Case Title: Cramer v. Auglaize Acres

Citation: 2007-Ohio-1946

Docket Number: 20051629

State: ohio

Court: Ohio Supreme Court

Date: 2007-05-09T00:00:00Z

Document:
[Cite as Cramer v. Auglaize Acres, 113 Ohio St.3d 266, 2007-Ohio-1946.] 
 
 
 
CRAMER, ADMR., APPELLANT, v. AUGLAIZE ACRES ET AL.,  APPELLEES. 
[Cite as Cramer v. Auglaize Acres, 113 Ohio St.3d 266, 2007-Ohio-1946.] 
Governmental immunity — Former R.C. 3721.17(I)(a) specifically abrogates 
governmental immunity and grants a cause of action to residents of 
unlicensed county nursing homes against a political subdivision for 
violations of R.C. 3721.10 through 3721.17, the Ohio Nursing Home 
Patients’ Bill of Rights. 
(No. 2005-1629 – Submitted October 18, 2006 – Decided May 9, 2007.) 
APPEAL from the Court of Appeals for Auglaize County,  
No. 2-04-39, 2005-Ohio-3609. 
__________________ 
SYLLABUS OF THE COURT 
Former R.C. 3721.17(I)(1) specifically abrogates governmental immunity and 
grants a cause of action to residents of unlicensed county nursing homes 
against a political subdivision for violations of R.C. 3721.10 through 
3721.17, the Ohio Nursing Home Patients’ Bill of Rights. 
__________________ 
LANZINGER, J. 
{¶ 1} In this discretionary appeal, we are asked whether governmental 
immunity, as set forth in R.C. Chapter 27441 applies to an unlicensed county 
nursing home and its employees.  We hold that R.C. 3721.17(I)(1)2 specifically 
abrogates governmental immunity and grants a cause of action to residents of 
                                                          
 
1 
Citations to R.C. 2744.02 and 2744.03 throughout this opinion refer to the version in 
effect as of January 2002.  Am.Sub.S.B. No. 108, 149 Ohio Laws, Part I, 382. 
 
2 
Citations to R.C. 3721.17 throughout this opinion refer to the version of that statute as it 
existed in January 2002.  Am.Sub.H.B. No. 94, 149 Ohio Laws, Part III, 4126, 4748-4751.  The 
current version is substantially similar. 
SUPREME COURT OF OHIO 
2 
unlicensed county nursing homes against a political subdivision for violations of 
R.C. 3721.10 through 3721.17, the Ohio Nursing Home Patients’ Bill of Rights. 
Case Procedure 
{¶ 2} Frank Cramer was 71 years old and a resident of Auglaize Acres, a 
county home created by the Auglaize County Board of County Commissioners 
pursuant to R.C. 307.01(A).  On January 27, 2002, around 8:00 p.m., Frank fell 
while two nurses employed by the home were helping him into bed using a Hoyer 
lift.3  Approximately five hours later, another nurse saw that Frank was in pain 
and that he had swelling in his left leg and foot and a deformity of the leg above 
the knee.  He was taken to the hospital, where he was diagnosed with a fractured 
left femur.  Following surgery to repair the break, Frank died on January 29, 
2002. 
{¶ 3} Appellant Rex Cramer, Frank’s son, filed a complaint as 
administrator of his father’s estate against appellees Auglaize Acres, the county 
commissioners, and Auglaize Acres employees Linda Green, R.N., and Margaret 
Warder, L.P.N.  Cramer’s first amended complaint alleged negligence or, in the 
alternative, falsification of medical records, intentional infliction of emotional 
distress, and violations of the Ohio Nursing Home Patients’ Bill of Rights 
(“Patients’ Bill of Rights”).  The complaint also claimed that the county was 
liable for its employees’ actions under theories of respondeat superior and agency 
by estoppel.  Appellees asserted a general denial and raised the defense of 
governmental immunity, as well as other affirmative defenses. 
{¶ 4} Appellees filed a motion for summary judgment, asserting that 
Auglaize Acres and the Auglaize County Board of County Commissioners were 
protected by the political subdivision immunity set forth in R.C. 2744.02(A)(1) 
                                                          
 
3 
A Hoyer lift is a device used to help get patients in and out of bed.  It involves placing a 
sling under a patient and attaching the sling to a metal frame with chains.  The patient is then 
lifted, and the frame is maneuvered to the desired location.  
January Term, 2007 
3 
and the defenses available in R.C. 2744.03(A)(3) and (5) and that Green and 
Warder were immune from liability, as employees of a political subdivision, 
under R.C. 2744.03(A)(6). 
{¶ 5} Appellees’ motion was granted in part and denied in part.  The trial 
court granted summary judgment to Green and Warder on the claim of 
negligence.  It granted summary judgment to Auglaize Acres and the Auglaize 
County Board of County Commissioners (“the county appellees”) on the claim of 
intentional infliction of emotional distress and on the claims of negligence and 
violation of patient rights insofar as punitive damages were sought.  It denied the 
summary judgment motion in all other aspects, finding that the allegation of 
wanton and reckless conduct precluded Green and Warder’s defense of immunity 
on the claim for intentional infliction of emotional distress, that R.C. 
3721.17(I)(1) created a cause of action against the nurses for allegedly violating 
Frank’s rights, and that the county appellees were not immune for their 
employees’ negligence. 
{¶ 6} Appellant and appellees appealed to the Third District Court of 
Appeals, with Cramer challenging the trial court’s application of governmental 
immunity as well as the constitutionality of R.C. Chapter 2744. 
{¶ 7} The Third District Court of Appeals affirmed in part and reversed 
in part. Cramer v. Auglaize Acres, Auglaize App. No. 2-04-39, 2005-Ohio-3609.  
The court of appeals affirmed the granting of summary judgment to the county 
appellees on the claim for intentional infliction of emotional distress; it agreed 
that the operation of the county home was a proprietary function and that R.C. 
2744.05(A) prohibited Cramer from collecting punitive damages against Auglaize 
Acres or the county commissioners; and it affirmed the holding that Green and 
Warder were not protected against allegations of intentional tort. 
{¶ 8} On the other hand, the court of appeals held that the trial court 
erred in failing to grant summary judgment to the county appellees on the claims 
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to the extent that they alleged intentional actions, in failing to consider a defense 
under R.C. 2744.05(A)(5) that Green and Warder’s decisions in providing 
medical care were discretionary, and in holding that R.C. 3721.17(I)(1) imposed 
liability on Green and Warder for violations of the Patients’ Bill of Rights.  We 
accepted appellant Cramer’s request for a discretionary appeal and agreed to 
determine whether governmental immunity, as set forth in R.C. Chapter 2744, 
applies to an unlicensed county nursing home and its employees when they are sued 
for violations of the Patients’ Bill of Rights.  It will not be necessary to reach the 
issue of whether R.C. Chapter 2744 is unconstitutional.  See Smith v. Leis, 106 
Ohio St.3d 309, 2005-Ohio-5125, 835 N.E.2d 5, ¶ 54 (“courts decide constitutional 
issues only when absolutely necessary”).  We hold that R.C. 3721.17(I)(1) 
specifically grants a cause of action to residents of county nursing homes, including 
unlicensed homes, against a political subdivision for violations of R.C. 3721.10 
through 3721.17, the Patients’ Bill of Rights. 
Patients’ Bill of Rights 
{¶ 9} Enacted in 1978, Am.Sub.H.B. No. 600, 137 Ohio Laws, Part II, 
3064 (“H.B. 600”), set forth a nonexhaustive list of rights for the safety, 
treatment, privacy, and civil rights of nursing home patients.  Previous legislation 
had been viewed as ineffective in ensuring the humane treatment of nursing home 
patients.  Note, H.B. 600: Ohio’s Bill of Rights for Nursing Home Patients 
(1980), 5 U.Dayton L.Rev. 507, 508-509.  The goal of H.B. 600 was “ ‘not to give 
special treatment to residents of nursing homes [but] to restore those human rights 
which have been eroded by misunderstanding, administrative convenience, or 
neglect.’ ”  (Emphasis sic.) Id. at 510-511, quoting Ohio Nursing Home Comm., 
113th Gen. Assembly, Final Report (July 1979) 10. 
{¶ 10} Currently, R.C. 3721.13 enumerates 32 subsections that outline a 
nursing home resident’s rights, which include the right to a safe and clean living 
January Term, 2007 
5 
environment;4 to be free from physical, verbal, mental, and emotional abuse;5 to 
adequate and appropriate medical treatment and nursing care;6 to confidential 
treatment of personal and medical records;7 to be free from certain physical or 
chemical restraints;8 to exercise all civil rights;9 to observe religious obligations 
and participate in religious activities;10 and to voice grievances without 
discrimination or reprisal.11  The administrator of the home is required to 
prominently post a copy of the nursing home patients’ rights as listed in R.C. 
3721.13.12 
{¶ 11} There are three alternative remedies when a nursing home 
resident’s rights under R.C. 3721.10 to 3721.17 have been violated: (1) the 
resident may file a grievance with a grievance committee established pursuant to 
R.C. 3721.12(A)(2),13 (2)  anyone who believes that a resident’s rights have been 
violated may file a report with the department of health,14 and (3)  a resident or 
the resident’s sponsor may file a civil lawsuit against any person or home 
                                                          
 
4  R.C. 3721.13(A)(1). 
 
5  R.C. 3721.13(A)(2). 
 
6  R.C. 3721.13(A)(3). 
 
7  R.C. 3721.13(A)(10). 
 
8  R.C. 3721.13(A)(13). 
 
9  R.C. 3721.13(A)(15). 
 
10  R.C. 3721.13(A)(20). 
 
11  R.C. 3721.13(A)(31). 
 
12  R.C. 3721.12(C)(1). 
 
13  R.C. 3721.17(A). 
 
14  R.C. 3721.13(B). 
 
SUPREME COURT OF OHIO 
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committing the violation.15  “The right to private action was included in the 
statute specifically because those who drafted the statute distrusted the 
Department of Health.”  Note, H.B. 600: Ohio’s Bill of Rights for Nursing Home 
Patients (1980), 5 U.Dayton L.Rev. 507, 523, fn. 108. 
{¶ 12} In this case, Cramer opted to file suit against the Auglaize County 
Board of County Commissioners, the nursing home, and the two nurses attending 
to his father when he fell out of the Hoyer lift.  Appellees all contend that they are 
immune to the claims brought against them pursuant to R.C. 3721.10 through 
3721.17. 
Governmental Immunity 
{¶ 13} In 1985, the General Assembly enacted R.C. Chapter 2744, the 
Political Subdivision Tort Liability Act, in response to the judicial abolishment of 
common-law sovereign immunity by this court’s decision in Haverlack v. Portage 
Homes, Inc. (1982), 2 Ohio St.3d 26, 2 OBR 572, 442 N.E.2d 749.  We described 
the framework for political subdivision immunity under R.C. Chapter 2744 in 
Colbert v. Cleveland, 99 Ohio St.3d 215, 2003-Ohio-3319, 790 N.E.2d 781: 
{¶ 14} “Determining whether a political subdivision is immune from tort 
liability pursuant to R.C. Chapter 2744 involves a three-tiered analysis.  Greene 
Cty. Agricultural Soc. v. Liming (2000), 89 Ohio St.3d 551, 556-557, 733 N.E.2d 
1141.  The first tier is the general rule that a political subdivision is immune from 
liability incurred in performing either a governmental function or proprietary 
function.  Id. at 556-557, 733 N.E.2d 1141; R.C. 2744.02(A)(1).  However, that 
immunity is not absolute.  R.C. 2744.02(B); Cater v. Cleveland (1998), 83 Ohio 
St.3d 24, 28, 697 N.E.2d 610. 
{¶ 15} “The second tier of the analysis requires a court to determine 
whether any of the five exceptions to immunity listed in R.C. 2744.02(B) apply to 
expose the political subdivision to liability.  Id. at 28, 697 N.E.2d 610.  * * * 
                                                          
 
15  R.C. 3721.17(I)(1). 
January Term, 2007 
7 
{¶ 16} “If any of the exceptions to immunity in R.C. 2744.02(B) do apply 
and no defense in that section protects the political subdivision from liability, then 
the third tier of the analysis requires a court to determine whether any of the 
defenses in R.C. 2744.03 apply, thereby providing the political subdivision a 
defense against liability.”  Colbert at ¶ 7 – 9. 
{¶ 17} For the individual employees of political subdivisions, the analysis 
of immunity differs.  Instead of the three-tiered analysis described in Colbert, R.C. 
2744.03(A)(6) states that an employee is immune from liability unless the 
employee’s actions or omissions are manifestly outside the scope of employment or 
the employee’s official responsibilities, the employee’s acts or omissions were 
malicious, in bad faith, or wanton or reckless, or liability is expressly imposed upon 
the employee by a section of the Revised Code. 
{¶ 18} Both lower courts in this case agreed that the county appellees were 
engaged in a proprietary function and that the exception to immunity under R.C. 
2744.02(B)(2)16 applied.  Those courts, however, did not agree on whether Green 
and Warder are themselves immune for their allegedly negligent actions.  The trial 
court found that the nurses’ immunity was abrogated because liability was imposed 
on them by R.C. 3721.17(I)(1).  The Third District determined that R.C. 
3721.17(I)(1) did not expressly impose liability on political subdivision employees 
and that therefore the nurses are immune. 
{¶ 19} Cramer also argued that the exception to political subdivision 
immunity under R.C. 2744.02(B)(5) applied to the county appellees because 
Warder’s and Green’s actions violated R.C. 3721.17(I)(1).  The Third District 
characterized this exception as moot and declined to consider it because the county 
appellees were already subject to liability under R.C. 2744.02(B)(2) for any 
                                                          
 
16 
R.C. 2744.02(B)(2) provided that political subdivisions may be “liable for injury, death, 
or loss to person or property caused by the negligent performance of acts by their employees with 
respect to proprietary functions of the political subdivisions.”  The determination that appellees 
had engaged in a proprietary function has not been challenged on appeal to this court. 
SUPREME COURT OF OHIO 
8 
negligent acts.  Cramer v. Auglaize Acres, 2005-Ohio-3609, at ¶ 36.  We do not 
agree.  Unlike sections R.C. 2744.02(B)(1) through (4), R.C. 2744.02(B)(5) is not 
limited to negligent actions.  Therefore, we must also examine whether the 
exception to immunity pursuant to R.C. 2744.02(B)(5) applies. 
Liability Expressly Imposed by R.C. 3721.17(I)(1) 
{¶ 20} If the General Assembly expressly imposes liability on a political 
subdivision in another section of the Revised Code, a political subdivision is liable 
for injury, death, or loss to person or property.  In 2002, R.C. 2744.02(B)(5) 
provided, “In addition to the circumstances described in divisions (B)(1) to (4) of 
this section, a political subdivision is liable for injury, death, or loss to person or 
property when liability is expressly imposed upon the political subdivision by a 
section of the Revised Code, including, but not limited to, sections 2743.02 and 
5591.37 of the Revised Code.  Liability shall not be construed to exist under 
another section of the Revised Code merely because a responsibility is imposed 
upon a political subdivision or because of a general authorization that a political 
subdivision may sue and be sued.”  Similarly, R.C. 2744.03(A)(6)(c) provided that 
an employee will not be immune if “[l]iability is expressly imposed upon the 
employee by a section of the Revised Code.” 
{¶ 21} Cramer contends that R.C. 3721.17(I)(1) expressly imposes liability 
on the county and its employees, without distinguishing between negligent and 
intentional acts.  This section states: “Any resident whose rights under sections 
3721.10 to 3721.17 of the Revised Code are violated has a cause of action against 
any person or home committing the violation.” (Emphasis added.)  Appellees 
argue that R.C. 3721.17(I)(1) does not satisfy the requirements of R.C. 
2744.02(B)(5) or 2744.03(A)(6)(c) by expressly imposing liability on either the 
county appellees or their employees, Green and Warder.  Appellees contend that 
R.C. 3721.17(I)(1) is a statute that imposes general sanctions against everyone 
rather than against a political subdivision or its employees. 
January Term, 2007 
9 
{¶ 22} Appellees also assert that there is no clear intention to impose 
liability on a county home because a county home does not qualify as a “home” 
under the Ohio Nursing Home Patients’ Bill of Rights.  They rely on R.C. 
3721.01(A)(1)(c)(xi), which provides that “home” does not mean “[a] county 
home or district home that has never been licensed as a residential care facility.”17  
                                                          
 
17               {¶ a} The definition of “home” under R.C. 3721.01 is as follows: 
{¶ b} “(A) As used in sections 3721.01 to 3721.09 and 3721.99 of the Revised Code: 
{¶ c} “(1)(a) ‘Home’ means an institution, residence, or facility that provides, for a 
period of more than twenty-four hours, whether for a consideration or not, accommodations to 
three or more unrelated individuals who are dependent upon the services of others, including a 
nursing home, residential care facility, home for the aging, and a veterans' home operated under 
Chapter 5907. of the Revised Code. 
{¶ d} “(b) ‘Home’ also means both of the following: 
{¶ e} “(i) Any facility that a person, as defined in section 3702.51 of the Revised 
Code, proposes for certification as a skilled nursing facility or nursing facility under Title XVIII 
or XIX of the ‘Social Security Act,’ 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended, and for 
which a certificate of need, other than a certificate to recategorize hospital beds as described in 
section 3702.522 of the Revised Code or division (R)(7)(d) of the version of section 3702.51 of 
the Revised Code in effect immediately prior to April 20, 1995, has been granted to the person 
under sections 3702.51 to 3702.62 of the Revised Code after August 5, 1989; 
{¶ f} “(ii) A county home or district home that is or has been licensed as a residential 
care facility. 
{¶ g} “(c) ‘Home’ does not mean any of the following: 
{¶ h} “(i) Except as provided in division (A)(1)(b) of this section, a public hospital or 
hospital as defined in section 3701.01 or 5122.01 of the Revised Code; 
{¶ i} “(ii) A residential facility for mentally ill persons as defined under section 
5119.22 of the Revised Code; 
{¶ j} “(iii) A residential facility as defined in section 5123.19 of the Revised Code; 
{¶ k} “(iv) A community alternative home as defined in section 3724.01 of the 
Revised Code; 
{¶ l} “(v) An adult care facility as defined in section 3722.01 of the Revised Code; 
{¶ m} “(vi) An alcohol or drug addiction program as defined in section 3793.01 of the 
Revised Code; 
{¶ n} “(vii) A facility licensed to provide methadone treatment under section 3793.11 
of the Revised Code; 
{¶ o} “(viii) A facility providing services under contract with the department of 
mental retardation and developmental disabilities under section 5123.18 of the Revised Code; 
{¶ p} “(ix) A facility operated by a hospice care program licensed under section 
3712.04 of the Revised Code that is used exclusively for care of hospice patients; 
{¶ q} “(x) A facility, infirmary, or other entity that is operated by a religious order, 
provides care exclusively to members of religious orders who take vows of celibacy and live by 
virtue of their vows within the orders as if related, and does not participate in the medicare 
program established under Title XVIII of the ‘Social Security Act’ or the medical assistance 
program established under Chapter 5111. of the Revised Code and Title XIX of the ‘Social 
SUPREME COURT OF OHIO 
10 
Although there is no dispute that Auglaize Acres is an unlicensed county home, 
appellees’ reliance on R.C. 3721.01 is misplaced.  This definitional section is 
limited to sections 3721.01 to 3721.09 and 3721.99 of the Revised Code.  R.C. 
3721.01(A). 
{¶ 23} Cramer contends instead that the broader definition of “home” 
found in R.C. 3721.10(A) should apply.  We agree.  R.C. 3721.10(A) begins by 
stating that it relates particularly to “sections 3721.10 to 3721.18 of the Revised 
Code.”  Pursuant to R.C. 3121.10(A): 
{¶ 24} “ ‘Home’ means all of the following: 
{¶ 25} “(1) A home as defined in section 3721.01 of the Revised Code; 
{¶ 26} “(2) Any facility or part of a facility not defined as a home under 
section 3721.01 of the Revised Code that is certified as a skilled nursing facility 
under Title XVIII of the ‘Social Security Act,’ 79 Stat. 286 (1965), 42 U.S.C.A. 
1395 and 1396, as amended, or as a nursing facility as defined in section 5111.20 
of the Revised Code; 
{¶ 27} “(3) A county home or district home operated pursuant to Chapter 
5155. of the Revised Code.” (Emphasis added.) 
{¶ 28} By adding to the definition of “home” found in R.C. 3721.01 
(which admittedly does exempt unlicensed county homes not licensed as 
residential care facilities18) a specific reference to “county homes” operated 
pursuant to R.C. Chapter 5155, the General Assembly expressed its intent to give 
                                                                                                                                                              
 
Security Act,’ if on January 1, 1994, the facility, infirmary, or entity was providing care 
exclusively to members of the religious order; 
{¶ r} “(xi) A county home or district home that has never been licensed as a 
residential care facility.” 
 
18  R.C. 3721.01(A)(1)(c)(xi). 
 
January Term, 2007 
11 
to all county nursing-home residents the rights set forth in R.C. 3721.10 through 
3721.17.19   
{¶ 29} This court has previously held that immunity is negated under R.C. 
2744.02(B)(5) and 2744.03(A)(6)(c) by the express provisions of R.C. 2151.421, 
which imposes liability on a political subdivision and its employees for a failure 
to report known or suspected child abuse.  In Campbell v. Burton (2001), 92 Ohio 
St.3d 336, 750 N.E.2d 539, we observed that R.C. 2151.421(A)(1)(b) listed those 
persons required to report abuse or neglect, and R.C. 2151.99 provided that 
whoever violated R.C. 2151.421 was guilty of a fourth-degree misdemeanor.  In 
holding that R.C. 2151.421 expressly imposed liability within the meaning of 
R.C. 2744.02(B)(5) and 2744.03(A)(6)(c), we stated: “[I]t is clear that the concern 
of the General Assembly in enacting R.C. 2151.421 was not political subdivisions 
or their employees, but the protection of children from abuse and neglect.”  Id. at 
341, 750 N.E.2d 539. 
{¶ 30} A similar sentiment is true in this case.  Like children, the elderly 
are vulnerable to abuse and neglect by others.  R.C. 3721.10 through 3721.17 was 
enacted to protect nursing home residents.  The General Assembly specifically 
included county homes operated pursuant to R.C. Chapter 5155 within its 
definition of the “homes” that can be sued and thus specifically imposed liability 
on county-operated homes for any violation of the Patients’ Bill of Rights. 
{¶ 31} The county appellees also argue that the General Assembly could 
not have intended to make unlicensed county homes subject to the Patients’ Bill 
of Rights because R.C. 3721.17(I)(2)(a) allows a resident to recover punitive 
                                                          
 
19 
R.C. 3721.10(A)(3) also does not distinguish between licensed and unlicensed county 
homes; therefore, the fact that Auglaize Acres is an unlicensed county home does not prevent it 
from being a “home” under the plain language of R.C. 3721.10. 
 
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damages for a violation,20 and R.C. 2744.05(A) prohibits the award of punitive 
damages against a political subdivision.21  A conflict over the recovery of punitive 
damages does not prevent the application of R.C. 3721.17(I)(1) to the county 
appellees.  Although punitive damages may not be awarded against a political 
subdivision, we hold that R.C. 3721.17 expressly imposes liability on county-
operated nursing homes for violations of R.C. 3721.10 through 3721.17.  Thus 
Cramer’s cause of action against the county appellees under the Patients’ Bill of 
Rights falls under the exception to immunity found in R.C. 2744.02(B)(5). 
{¶ 32} With respect to nurses Warder and Green, the court of appeals 
determined that the use of the term “person” in R.C. 3721.17(I)(1) was too 
general to expressly impose liability on an employee of a political subdivision.  
Unlike the term “home,” the term “person” is not defined in the Patients’ Bill of 
Rights.  Under R.C. 3721.13, certain patients’ rights—such as the right to 
adequate and appropriate medical treatment and nursing care and the right to 
communicate with the home’s physician and employees in planning treatment or 
care—involve the conduct of nursing home employees, but there is no express 
statement that the employees of a county nursing home will be liable individually 
for violations of the Patients’ Bill of Rights.  We therefore hold that R.C. 
3721.17(I)(1) does not expressly impose liability on the employees of the county 
nursing home within the meaning of R.C. 2744.03(A)(6)(a).  Thus, Cramer has no 
cause of action against the nurses under the Patients’ Bill of Rights. 
Defense under R.C. 2744.03(A)(5) 
                                                          
 
20  
The current version of the statute provides for an award of punitive damages under R.C. 
3721.17(I)(2)(b). 
 
21  
{¶ a} R.C. 2744.05 provides: 
{¶ b} “Notwithstanding any other provision of the Revised Code or rules of a court to the 
contrary, in an action against a political subdivision to recover damages for injury, death, or loss to 
person or property caused by an act or omission in connection with a governmental or proprietary 
function: 
{¶ c} “(A) Punitive or exemplary damages shall not be awarded.” 
January Term, 2007 
13 
{¶ 33} Because the exceptions to political subdivision immunity under 
R.C. 2744.02(B)(2) and (5) apply with regard to the county appellees, we must 
consider whether any defense under R.C. 2744.03 reinstates that immunity.  The 
court of appeals determined that there was a material issue of fact concerning 
whether the defense in R.C. 2744.03(A)(5) could be applied.  We agree. 
{¶ 34} R.C. 2744.03(A)(5) restores a political subdivision’s immunity if 
“the injury, death, or loss to person or property resulted from the exercise of 
judgment or discretion in determining whether to acquire, or how to use, 
equipment, supplies, materials, personnel, facilities, and other resources unless the 
judgment or discretion was exercised with malicious purpose, in bad faith, or in a 
wanton or reckless manner.”  Cramer argues that as a matter of law, the defense in 
R.C. 2744.03(A)(5) is not available to the county appellees.  He concedes that 
Green and Warder had discretion to decide whether to use the Hoyer lift to put 
Frank in bed.  But once the nurses decided to use the lift, Cramer maintains, there 
was no discretion left because there is only one method for using it.  Cramer also 
contends that after Frank fell, the nurses failed to follow Auglaize Acre’s policy 
regarding falls. 
{¶ 35} We do not agree that the decision to use the Hoyer lift is the only 
discretionary act involved, for the nurses’ treatment decisions concerning Frank 
are also discretionary.  Furthermore, the proper method for using the Hoyer lift 
and the issue of whether the nurses properly followed the home’s policy 
concerning patient falls are also disputed.  Because there are material issues of 
fact as to whether the nurses acted maliciously, in bad faith, wantonly, or 
recklessly,  we cannot say as a matter of law that R.C. 2744.03(A)(5) is 
inapplicable in this case.  Resolution of these questions will be for the factfinder 
to decide. 
Conclusion 
SUPREME COURT OF OHIO 
14 
{¶ 36} We 
hold 
that 
R.C. 
3721.17(I)(1) 
specifically 
abrogates 
governmental immunity and grants a cause of action to residents of unlicensed 
county nursing homes against a political subdivision for violations of R.C. 3721.10 
through 3721.17, the Ohio Nursing Home Patients’ Bill of Rights.  We hold further 
that R.C. 3721.17(I)(1) does not expressly impose liability on political 
subdivision employees within the meaning of R.C. 2744.03(A)(6)(a).  In this case, 
there is a material question of fact as to whether the defense in R.C. 
2744.03(A)(5) applies. 
{¶ 37} For the foregoing reasons, the judgment of the court of appeals is 
reversed to the extent that it refused to recognize a cause of action under the Ohio 
Nursing Home Patients’ Bill of Rights against Auglaize Acres and the Auglaize 
County Board of County Commissioners.  The judgment is affirmed in all other 
respects.  The case is remanded to the trial court for further proceedings. 
Judgment affirmed in part 
and reversed in part,  
and cause remanded. 
 
MOYER, C.J., MOORE, PFEIFER, LUNDBERG STRATTON, O’CONNOR and 
O’DONNELL, JJ., concur. 
 
CARLA D. MOORE, J., of the Ninth Appellate District, was assigned to sit 
for RESNICK, J., whose term ended on January 1, 2007. 
 
CUPP, J., whose term began on January 2, 2007, did not participate in the 
consideration or decision of this case. 
__________________ 
 
Wilson Law, Gregory D. Wilson, and Eric J. Wilson, for appellant. 
 
Ritter, Robinson, McCready & James, Ltd., Brad A. Everhardt, Timothy 
C. James, and Mark P. Seitzinger, for appellees. 
January Term, 2007 
15 
 
Paul W. Flowers Co., L.P.A., and Paul W. Flowers; Dickson & Campbell, 
L.L.C., and Blake A. Dickson, urging reversal for amicus curiae, Ohio Academy 
of Trial Lawyers. 
 
Isaac, Brant, Ledman &Teetor, L.L.P., Mark Landes, and Michael V. 
Passella; Benesch, Friedlander, Coplan & Aronoff, L.L.P., and Martha J. 
Sweterlitsch, urging affirmance for amici curiae, County Commissioners 
Association of Ohio and Ohio County Homes Association. 
 
Subashi, Wildermuth & Ballato, Nicholas Subashi, and Kate M. 
Rottmayer, urging affirmance for amicus curiae Ohio Association of Civil Trial 
Attorneys. 
 
William F. Schenck, Greene County Prosecuting Attorney, and Amy D. 
Ikerd, Assistant Mercer County Prosecuting Attorney, urging affirmance for 
amicus curiae, Ohio Prosecuting Attorneys’ Association. 
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