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Sheri Callantine (Callantine) brought the instant action after her termination by Staff Builders, Inc. A jury returned a verdict in favor of Callantine on her state law claims for wrongful termination and for failure to provide a service letter as required by Missouri state law.

Stewart, Jefferson City, Missouri, argued, for appellant/cross-appellee. Mc Donald, Springfield, Missouri, argued, for appellee/cross-appellant.

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Additionally, Callantine cross-appeals challenging the district court's entry of an order of remittitur, which decreased the punitive damage awards to ,000 and ,000, respectively.

Callantine provided skilled nursing services to homebound patients, primarily Medicare and Medicaid patients.

The evidence adduced at trial shows that medical personnel, such as Callantine, are required by Medicare to fill out Form 485 for patients who use Medicare as their primary insurance.

A Form 485 includes a doctor's prescription for the treatment of a patient: for example, the doctor's determination that a patient is homebound and requires home health care for a certain length of time.

Callantine described the Form 485 as: “It's the doctor's orders.” A Form 485 generally spans a two-month certification time period from the start-of-care date, but may be designated for a shorter period of time.