In re the Estate of: Raymond Deforest Trahan, Deceased.

This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2018).

STATE OF MINNESOTA
IN COURT OF APPEALS
A19-1020

In re the Estate of:
Raymond Deforest Trahan, Deceased.

Filed February 3, 2020
Reversed and remanded
Kirk, Judge*
Dissenting, Johnson, Judge

Rice County District Court
File No. 66-PR-18-1421

Terence Swihart, Faribault, Minnesota (for appellant Rice County Social Services)

Laura J. Zdychnec, Long, Reher, Hanson & Price, P.A., Minneapolis, Minnesota (for
respondent personal representative)

Considered and decided by Johnson, Presiding Judge; Florey, Judge; and Kirk,
Judge.
U N P U B L I S H E D O P I N I O N
KIRK, Judge
The county appeals a district court order denying its petition for an allowance of
claim against an estate to recover the cost of medical -assistance benefits provided d uring
the decedent’s lifetime. We reverse and remand.

* Retired judge of the Minnesota Court of Appeals, serving by appointment pursuant to
Minn. Const. art. VI, § 10.

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FACTS
In May 2010, Raymond D. Trahan began receiving medical -assistance benefits
through appellant Rice County Social Services (the county). He continue d to receive
medical-assistance benefits, including Elderly -Waiver (EW) benefits , until his death on
May 12, 2018. EW is a program that provides health services to individuals who need the
level of care provided in a nursing home but choose to remain living in the community.
On September 13, 2018, the county filed a written statement of claim with the Rice County
Court Administrator against Trahan’s estate for $158,384.35, the cost of the medical -
assistance benefits paid on behalf of Trahan during his lifetime. On October 18, 2018,
respondent Lisa Evert, Trahan’s daughter and the personal representative for his estate,
sent a notice of disallowance of claim to the county and filed it with the district court the
following day. The county then filed a petition for the allowance of the claim and requested
that the district court order Evert to pay the claim. The parties agreed to submit the matter
based on written briefs, and the district court took the matter under advisement on March
4, 2019.
In support of its petition, the county acquired an d submitted a claims history
generated by the Minnesota Department of Human Services ( DHS). The claims history
lists services totaling $158,384.35. In response, Evert requested information from U-Care,
the managed care organization that managed her fathe r’s medical -assistance benefits.
Evert alleged that the U -Care documentation reflects that her father only received
$25,963.66 worth of medical assistance during his lifetime and , therefore, the county’s

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petition to allow the claim should be denied. Evert summarized the U-Care documents in
a spreadsheet, which she submitted into evidence.
On May 31, 2019, the district court denied the county’s petition to allow the claim.
The district court determined that Trahan was not eligible for EW because he did not
require the level of care provided in a nursing home, and therefore he had been “wrongly”
offered the benefits and the benefits had “wrongly continued from year to year.” The
district court concluded that the EW benefits were not “correctly paid” and could not be
recovered by the county. The district court further concluded that because Trahan should
not have received EW benefits, the court could not determine which of the other claims
listed in the claims summary could be properly recovered, and denied the petition for
allowance of the claim in its entirety. This appeal follows.
D E C I S I O N
Medicaid is a joint federal and state program that aims to provide assistance to
individuals “whose income and resources are insufficient to meet the cost s of necessary
medical services.” 42 U.S.C. § 1396-1 (2012). In Minnesota, this program is called
medical assistance (MA) and is administered by DHS through each county’s human -
services agency. Minn. Stat. § 256B.01, .04, subd. 1 (2018). Under the prog ram,
individuals with “long -term or chronic -care needs” are eligible for long -term care
consultation services. Minn. Stat. § 256B.0911, subd. 1(a) (2018). One such service is the
EW program, which provides services to individuals for which there has been “a nursing
facility level of care determination” to allow them to remain in the community. Minn. Stat.
§ 256S.05, subd. 2 (Supp. 2019). Both federal and state law permit claims against an estate

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to recover the cost of these services. Under 42 U.S.C. § 1396p(b)(1)(B)(i) (2012), estate
recovery is permitted for “any medical assistance correctly paid” for “nursing facility
services, home- and community-based services, and related hospital and prescription drug
services.” Minnesota law requires the county to file a claim against the estate of a decedent
who “received medical assistance services that consisted of nursing facility services, home-
and community-based services, or related hospital and prescription drug benefits.” Minn.
Stat. § 256B.15, subd. 1a(e)(3) (2018).
The county argues that the district court erred by denying the petition to allow its
claim against the estate to recover the cost of MA benefits provided to Trahan. The county
timely filed a petition to recover the cost paid on behalf of Trahan for the above -listed
services. The claims summary submitted by the county included services that Trahan
received through the EW program, which are eligible for estate recovery . The county
argues that the district court misapplied the law when it determined that the county did not
have a valid claim against the estate because Trahan should not have been deemed eligible
for the EW program.
When the facts are not in dispute, we r eview the district court’s application of the
law de novo. In re Estate of Perrin, 796 N.W.2d 175, 178 (Minn. App. 2011). Here, it is
undisputed that Trahan received benefits through the EW program. But the district court
determined that Trahan was “wro ngly” offered the EW program and that it “wrongly
continued from year to year” because, based on the court’s review of the affidavits
submitted by Trahan’s children, Trahan did not require the level of care provided by a
nursing facility and was therefore not eligible for the EW program. The county argues that

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the district court misapplied the law when it made this determination because it is
inconsistent with the statutory framework that sets forth the process for making a nursing-
facility-level-of-care determination. We agree.
When an individual applies for the EW program, a nursing -facility-level-of-care
determination is required. Minn. Stat. § 256S.05, subd. 2. Under the statute, “only face -
to-face assessments conducted according to section 256B.09 11, subdivisions 3, 3a, and
3b . . . shall be accepted” for initial and ongoing participation in the EW program. Id.
Minnesota law requires that ass essors be certified. Minn. Stat. § 256B.0911, subd. 2b
(2018). The collaborative-care plan submitted indicates that Trahan was assessed utilizing
the “LTCC” assessment tool, which refers to the long -term care consultation assessment
method. This assessment method is outlined by Minn. Stat. § 256B.0911 (2018) and is the
assessment method referenced in the statute governing eligibility for the EW program.
Accordingly, the record reflects that Trahan was assessed and approved for the EW
program in accordance with the statutor y framework, while the district court’s
determination was plainly not made in accorda nce with the statutory requirements. The
district court therefore misapplied the law when it made an independent nursing -facility-
level-of-care determination and determined that Trahan should not have been deemed
eligible for the EW program. Evert argues that there was no method under the statute for
Trahan to appeal his participation in the EW program because an appeal is only available
when an applicant receives an adverse decision. But it seems absurd to argue that he would
feel aggrieved and want to appeal the determination that he was eligible for the program.
Trahan did not receive an adverse decision. Rather, he was approved for a program to

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which he chose to apply. Trahan subsequently accepted and received benefits through the
EW program, and re covery of the costs of such benefits from the estate is explicitly
authorized by law. Trahan could have notified the county at any time that he no longer
wanted or needed these benefits . There was no reason for him to file an appeal to end his
participation in the program. The district court therefore erred by determining that the
county could not recover the cost of the benefits paid to Trahan through the EW program.
The district court also determined that the county failed to establish the v alidity of
its medical claims summary by a preponderance of the evidence. But this determination
was based largely on the district court’s conclusion that it could not discern the charges
that could be recouped from those which could not—the benefits received after Trahan was
“improperly qualified for” the EW program. Because we conclude that the district court
erred in determining that the county could not recover the benefits paid through the EW
program, we must remand to the district court to reexamine the record in light of this
conclusion. We leave it to the discretion of the district court whether to reopen the record.
Finally, we note that Evert alleged that the county misled Trahan into applying for
and accepting EW benefits because a county wor ker informed Trahan that the cost of the
benefits would not be recoverable against the estate. Based on this assertion, she argued
in the memorandum of law in support of the denial of the claim, that the principles of due
process, notice, and equity shoul d bar recovery of the costs of the benefits Trahan was
misled into accepting. The district court acknowledged these arguments but did not reach

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any legal conclusions on them. Accordingly, the district court may consider these
arguments on remand.
Reversed and remanded.

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JOHNSON, Judge (dissenting)
“It is the policy of this state that individuals or couples, either or both of whom
participate in the medical assistance program, use their own assets to pay their share of the
cost of their care during or after their enrollment in the program according to applicable
federal law and the laws of this state.” Minn. Stat. § 256B.15, subd. 1 (2018). This general
policy is not being challenged by t he personal representative of the Estate of Raymond
Deforest Trahan. She argued to the district court that, for three reasons that are peculiar to
this case, the county is not entitled to the money it seeks from her father’s estate . The
district court carefully cons idered th ose arguments, made detailed findings of fact and
conclusions of law in her favor, and denied the county’s claim. The district court’s findings
of fact are not clearly erroneous, and its conclusions of law are not contrary to the
applicable statutes and caselaw. Therefore, I respectfully dissent from the opinion of the
court.
To understand the district court’s ruling, it is important to understand the evidentiary
record. Although the county sought a substantial amount of money, it submitted only one
piece of evidence to support that claim: an exhibit consisting of a 19-page, 487-line print-
out with letter and number codes, abbreviated descriptions of broad categories of services,
dates, and dollar figures that add up to $158,384.35. That document, by itself, does not tell
a story, and the county did not introduce any evidence to explain the document or give it
meaning. Similarly, in its memorandum of law, the county did not attempt to make sense
of the document or extract any meaningful information from it. The county practically
disclaimed responsibility for the document, stating that it merely had requested and

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received the document from the state department of human services. And the county
essentially admitted that the document may n ot be accurate, stating that “it is not
uncommon for total amounts to change” because “amounts billed may be adjusted at a later
date” and adjustments may occur “based on when MA providers provide their bill to DHS.”
The county’s arguments did not assist the district court by clarifying the document; i f
anything, the county’s arguments made the document appear less clear and less reliable.
The district court said as much, commenting , with apparent understatement, that the
county’s argument “does not inspi re confidence in the accuracy of the County list of
charges.”
On the other hand, the personal representative, Trahan’s daughter, Lisa Evert,
introduced a respectable body of evidence contradicting the county’s 19-page print-out and
otherwise undercutting the county’s claim. Evert introduced written correspondence
between her attorney and the county in which Evert sought explanations of the factual bases
of the county’s claim and its 19-page print-out. In response, the assistant county attorney
informed Evert’s attorney that, “unfortunately the only specific information the County has
is that which has already been provided.” Evert also introduced copies of two care plans
that were prepared by county social workers for Trahan in April 2015 and April 2017,
which prescribe certain services and state the monthly costs associated with each service .
A cursory review of expense s listed in the 19 -page print -out shows that it does not
correspond to the expenses described in the care plans. Having received no assistance from
the county, Evert commendably sought additional information from UCare, which was
identified in the care plans as the third -party provide r of services to Trahan. The

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information provided by UCare, which Evert summarized in a seven-page document, does
not correspond to the county’s 1 9-page print -out or the two care plans. Given the
information available to her, Evert very reasonably refused to pay the county’s claim.
In addition, Evert introduced two affidavits concerning whether her father qualified
for the services that the county provided to him. She stated that, while her father received
services from the county, he “continued to drive, and he rode his ATV frequently on the
trails by his home,” “lived alone and independently, drove himself on errands or to doctor
appointments, and m anaged all of his daily living activities (eating, bathing, toileting,
transferring, etc.) without assistance as documented in Rice County’s care plans.” Trahan’s
son, Dean Trahan, stated that , while Trahan was receiving services from the county, he
“managed the Tri -County ATV Park, which consisted of daily monitoring of the people
riding their ATVs at the park, all maintenance of the facility including running tractors, a
bulldozer, trimming trees along trails, using his gator to patrol the area, [and] mowing over
four acres of grass every summer.” Dean Trahan also stated that his father accepted the
county’s services “because he was told they were free services” and that his father “did not
know that those serv ices were recoverable” from his estate. Dean Trahan elaborated by
stating that a particular social worker, whom he named, told his father “that the services he
received were not subject to estate recovery,” and that Dean “specifically asked” the social
worker “if any of the benefits he received ever needed to be paid back . . . , and she stated,
‘No, he is not on any of those programs,’” and, “‘Ray, take advantage of this, it’s free.’”
The county did not introduce any evidence or argument to respond to or rebut
Evert’s evidence and argument . The lack of such evidence and argument may be

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attributable, in part, to a prior agreement between counsel to forgo a hearing and, instead,
simultaneously submit evidence and argument in writing. But nothing prevented the
county, after it had received and reviewed Evert’s evidence and memorandum of law, from
seeking leave from the district court to submit additional evidence and argument. In any
event, the district court was required to rule on the county’s claim based on the evidence
and arguments that the parties chose to present. It should be no surprise that the district
court, after reviewing the evidentiary record, denied the county’s claim.
I.
Evert’s first argument to the district court was that the county is not entitled to any
reimbursement for expenses it incurred on Trahan’s behalf on the ground that all such
expenses were not “correctly paid” because Trahan did not require a nursing -facility level
of care, which is a prerequisite of the program in which services were provided to him.
Evert argued to the district court that the applicable federal statute authorizes a state
or county to recover only the expenses of “medical assistance correctly paid on behalf of
an individual.” See 42 U.S.C. § 1396p(b)(1) (2018) (emphasis added). She further argued
that none of the expenses of the services provided to Trahan were “correctly paid” because
he was not eligible for those services because he did not require a nursing -facility level of
care. She identified a state statute providing that a person requires a nursing-facility level
of care only if he or she satisfies any one of seven criteria, such as needing assistance in at
least four activities of daily living (such as bathing, dressing, eating, groo ming, and
walking), needing assistance in using a toilet , and having significant difficulty with
memory. See Minn. Stat. § 144.0724, subd. 11 (20 18 & Supp. 2019 ). The district court

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adopted the legal premises of Evert’s argument and concluded that Trahan “did not qualify
for the Elderly Waiver program, which was wrongly offered and wrongly continued from
year to year” and that the county’s claim must be denied because it “incorrectly qualified
Mr. Trahan for the program.”
On appeal, the county does not dispute that 42 U.S.C. § 1396p(b)(1) applies. Also,
the county does not contend that Trahan ’s condition satisfied the criteria in Minnesota
Statutes section 144.0724, subdivision 11, or that he was otherwise eligible for the services
he received. Rather, the county argues only that the district court did not have subject
matter jurisdiction to determine Trahan’s eligibility for the services he received, that Evert
should not be allowed to argue in 2019 that Trahan was ineligible for services because
Trahan had accepted the services between 2010 and 2018 , and that allowing the district
court to retrospectively determine Trahan’s eligibility for services would be contrary to
public policy. The majority does not agree with the county’s argument concerning subject-
matter jurisdiction but nonetheless concludes that Evert should not be permitted to
challenge the county’s prior decision that Trahan was eligible for the services he received.
I see no reason to conclude that the district court was not authorized to determine
whether Trahan was eligible for the services he received. Given the application of
42 U.S.C. § 1396p(b)(1), the county may recover the expenses of the services provided to
Trahan only if the expenses were “correctly paid.” As a general matter, district courts
frequently are asked to determine whether a party to a civil action acted correctly. The
occasions when a party’s prior actions are exempt or immune from judicial disapproval are
rare and well defined. In this case, there is no authority for the proposition that the district

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court was without authority to determine whether the county’s previous determination of
eligibility was correct. Whether the county properly determined that Trahan was eligible
for the services he received is simply a matter of proof.
On that issue, the count y bore the burden of proof, as it acknowledged in its
memorandum of law to the district court . Yet the county introduced no evidence that
Trahan was eligible for the services he received. Notably, t he care plans on which the
majority opinion relies, which were introduced by Evert, do not state that Trahan is eligible
for the services he received, either expressly or by implication. Furthermore, the care plans
do not contain any information that would allow a reasonable fact-finder to conclude that
Trahan satisfied the criteria in section 144. 0724, subdivision 11. In fact, th e care plans
support the district court’s conclusion that Trahan was not eligible. In the 2015 care plan,
the county’s social worker wrote that Trahan “enjoys staying busy at his home,” “lives near
the ATV park which he continues to help manage/run,” and “is limited in his ability due to
his shortness of breath.” Nothing in the 2015 care plan suggests that Trahan satisfied any
of the crite ria for a nursing -facility level of care. See Minn. Stat. § 144.0724, subd. 11.
Moreover, there is no care plan in the record concerning Trahan’s condition in 2010, when
he first began receiving services. The only evidence in the record of his condition in 2010
are the affidavits of Evert and of Dean Trahan, who described Trahan’s lifestyle in ways
that are inconsistent with a determination that he required a nursing-facility level of care.
In light of the evidentiary record, the district court did not err in its findings of fact
or in its ultimate determination that Trahan did not require a nursing-facility level of care,

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that he was ineligible for the services he received, and, thus, that the expenses incurred by
the county were not “correctly paid.”
II.
Evert’s second argument to the district court was that the county is not entitled to
any reimbursement for expenses it incurred on Trahan’s behalf on the ground that all such
expenses were not “correctly paid” because a Rice County social worker expressly told
Trahan, before he accepted services, that the county could not seek to recover the expenses
from his estate.
Evert’s second argument was based on the statements in her own affidavit and in
Dean Trahan’s affidavit concerning the representatio ns that were made to their father by
the county’s social workers to the effect that the services were “free” and not subject to
recovery from his estate. The county did not address this issue in any way. The county
did not introduce any evidence to contradict or rebut Evert’s evidence, such as an affidavit
of the social worker identified in Dean Trahan’s affidavit, and the county did not present
any responsive argument in a memorandum of law.
The district court made findings that fully agree with Evert’s argument on this issue.
The district court stated that Evert presented “compelling” evidence that Trahan “did not
receive proper notice because the social worker cajoled [him] into accepting services by
representing that they were free and not subject to estate recovery.” The district court
further stated that Trahan’s “decision was made on erroneous facts,” which “violates
procedural due process and further muddies the waters of what, in fact, is due to the State.”
But, as the majority opinion observes, the district court did not express ly make any

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conclusions of law with respect to this issue, perhaps because the district court already had
two other bases for denying the county’s claim . I agree with the majority that Evert’s
second argument remains unr esolved and that, given the majority’s resolution of Evert’s
first and third arguments, the district court should further consider the second issue and
finally determine it on the merits.
III.
Evert’s third argument to the district court was that, even if Trahan did require a
nursing-facility level of care such that the county is entitled to reimbursement for expenses
it incurred on Trahan’s behalf, the county is not entitled to the full amount it seeks because
only a lesser amount of expenses were “correctly paid.” Evert did not suggest an alternative
dollar amount that was correctly paid, but her summary of UCare’s records of payments
(which do not include the county’s case-management services, which were valued at $180
per month) adds up to $25,694.
Evert’s third argument was based, in part, on the two care plans. The 2015 care plan
called for two services (homemaking and nurse visits) , which, according to the care plan,
costed $158 and $16 1 per month, respectively, and case -management services , whic h
costed $180 per month, for a total of $499 per month. The 2017 care plan called for three
services (homemaking, delivered meals, and nurse visits) , which costed $240, $99, and
$163 per month, respectively, and case -management services , which costed $180 per
month, for a total of $681 per month. These services were to be provided or paid by UCare.
Evert’s third argument also was based on the summary of UCare’s records of payments ,
which shows that UCare’s payments are greater than what the county’s soci al workers

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approved in the two care plans that are based on the social workers’ assessments. More
importantly, Evert’s evidence shows that UCare’s payments are significantly less than what
the county seeks to recover with respect to any particular period of time.
The district court characterized Evert’s third argument as “true,” stating that there
were “substantial discrepancies between the County’s claimed charges, the County’s care
plans that detailed the agreed -to services, and the UCare -generated list of payouts.” The
district court also stated, “It is impossible to divine from the County list [ i.e., the 19-page
print-out] why the services were charged.” The district court also stated that “many of the
charges on the County’s list were for services of a sort not contained in the care plans.”
The district court concluded, “The Count y has not met its burden in validating that the
claimed amount is more likely proper and accurate than not.”
On appeal, the county argues simply that it has a valid claim for $158,384.35. But
the county does not attempt to argue that the district court’s findings are clearly erroneous.
Indeed, the district court’s findings are well supported by the evidence in the record. The
county’s evidence is inadequate by itself. The district court did not clearly err by reasoning
that the county’s 19 -page print -out is unreliable and insufficient . When considered
alongside Evert’s evidence, the weakness of the county’s evidence becomes more apparent.
If the county’s care plans ind icate what services are proper (which is the premise of the
majority’s decision to reverse the district court with respect to Evert’s first argument), the
county has not proved that the amounts on its 19-page print-out were “correctly paid.”
Thus, I would conclude that the district court did not clearly err by finding that the
county failed to satisfy its burden of proving the validity of its claim for $158,384.35.

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There is no reason why the county should get a second opportunity to persuade the district
court of the validity of its claim, let alone a second opportunity to introduce evidence on
the issue.
For the reasons stated above in parts I and III , I would affirm the district court’s
decision to deny the county’s claim.