This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2006).
IN COURT OF APPEALS
In re the Estate of: Bertha Belle Borg, Decedent
Affirmed and remanded
Crow Wing County District Court
File No. P2-04-2944
Donald F. Ryan, Crow Wing County Attorney, Candace Prigge, Assistant County Attorney, 213 Laurel Street, Suite 31, Brainerd, MN 56401 (for appellant Crow Wing County)
Virginia J. Knudson, Borden, Steinbauer, Kreuger & Knudson, 302 South Sixth Street, P.O. Box 411, Brainerd, MN 56401; and
Julian J. Zweber,
Lori Swanson, Attorney General, Robin Christopher Vue-Benson, Assistant Attorney General, 1800 Bremer Tower, 445 Minnesota Street, St. Paul, MN 55101-2134 (for Amicus Curiae)
Considered and decided by Kalitowski, Presiding Judge; Klaphake, Judge; and Minge, Judge.
Borg began receiving medical-assistance benefits from appellant
In December 1993, Bertha found it increasingly difficult to live in her home. At this time, Jule moved into the homestead. Although she was working full time at the Brainerd Regional Treatment Facility, Jule assisted her mother with housekeeping, transportation, shopping, and safety matters. In January 1994, Bertha was evaluated by the Crow Wing County Social Services Department to determine her need for a nursing-home level of care. The evaluator concluded that despite Jule’s assistance, Bertha was “at risk of institutionalization without additional services.” The evaluator recommended that Bertha participate in a medical-assistance program that provided various services in the home. Both Bertha and Jule agreed, and Bertha began receiving homemaker services, personal-care-attendant services, registered-nursing services, equipment, bathroom remodeling, reimbursement for mileage to doctor appointments, and nutritional supplements under the elderly waiver program, a part of medical assistance.
2002, when Jule’s position at the
1987 until her death, Bertha received substantial medical-assistance payments. After Bertha’s will was admitted to probate,
appellant Crow Wing County filed a claim
against the estate, seeking to recover the medical-assistance benefits provided
for Bertha’s care. Because the only
significant asset of the estate was the home, the claim was in essence against
The county challenged the disallowance in the probate division of district court. The parties agreed to address whether the homestead was exempt from the county’s claim under Minn. Stat. § 256B.15, subd. 4(b) (2004), on cross-motions for summary judgment. The district court granted the estate’s motion and denied the county’s. Its decision focused on questions of institutionalization. The district court first determined that Bertha’s hospitalization did not constitute “institutionalization” under Minn. Stat. § 256B.15, subd. 4(b). Then the district court recognized that Minn. Stat. § 256B.15, subd. 4(b), referred to “institutionalization” in limiting medical-assistance claims against homestead, but ultimately decided that the statute was ambiguous and that, in this case, actual institutionalization was unnecessary to exempt the homestead from the county’s claim. Finally, the district court decided that medical-assistance claims in this setting are limited to the value of the nonhomestead property in the estate, that there were no nonhomestead assets, and that the respondent properly disallowed the claim. This appeal follows.
appeal from summary judgment, we consider two questions: “(1) whether there are
any genuine issues of material fact and (2) whether the [district] court
erred in [its] application of the law.” State by Cooper v. French, 460 N.W.2d 2,
The first issue is
whether in this setting the homestead exemption in
Both federal and state law govern the recovery of medical-assistance benefits. Since 1993, federal law has required states to pursue recovery of medical-assistance payments from estates of individuals over the age of 55 to whom medical-assistance benefits were provided. West Virginia v. Thompson, 475 F.3d 204, 207 (4th Cir. 2007) (citing 42 U.S.C. § 1396p(b)(1)(B)(ii) (2000)). But states must delay recovery until
no son or daughter of the individual (who was residing in the individual’s home for a period of at least two years immediately before the date of the individual’s admission to the medical institution, and who establishes to the satisfaction of the State that he or she provided care to such individual which permitted such individual to reside at home rather than in an institution), is lawfully residing in such home who has lawfully resided in such home on a continuous basis since the date of the individual’s admission to the medical institution.
42 U.S.C. § 1396p(b)(2)(B)(ii).
If the decedent who was single . . . is survived by one of the following persons, a claim exists against the estate in an amount not to exceed the value of the nonhomestead property included in the estate . . . .
. . . .
(b) a son or daughter or a grandchild who resided in the decedent medical assistance recipient’s home for at least two years immediately before the parent’s or grandparent’s institutionalization and continuously since the date of institutionalization, and who establishes by a preponderance of the evidence having provided care to the parent or grandparent who received medical assistance, that the care was provided before institutionalization, and that the care permitted the parent or grandparent to reside at home rather than in an institution.
policies are relevant to consideration of the controversy before us. First, it is the policy of the State of
the same time, we are dealing with a claim of the decedent’s daughter to the
Here, it is undisputed that Jule: (a) lived in Bertha’s home; (b) provided care that permitted Bertha to continue living at home rather than in a nursing home; and (c) has continuously resided in the home since approximately December 1993. Therefore, the sole disputed issue involves the institutionalization requirement of the statute.
The district court determined that Minn. Stat. § 265B.15, subd. 4, is ambiguous and considered the statute’s legislative intent. According to the district court, delaying institutionalization is “a primary purpose of the statute,” but actual “[p]revention of institutionalization [is] a more important objective.” The district court clearly believed that minimization of the county’s expenditures for medical assistance would be most effectively realized if, because of the family’s efforts, the decedent never entered an institution. The district court observed: “The requirement that a parent be institutionalized to invoke the two years of needed care rule adds nothing to [the] accomplishment of any possible purpose of [Minn. Stat. § 256B.15, subd. 4] (b), except to add an absurd and unreasonable requirement.” Because it did not believe it should enforce a patently absurd requirement, the district court concluded that the statute does not require actual institutionalization of the medical-assistance recipient.
The statutory directives for statutory interpretation provide that:
The object of all interpretation and construction of laws is to ascertain and effectuate the intention of the legislature. Every law shall be construed, if possible, to give effect to all its provisions.
When the words of a law in their application to an existing situation are clear and free from all ambiguity, the letter of the law shall not be disregarded under the pretext of pursuing the spirit.
are “not to challenge the wisdom of the legislature’s act from a distance, but
rather to give effect to its will as expressed in the unambiguous language of
the statute.” Olson v. Ford Motor Co., 558 N.W.2d 491, 496 (
much as we sympathize with the district court’s frustration, we conclude that
the institutionalization requirement of Minn. Stat. § 256B.14, subd. 4(b) is
not ambiguous. Subdivision 4(b) refers
to the concept four times. First, the
subdivision requires that the relative reside in the medical-assistance-recipient’s
home “for at least two years immediately before the parent’s . . .
Because we conclude that the statute unambiguously requires institutionalization, we reject the district court’s decision to read “institutionalization” out of the statute.
Second, in its brief, the estate argued that the district court erred by failing to treat Bertha’s hospitalization as institutionalization under Minn. Stat. § 256B.15, subd. 4(b). Prior to oral argument, the county moved to strike this argument because the estate failed to file a notice of review under Minn. R. Civ. App. P. 106. The county also filed a conditional motion to supplement the record with a 1994 Department of Human Services combined manual, if this court denied its motion to strike. By special-term order, this court granted appellant’s motion to strike the portions of respondent’s brief challenging the district court’s ruling that Bertha was not institutionalized and denied as moot appellant’s motion to supplement the record.
law-of-the-case doctrine provides that “when a court decides upon a rule of
law, that decision should continue to govern the same issues in subsequent stages in the same case.” Kornberg v. Kornberg, 525 N.W.2d 14, 18
Minnesota Rules of Appellate Procedure provide that “[i]n the interest of
expediting decision upon any matter before it, or for other good cause shown,”
this court may suspend certain requirements of the appellate rules.
At the outset, we recognize that faithful observance of appellate norms and rules is important and that, absent extraordinary circumstances, the rules should govern our decisions. Conversely, we recognize that a variety of factors may support our consideration of an issue. Consideration of an issue is appropriate for “good cause” if it promotes the full and proper determination of the case. Here, the district court was so profoundly disturbed by the institutionalization requirement that it took the extraordinary step of reading it out of the law. Whether institutionalization was required and what constitutes institutionalization are essentially two sides of the same coin. In this process, the district court found that Bertha was not institutionalized.
Another factor favoring consideration is presentation of the issue. Here, the parties have had a fair opportunity to present arguments on this issue. In the district court, the parties fully litigated the issue of whether Bertha was institutionalized. And the parties also had presented appellate argument on this issue. Respondent moved to strike in December 2006, well after briefing was completed. A review of the briefs demonstrates that both parties fully addressed the issue of whether Bertha’s hospitalization qualifies as institutionalization. The county has acted to supplement the record. Therefore, no prejudice results from our decision to address the issue.
Based on the unique considerations in this particular case, we determine that good cause exists and the interest of justice is served by our consideration of whether Bertha was institutionalized. We also grant the county’s motion to supplement the record and consider the material submitted.
Minn. Stat. § 256B.15, subd. 4(b), does not define “institutionalization,” “institutionalized,” or even “institution.” And because the meaning of the word “institutionalization” under this subdivision has never been examined by this court, there is no direct guidance on how to interpret it in this case.
The lack of clarity in the statute led the district court to essentially rewrite the statute. Finding that Bertha did not “reside” at the hospital, the district court concluded that Bertha was never institutionalized. While we reject the district court’s decision to read the word “institutionalization” out of the law or to add the words “or death” each time the word “institutionalization” appears, we recognize the district court’s frustration with the policy inconsistency in the law.
medical-assistance chapter of the Minnesota Statutes contains various
definitions of “institution” and “institutionalized” for use in other contexts. For example, subdivision 1a of the
estate-recovery statute provides that a county may pursue estate recovery when
the recipient “resided in a medical institution for six months or longer, received services under this chapter, and, at
the time of institutionalization or application for medical assistance,
whichever is later, the person could not have reasonably been expected to be
discharged and returned home.”
Also, on review, we have considered appellant’s submitted supplemental document, Minn. Dep’t of Human Servs., Combined Manual (1994). According to this document, DHS has limited “institutionalization” to mean admission to a long-term-care facility. However, this limit is only effective to the extent it is consistent with the statute.
are to give effect to a statute’s plain meaning. See
The use of these commonly recognized dictionary definitions in this case does not produce an absurd result. The fact that in some settings the medical-assistance program limits institutionalization to a nursing home and imposes varying durational requirements suggests that when no such limits appear in the statute in question, a less demanding definition is in order. Recall that the district court felt compelled to ignore the requirement of “institutionalization.” The violence to the law that comes from the district court’s approach is avoided by minimizing any place or time requirement. As the district court observed, the shorter the institutional stay, the greater the medical-assistance savings and the more logical the law. In our setting, there is no overriding policy that supports imposing a minimum time or narrow type-of-facility requirement to the definition of “institutionalization.”
Here, Bertha was admitted to the hospital with apparent lung cancer. Her condition was so acute that she was not discharged. She died within a week, and she never returned home. Her stay was mercifully brief. We conclude that on the facts presented, Bertha’s short hospital stay preceding her death qualifies as institutionalization for purposes of Minn. Stat. § 256B.15, subd. 4. Accordingly, although we disagree with the district court’s interpretation of Minn. Stat. § 256B.15, subd. 4, we affirm its ultimate denial of the county’s medical-assistance claim.
the county argues that the district court erroneously failed to apply the lien
provisions of Minn. Stat. § 256B.15. As
a preliminary matter, respondent contends that this issue is improper for
appellate consideration because it was not before the district court. Generally, we are precluded from considering
issues that were neither addressed nor decided by the district court. Thiele
v. Stich, 425 N.W.2d 580, 582 (
Here, the district court addressed the status of the county’s claim and ruled that it was properly denied in its entirety. Left unclear is whether the county can hold a lien against the homestead for medical-assistance expenditures when its claim in the estate has been limited to nonhomestead property and, given the lack of such property, completely denied. Although the district court’s decision does not address this aspect of the issue, it looms over this case like an 800-pound gorilla. Because the parties have fully briefed the issue, it is entirely a matter of statutory construction, it has a dramatic effect on the position of the parties in the future, and it will clearly continue to be a major issue in the ongoing probate proceeding, we will address the issue on appeal.
previously set forth in this opinion, in 2004,
2003, the following language was added to Minn. Stat. § 256B.15, subd. 4: “[T]he
personal representative shall make, execute, and deliver to the county agency a lien against the homestead property in
the estate for any unpaid balance of the claim . . . .” 2003
(a) If payment of a claim filed under this section is limited as provided in subdivision 4, and if the estate does not have other assets sufficient to pay the claim in full, as allowed, the personal representative or the court shall make, execute, and deliver a lien on the property in the estate that is exempt from the claim under subdivision 4 in favor of the commissioner of human services . . . . If the estate pays a claim filed under this section in full from other assets of the estate, no lien shall be filed against the property described in subdivision 4.
(b) The lien shall be in an amount equal to the unpaid balance of the allowed claim under this section remaining after the estate has applied all other available assets of the estate to pay the claim. The property exempt under subdivision 4 shall not be sold, assigned, transferred, conveyed, encumbered, or distributed until after the personal representative has determined the estate has other assets sufficient to pay the allowed claim in full, or until after the lien has been filed or recorded. The lien . . . shall attach to the property it describes upon filing or recording, and shall remain a lien on the real property it describes for a period of 20 years from the date it is filed or recorded.
contends that subdivision 1j applies only to the collection of an “allowed claim” and that because the
claim was disallowed on the basis of
the language in Minn. Stat. § 256B.15, subd. 4, there is no remaining claim
balance on which to base a lien. This is an awkward situation. The statute uses the word “claim” in an
ambiguous fashion. In evaluating this
problem, we first note that subdivision 1j specifically refers to claims that
are “limited as provided in subdivision 4,” the homestead exemption.
has challenged the statutory change as an unfair, retroactive surprise. We also note that the legislature, by
providing that the lien-provision amendments apply to deaths occurring on or
after August 1, 2003, expressly required application of the amendment to cases
such as this, when the recipient died after the effective date. A family member has no vested property right
in the homestead until after the medical-assistance recipient dies. This is not properly characterized as an
unfair, retroactive law. Finally, we note
that the legislature apparently was advised that the language in the 2003
amendment to Minn. Stat. § 256B.15 was unclear and further amended the law in
the 2005 session to clarify the status of the “claim” after the homestead
confused, the language in effect at the time of Bertha’s death in 2004 is not hopeless. To say that there can be no lien because the
homestead exemption destroys the claim and leaves no amount to be secured by
the lien is a strained interpretation of the law. Respondent’s position would render the lien
language in Minn. Stat. § 256B.15, subd. 1j meaningless. We are obliged to interpret a law to give
effect to all of its parts. See
Here, when disallowing the claim, the district court found that “the only asset in Bertha’s estate is her homestead.” We conclude that under Minn. Stat. § 256B.15, subds. 1j and 4, the county is entitled to place a lien on the homestead property to the extent there are not nonhomestead assets to satisfy the medical-assistance claim. The amount of the lien is the unsatisfied claim. Because the district court did not address the applicable lien provisions, we remand for determination of the extent of the lien consistent with this opinion.
Affirmed and remanded.
 The statutes defining the county’s right to recovery
against a homestead for medical-assistance benefits have been amended several
times in ways that are relevant to this proceeding. This opinion interprets and applies the law
in effect at the time of decedent’s death.
As discussed at the conclusion of this opinion, the 2003 amendments
apply to deaths occurring after August 1, 2003.
 At various points, respondent asserts that it offered
to settle the case. However, the offer
was not accepted and is not relevant here.
 This emphasis on institutionalization is consistent with the previously quoted federal statute that no doubt influenced our state legislation. See 42 U.S.C. § 1396p(b)(2)(B)(ii).
 In its brief, respondent refers to several district court decisions presenting similar issues. In one decision, the district court refused to apply the 2003 amendments to the lien provisions, holding, inter alia, that to do so would constitute an unfair retroactive application of the statute. Another referred to the statutory scheme as being as “clear as mud.”
 After the 2005 amendment, the statute provides that “a claim exists against the
estate payable first from the value
of the nonhomestead property included in the estate and the personal
representative shall make, execute,
and deliver to the county agency a lien
against the homestead property in the estate for any unpaid balance of the
claim to the claimant as provided under this section . . . .” Minn. Stat. § 256B.15, subd. 4 (2006); 2005