County of Lander v. BOARD OF TR. OF ELKO GEN. HOSP.County of Lander v. BOARD OF TR. OF ELKO GEN. HOSP.
OPINION
By the Court,
This аppeal from a judgment in favor of respondent and against the appellant county in the sum of $5,416.64 for the balance due for hospital services rendered to a resident of Lander County, who was without means to pay the same, presents the following issues! These issues, although not so stated in appellant’s opening brief, appear to us to be (1) whether the Elko General Hospital had the right in the first instance to make the determination that the patient, one Frank P. Grunstad, was an indigent or poor person; (2) whether, assuming the hоspital had this right, Grunstad was in fact an indigent or poor person as held by the trial court; and (3) whether the respondent hospital gave sufficient notice to the appellant county in compliance with the requirements of the statute.
We first turn to the facts. Frank P. Grunstad resided in Battle Mountain, Lander
For many years prior to his death, Mr. Grunstad lived in or near Battle Mountain, in Lander County, and was engaged in various mining and other ventures. At the time of his initial hospitalization in February, 1963, he was unemployed but drawing old-age insurance benefits. His livelihood was substantially dependent upon these insurance payments, even though testimony at the trial indicated he did odd jobs from time to time as they were available and as his health permitted. He had never applied for or been granted indigent or pauper’s aid by Lander County or the state. Hе owned no real or personal property except his immediate personal effects. He had recently owned an automobile which was wrecked and apparently never repaired. He has at least two brothers, one living in Sparks, Nevada, who appeared and testified as a witness for the plaintiff-respondent, and one living somewhere in California.
Mr. Grunstad traveled to Elko from Battle Mountain in February, 1963, and as a private patient consulted John M. Read, M.D. He was admitted to the Elko General Hospitаl under the care of Dr. Read on February 13, 1963. An esophageal biopsy was performed by Hugh S. Collett, M.D., on February 14. Mr. Grunstad was discharged from the hospital on February 15, after incurring charges of $139.20, which sum was paid through his insurer, Bankers Life of Chicago, Illinois. There is no evidence that hе was looked upon or considered to be an indigent during this period of hospitalization. No notice of this hospitalization or his financial condition was given to Lander County.
On March 6, 1963, he was re-admitted to the Elko General Hospital and two major operatiоns were performed upon him. He remained in the hospital until his death on July 24, 1963. From the date of his re-admission to the hospital until his death, he was under the care of Dr. Collett, and at no time was his condition sufficiently improved to enable him to leave the hospital and be сared for either at home or at the hospital in Battle Mountain. His hospital ledger sheet indicates he lived in Battle Mountain, was an unemployed laborer, classified as insured, gave the name and address of his brother in Sparks, and listed his insurance carrier as Bankеrs Life under policy No. 54562431. When he died, he had incurred hospitalization costs of $6,006.75. Of this sum, $139.20 was apparently paid by his insurer; and his brother, D. W. Grunstad, testified that he paid $450.91 from the proceeds of three social security checks belonging to the decedent, which he had obtainеd in some sort of probate proceedings in Washoe County. Part of the latter funds were applied to the payment of the decedent’s debts and his funeral expenses, the remainder of the balance available being paid to the Elko General Hosрital. These transactions left a balance owing the hospital of $5,416.64, the amount of the judgment recovered by the respondent in the lower court.
The first notice given Lander County by the Elko Hospital that Mr. Grunstad was a patient there, claimed by the hospital to be а resident of Lander County, an indigent, pauper, poor person or incapacitated by disease, and the responsibility of Lander County was the notice or letter, dated March 8, 1963. This letter, signed by the business manager of the hospital, was addressed to the “Board оf County Commissioners, Lander County, Austin, Nevada.”
1
It was received
Respondent filed its action аgainst Lander County on the basis of the provisions of
The appellant county contends that the determination of Grunstad’s status was entirely within the jurisdiction of the Board of County Commissioners of Lander County and that said county commissioners were unlawfully ousted of such jurisdiction by the аction of the superintendent of the Elko General Hospital in determining that Grunstad was a pauper or poor or an indigent person. We think, however, that it is clear from a reading of NB.S 450.400 that the original determination of Grunstad’s status must be made by the hospital.
The factual determination is beyond doubt, as Grunstad’s assets were grossly inadequate to provide the needed medical care. A realization on all his assets provided only $450.91 on the hospital’s bill of $6,006.75. Evidence as to his status and as to the extent of his assets and as to the hospitаl bill were all produced before the district court and amply justify the court’s findings.
The notice addressed to the Board of County Commissioners of Lander County complied in all respects with the requirements of the statute.
A county’s obligation to support indigents, paupers, аnd poor people results only from a statutory provision imposing such a legal obligation. 41 Am.Jur., Poor and Poor Laws § 2. This obligation is fixed in this state by
the provisions of
Authorities to the contrary did not involve such a statute as
Lander County of course had the right to challenge Grunstad’s status in the action in the district court and to rebut the hospital’s determination that he was entitled to relief and aid. This it attempted to do without success. The evidence shows that he was previously hospitalized and his insurance company paid his $139.20 bill; that he received old-age insurance payments which he lived upon; that he had no assets or real property; and that he was unemployed prior to being admitted to the hospital in March. The appellant tried to establish that Mr. Grunstad had a good credit standing in the community. The sheriff of Lander County testified that Mr. Grunstad always paid his $10 a month cabin rent onе month in advance; and to the question of whether Mr. Grunstad was a man in the community whose credit was good, he stated, “yes, because I never heard anything to the contrary.”
Although a person has some property, he may still be considered a pauper or indigent if such property is not available for his immediate relief or is manifestly disproportionate to his needs. Annot.,
Appellant relies on Lander County v. Humboldt County,
Two rulings of the trial court on the admissibility of evidence are cited as reversible. We do not so find thеm and consider any enlarged discussion unnecessary.
The judgment is affirmed.
Notes
The letter was signed by the business office manager of Elko General Hospital and was in the following words:
“Please be advised that Frank P. Grunstad who reports his address as Box 243, Battle Mountain, Nevada, was admitted to the Elko General Hospital on 3/6/63 under the care of Dr. Collett.
“The above mentioned patient reports: [he] became sick in your county, * * * and under section 450.000 of the Nevada Revised Statutes hospital privileges are being extended to this patient.
“Information regarding this рatient may be' secured from the attending Physician. Would you kindly forward your county voucher for submission of claim?”
“1. When the privileges and use of the hospital are extended to a resident of another county who is entitled under the laws of this state to relief, support, care, nursing, medicine, medical or surgical aid from such other county, or to one who is injured, maimed
or falls sick in such other county, the governing head shall immediately notify the board of county commissioners of such county.
“2. The notice shall be in writing and addressed to the board оf county commissioners of such county.
“3. The board of county commissioners receiving the notice shall cause such person to be removed immediately to that county, and shall pay a reasonable sum to the hospital for the temporary occuрancy, care, nursing, medicine, and attendance, other than medical or surgical attendance, furnished such person.
“4. If the board of county commissioners shall neglect or refuse to remove such person, or if in the opinion of the attending physician it is not advisable to remove such person, the governing head shall have a legal claim against the county for all occupancy, nursing, care, medicine, and attendance, other than medical or surgical attendance, necessarily furnished, and may recover the same in a suit at law.”