randolph County. In the medical opinion of the Division of Health inspectors, five persons in the home required and needed 'sheltered care, nursing care and medical supervision, above and beyond the basic requirements of food shelter and laundry.'

The inspectors were in the home for approximately forty minutes. During their inspection they saw no personal service or nursing care rendered by anyone to the residents. At the time of the inspection, two wheel chairs, three commodes, five bedpans, three hospital beds, three sets of bedrails and two stocked medicine cabinets were being 'utilized' on the premises.

Mrs. Patrick admitted she kept more than four persons who needed nursing care. She denied, however, that she provided any care, other than food, shelter and laundry, or treatment for them or any other patients. She served food at mealtime on cafeteria style trays. Food service was provided either at the bedside of the patient or in a chair, if the patient was sitting up. Mrs. Patrick did change and launder sheets and bed clothes in all rooms of the home.

According to the agreed statement, the position of the appellant was that she could keep as many patients as she wished who need care so long as she did not provide the needed care. In her brief in this court, she contends that the statute must be construed strictly in her favor and that the facts and circumstances enumerated in the agreed statement could bring her within the statutory definition only by a 'strained interpretation' of Sec. 198.011.

In construing Sec. 198.011, we reject appellant's contention that the section is to be strictly construed. The obvious purpose of this statute is to protect the health and safety of citizens who are unable fully to take care of themselves, particularly the more elderly persons, who, from necessity or choice, spend their later years in homes of the type which the statute would license and regulate. We know that the 1957 statute was enacted after a disastrous fire at a nursing home in Warrenton, in which more than 70 lives were lost. See Roport of Joint Committee on the Warrenton Fire, Senate Journal, 69th General Assembly (1957), p. 1240. Such an enactment as this is a vital and most important exercise of the state's police power. City of Chicago v. Heffron, 346 Ill.App. 248, 104 N.E.2d 846. As such its construction, consistent with its terms, should be sufficiently liberal to permit accomplishment of the legislative objective. 3 Sutherland, Statutory Construction (3rd ed.), Sec. 7202, p. 397.

In reviewing the evidence, we must keep in mind the requirement that the plaintiff, in an action such as this, must establish the violation of the statute and a right to an injunction by clear and convicting evidence. State ex rel. Taylor v. Anderson, 363 Mo. 884, 254 S.W.2d 609. However, the trial court could draw all reasonable and legitimate inferences from the evidence presented before it, and base ultimate findings upon such reasonable inferences. Howard v. Zweigart, Mo.Sup., 197 S.W. 46; Schanbacher v. Lucido Bros. Grocery Co., Mo.App., 93 S.W.2d 1076, 1081. Hogue v. Wurdack, Mo.App., 298 S.W.2d 492. We may do likewise upon our review here, reviewing, as we do in a case such as this, the matter on its merits, and, in view of the submission of the case on an agreed statement of facts, without the deference ordinarily in an equity appeal accorded the findings of the trial court. Berghorn v. Reorganized School Dist., 364 Mo. 121, 260 S.W.2d 573, 583(15).

Analysis of the statute shows that two separate operations are included within its definition of nursing, convalescent or boarding home. The first category includes institutions at which, through the ownership or management, there is provided maintenance, personal care or nursing, for three or more individuals not related to the operator, who, because of illness, physical infirmity or advanced age, are unable to care for themselves. The second category encompasses institutions which provide 'sheltered care to three or more individuals not related to the operator, which includes treatment or services which meet some need of the individual beyond the basic requirements of food, shelter and laundry.' Note that nothing is said as to the physical or mental capacity of the residents of institutions in this category.

A further classification of institutions covered by the law is found in Sec. 198.072 which requires the Division of Health to publish minimum standards for homes, 'distinguishing between the home which has professional nursing care, the home which has practical nursing care and the home which has only domiciliary or personal care.'

Pursuant to this statute, the Division of Health has issued regulations for professional nursing homes, practical nursing homes and domiciliary homes. These regulations define the three types of homes as follows:

'PROFESSIONAL NURSING HOME--A facility in which all nursing care shall be under the general direction of a registered professional nurse who shall assume responsibility for all nursing care within the facility and who shall perform her duties under the general direction of persons licensed to practice medicine or surgery in the state of Missouri. A professional nursing home shall be so equipped and designed that it may accommodate convalescent or other persons who are not acutely ill and not in need of hospital care, but who do require skilled nursing care under the direction of licensed physician.

'PRACTICAL NURSING HOME--A facility equipped to render service to the residents as found in the above definition of a professional nursing home. Such services shall be rendered within the limits of the practical nurse law. The practical nursing home does not meet the professional requirements of the professional nursing home. It must, however, render care under the direction of a physician licensed to practice medicine and surgery in the State of Missouri. Such care shall meet the requirements of the manual and code.

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