October 26, 2017
appeal from Superior Court of New Jersey, Law Division,
Special Civil Part, Warren County, Docket No. DC-1810-14.
Richard A. Mastro argued the cause for appellant (Legal
Services of Northwest Jersey, Inc., attorneys; Richard A.
Mastro, on the briefs).
Anthony J. Her argued the cause for respondent (The Law
Offices of Richard W. Krieg, LLC, attorneys; Anthony J. Her
and John T. Grogan, Jr., of counsel and on the brief).
Judges Simonelli, Haas and Rothstadt.
appeal, we are asked to determine whether a patient who
requires emergent psychiatric treatment, resulting in his
involuntary commitment to a hospital, should be treated
differently for charity care purposes than a patient who
suffers a physical injury or illness. This issue of first
impression arises from a dispute regarding a hospital's
attempt to recover payment from an indigent mental health
patient, who was involuntarily committed to its facility
after being screened by a psychiatric emergency screening
service (PESS), when the hospital followed the charity care
procedures applicable to a non-emergent admission instead of
those applicable to an admission through the hospital's
emergency room. The trial court determined on summary
judgment that the procedures governing a regular admission
applied, and the hospital was entitled to recover from the
patient based on a theory of quasi-contract. We disagree and
reasons that follow, we hold that when a mental health
patient is admitted to a hospital on an emergent basis
through the referral of a PESS, the provisions of the charity
care regulations dealing with emergency room admissions
facts giving rise to plaintiff, Newton Medical Center's
claim for payment from defendant, D.B.,  are undisputed.
Defendant, a diagnosed schizophrenic, was involuntarily
committed to plaintiff's short-term care facility
(STCF) on an emergent basis after he experienced
a psychotic episode and the Warren County PESS determined
that he was a danger to himself and others. After receiving
treatment at plaintiff's STCF from February 19 to
February 28, 2013, defendant accumulated a bill of $6745.50,
which he did not pay.
reported income in 2013 was well below the poverty level,
making him eligible for uncompensated care under New
Jersey's Charity Care Program, N.J.A.C. 10:52-11.1 to
-11.17. Defendant filled out and signed a charity
care application, but was advised that the application could
not be processed because he did not provide all of the
requisite documentation. Due to his condition,  defendant failed
to provide the documents within the allotted regulatory time
period. Plaintiff billed defendant, and subsequently sent
four letters demanding payment to defendant's
mother's address, where defendant was
residing. After he defaulted, plaintiff filed suit
for recovery of the unpaid bill.
trial, the parties filed cross-motions for summary judgment.
Defendant argued that plaintiff's claim was barred by the
payments it received from the DMHS. He contended that the
express contract between the State and plaintiff barred
plaintiff from recovering from him on a theory of unjust
enrichment because plaintiff could not have expected
remuneration from defendant. Defendant also asserted that
plaintiff could not recover because it failed to follow the
charity care application provisions of N.J.A.C. 10:52-11.16,
which governs emergency admissions. Plaintiff opposed
defendant's motion, arguing that N.J.A.C. 10:52-11.16 was
only applicable to patients admitted through the emergency
room, and that the provisions governing regular admission
were properly followed in defendant's case. In its
cross-motion, plaintiff maintained that because the facts
were undisputed and defendant presented no valid defenses, it
was entitled to judgment as a matter of law.
considering their submissions, the motion judge denied
defendant's motion and granted plaintiff's
cross-motion. As a threshold matter, the judge found that a
quasi-contract existed between plaintiff and defendant, which
entitled plaintiff to recover for the services it provided.
Relying on the plain meaning of the regulations, the judge
rejected defendant's argument that he should be afforded
the benefit of the same "stringent" regulations
applied to charity care applicants admitted to a hospital
through its emergency room for treatment of physical injuries
or illnesses. In his written statement of reasons, the judge
noted "defendant . . . provided no evidence that he was
admitted through an emergency room[, ]" which relieved
plaintiff of the screening requirements found in N.J.A.C.
10:52-11.16. The judge entered orders on March 10,
denying defendant's motion and granting plaintiff's
moved for reconsideration of the motion judge's grant of
summary judgment in favor of plaintiff and denial of his
motion for summary judgment. The judge entered an order
denying reconsideration on July 6, 2016. In his written
statement of reasons, the judge again explained:
The more stringent emergency room charity care regulations
apply only "[i]f a charity care applicant is admitted
through the hospital's emergency room." [N.J.A.C.]
10:52-11.16. The plain language of the regulation requires an
admission through the hospital's emergency room, in this
case [plaintiff's]. It does not apply to [a] transfer
from an emergency screening service or even from another
hospital's emergency room.
appeal from the motion judge's grant of summary judgment
and denial of reconsideration followed.
review a trial court's order granting summary judgment de
novo, applying the same standard as the trial court.
Conleyv. Guerrero, 228 N.J. 339, 346
(2017). That standard commands that summary judgment be
entered "if the pleadings, depositions, answers to
interrogatories and admissions on file, together with the
affidavits, if any, show that there is no genuine issue as to
any material fact challenged and that the moving party is
entitled to a judgment or order as a matter of law."
R. 4:46-2(c). When no issue of fact exists, and only
a question of law remains, we afford no special deference to
the legal determinations of the trial court. Manalapan
Realty, L.P. v. Twp. Comm. of Manalapan, 140 N.J. 366,
378 (1995). Because ...