decided: August 20, 1976.
COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF PUBLIC WELFARE, APPELLANT
AUSTIN WIEAND AND MARIANNE WIEAND, HIS WIFE, APPELLEES
Appeal from the Order of the Court of Common Pleas of Allegheny County in case of Commonwealth of Pennsylvania v. Austin Wieand and Marianne Wieand, his wife, No. 1394 April Term, 1973.
Robert S. Englesberg, Assistant Attorney General, with him Janet Moschetta, Assistant Attorney General, and Robert P. Kane, Attorney General, for appellant.
Matthew Verlich, with him Stokes, Lurie & Tracy, for appellee.
Judges Crumlish, Jr., Wilkinson, Jr., and Blatt, sitting as a panel of three. Opinion by Judge Blatt.
[ 26 Pa. Commw. Page 180]
The Commonwealth of Pennsylvania, Department of Public Welfare (DPW) filed a complaint in assumpsit on February 9, 1973 against Austin Wieand*fn1
[ 26 Pa. Commw. Page 181]
(defendant) to recover public funds expended by the DPW on his behalf. The Court of Common Pleas of Allegheny County granted judgment in favor of the defendant and the DPW has appealed, presenting the issue as to whether or not the DPW can use a per diem rate to compute the amount of money recoverable from a hospital patient.
On June 14, 1968, the defendant was involuntarily committed to Torrance State Hospital. On August 4, 1971, he signed a voluntary commitment application and, on November 2, 1971, he was discharged.*fn2 Section 501 of the Mental Health and Mental Retardation Act (Act), 50 P.S. § 4501 provides that "[w]henever public funds are expended under any provision of this act on behalf of a mentally disabled person, the governmental body expending such funds may
[ 26 Pa. Commw. Page 182]
recover the same from such person subject to the regulations of the department and for this purpose liability is hereby imposed upon such person admitted, committed or otherwise receiving any service or benefit under this act for all costs, payments or expenditures with reference thereto, including but not being limited to the costs of admission or commitment, transportation, treatment, training, maintenance, complete care, partial care or aftercare and discharge."
The DPW, pursuant to Section 504 of the Act,*fn3 50 P.S. § 4504, had determined that the defendant was financially capable of paying all costs attributable to his commitment*fn4 and billed the defendant for the moneys allegedly expended on his behalf in the total amount of $12,847.76, of which $8,412.80 has been paid, and filed suit seeking the balance of $4,434.96. Mr. Elridge Rager, the hospital's revenue agent, testified that the defendant was billed a per diem charge for each day spent in the hospital and that the DPW determined the per diem rate by taking the total cost of operating the institution and dividing that amount by the number of current patients.*fn5
[ 26 Pa. Commw. Page 183]
Section 5 of the Act of June 1, 1915, P.L. 661, as amended, 71 P.S. § 1785 provides as follows: "The sworn statement of the superintendent, steward, or other person in whose custody are kept the records of any hospital, home, asylum, or other institution not owned by the State wherein persons are maintained in part at the expense of this Commonwealth, and a statement of the Department of Revenue issued under its seal on behalf of any Stateowned institution wherein persons are maintained in part at the expense of the Commonwealth, shall be received as prima facie evidence in any court of this Commonwealth, of the amount expended by the Commonwealth for the support or maintenance of any such person, in any proceeding brought to recover the amount of such maintenance." (Emphasis added.)
The DPW introduced into evidence a "detailed and certified statement" of charges for the defendant's hospital care which indicated the periods of confinement, the total charges and total payments for each period, and the balance. This "statement" contained a certification that the claim was true and correct for the period of confinement indicated and that all absences from the institution had been credited, but it did not indicate specifically the days of attendance, or days of absence, and the applicable per diem rate. Although Mr. Rager could not detail the exact services received by the defendant, he testified that all patients received, and the per diem charge covered, overnight accommodations, daily meals and all necessary medical treatment and medication.
The lower court stated that "[n]o attempt was made by the Commonwealth during or subsequently [sic] to trial to offer any evidence, either oral or documented as to the precise number of days Austin
[ 26 Pa. Commw. Page 184]
Wieand was confined and/or hospitalized,*fn6 the number of meals he consumed, the amount of medical care and medicine administered to him, nor the pro rata costs of land, buildings and non-medical administration at Torrance State Hospital. In short, the 'detailed and certified statements' offered by the Commonwealth are nothing more than capsule summaries of services rendered. Although these statements are prima facie, the defendant has successfully challenged the adequacy of such 'statements' standing on their face."*fn7 (Footnote added.)
The lower court then concluded that if "charges are to be assessed for medical attention and hospital administration and upkeep, then it is incumbent for plaintiff to 'detail' instead of generalize actual services rendered" and entered judgment in favor of the defendant.
We believe that the lower court's opinion and decision as to the DPW's burden is in error as a matter of law and must be reversed. The Pennsylvania Supreme Court, in Reiver's Estate, 343 Pa. 137, 142, 22 A.2d 655, 657-658 (1941), held that, although it is "impossible to prove that each patient in an asylum or hospital receives his exact proportionate benefit
[ 26 Pa. Commw. Page 185]
from the total expenditures of the institution, the courts have never required the Commonwealth to prove, as a prerequisite to recovery of funds expended for maintenance of an inmate or patient, the exact expense incurred by the institution for the particular dependent, and, indeed, were such a requirement to exist, it would bar recovery altogether in such cases." (Emphasis added.)
We conclude, therefore, that, pursuant to Section 501 of the Act, a per diem charge may properly be used to determine the liability of persons subjected thereby to recovery of the public funds expended by public hospitals on their behalf. The DPW must, however, establish the exact number of days of institutionalization, and the applicable per diem rate, in order to inform the defendant fully as to the basis of the liability asserted against him and thereby to enable him to assert any available defenses. We, therefore, reverse the order of the lower court and remand the matter for a new trial.
Reversed and remanded.