Published by Georgia Watch’s Court Watch on November 23, 2015

In a ruling on October 6, 2015, the Court of Appeals of Georgia held that signing patient registration and consent forms on behalf of an incapacitated adult does not necessarily mean assuming responsibility for the payment of hospital bills.

In Winterboer v. Floyd Healthcare Mgmt., 2015 Ga. App. LEXIS 579, the Court of Appeals applied ordinary rules of contract construction to “patient registration consent” forms that are typically provided to patients upon admission to a hospital. The Court affirmed that where there is an ambiguity, apparent or latent, in reading the form, such ambiguity should be resolved by looking at the form as a whole to ascertain the original intent of the parties. The decision further stressed an established rule of contract construction which states that ambiguities in a contract shall be read in the light least favorable to the drafter.

In 2011, Mrs. Winterboer, the appellant, took her now-deceased adult son, Joshua, to Floyd Medical Center for emergency treatment on two separate occasions. Joshua was severely incapacitated in a motor vehicle accident when he was a child and could not sign the patient intake forms himself. The form in dispute contained the usual language about assumption of liability for any payments due to the hospital and physicians for administered treatments. It also contained three separate signature lines, one titled “Signature of Patient”, another – “Signature of Person Acting for Patient”, still another – “Relationship to Patient”, clearly intended to provide specifics whenever the second line was used. The form also contained checkboxes under the signature lines that provided for the reasons why the patient was not signing the forms him- or herself. Among those boxes was the one titled “[i]t is impractical for the patient to execute the document because patient’s mental or physical condition is such that patient should not be asked to transact business.” Winterboer v. Floyd Healthcare Mgmt., 2015 Ga. App. LEXIS 579, at 8.

When Mrs. Winterboer took Joshua to the hospital for the first time, in April 2011, she signed the second line, described herself as “mother” in the third, and checked the “[i]t is impractical . . .” box. When the need arose to take Joshua to the hospital again in June 2011, Mrs. Winterboer put her name into the “Signature of Patient” line, Joshua’s name into the second line, and “mother” into the third. She again ticked the “[i]t is impractical . . .” box. Winterboer, above at 9.

The hospital’s attorneys argued that by signing the form in the “Signature of Patient” line in June 2011, Mrs. Winterboer assumed responsibility for payment of all hospital bills as described in the general payment guarantee section of the form. The trial court agreed and granted an order obligating Mrs. Winterboer to pay the hefty bill. Winterboer, above at 4.

Mrs. Winterboer argued that by checking the appropriate boxes on the form and providing the nature of her relationship to Joshua in the third signature line, she clearly indicated that she signed the form solely in a capacity as Joshua’s representative and was not liable for his medical bills. Winterboer, above at 4. The Court of Appeals agreed and reversed trial court’s order.

Applying established rules of contract construction and interpretation to the case, the Court found that the contract was indeed ambiguous due to the overall generality of the hospital bills liability assumption provision and the specificity of the signatures section, which appeared to limit the applicability of the liability assumption provision. The Court of Appeals held that Mrs. Winterboer, despite signing the form in the line titled “Signature of Patient” in June 2011, clearly intended to sign the form on behalf of her incapacitated son. The Court held that those facts were sufficient to conclude that Mrs. Winterboer signed the forms on behalf of her son and not her own. Therefore, she could not be held liable on any bills that the treatment produced. Winterboer, above at 15.

It is not clear what practical implications the decision might have on hospital billing practices generally. However, in the short-term, it is apparent that the parents and guardians may feel safer signing consent forms on behalf of their adult children in cases of genuine emergency, as Georgia courts are obviously not inclined to hold minor mistakes in the forms against them.