LARISA'S HOME CARE, LLC, an Oregon limited liability company, Plaintiff-Respondent,
Karen NICHOLS-SHIELDS, the duly appointed Personal Representative of the Estate of Isabell Prichard, Deceased, Defendant-Appellant.
Submitted on remand December 11, 2017.
remand from the Oregon Supreme Court, Larisa's Home
Care, LLC v. Nichols-Shields, 362 Or. 115, 404 P.3d 912
(2 017) .
Washington County Circuit Court C124865CV; Janelle F. Wipper,
Daraee fled the briefs for appellant. Ross A. Day, Matthew
Swihart, and Day Law Group, PC, fled the briefs for
F. Rosenblum, Attorney General, Benjamin Gutman, Solicitor
General, and Jordan R. Silk, Assistant Attorney General, fled
the brief amicus curiae for Oregon Department of Justice.
Hadlock, Presiding Judge, and DeHoog, Judge, and Aoyagi,
Summary: This case is on remand from the Oregon Supreme
Court. Larisa's Home Care, LLC v.
Nichols-Shields, 362 Or. 115, 404 P.3d 912 (2017)
(Larisa's II). In Larisa's Home Care,
LLC v. Nichols-Shields, 277 Or.App. 811, 372 P.3d 595
(2016), the Court of Appeals held that the trial court had
erred in concluding that plaintiff had been unjustly
enriched. The Supreme Court reversed and remanded for the
Court of Appeals to consider an additional defense argument
that it had not reached in its original decision, which is
whether certain [297 Or.App. 220] provisions of Medicaid law
nevertheless prohibit plaintiff's recovery.
Held: In light of the Supreme Court's holdings
in Larisa's II, the arguments that defendant
made to the Court of Appeals do not establish that either
former OAR 411-050-0435(1)(d) (Jan 1, 2007) or any other law
precluded plaintiff from pursuing or prevailing in this
unjust enrichment action.
Or.App. 221] HADLOCK, P. J.
case comes to us on remand from the Supreme Court.
Larisa's Home Care, LLC v. Nichols-Shields, 362
Or. 115, 404 P.3d 912 (2017) (Larisa's II).
Plaintiff is a residential adult foster care provider that
brought an unjust enrichment claim to recover the reasonable
value of its services from defendant, the personal
representative of the estate of a former resident, Prichard,
who fraudulently obtained services from plaintiff at a lower
Medicaid-based rate. In response, defendant contended, among
other things, that Prichard's estate had not been
unjustly enriched; she moved to dismiss on that basis. The
trial court implicitly denied that motion and, following a
bench trial, "ruled in favor of plaintiff, concluding
that there was unjust enrichment." Id. at 120.
Defendant appealed. In our initial decision, we held that the
trial court had erred by concluding that defendant had been
unjustly enriched. We therefore reversed without reaching
additional arguments that defendant had made on appeal.
Larisa's Home Care, LLC v. Nichols-Shields, 277
Or.App. 811, 812, 820, 372 P.3d 595 (2016) (Larisa's
I). On review, the Supreme Court concluded that
plaintiff had established that the estate had been unjustly
enriched. Larisa's II, 362 Or at 123. It
reversed our decision on that basis and remanded the case to
us to consider an additional defense argument that we had not
reached-whether certain provisions of Medicaid law
nevertheless prohibit plaintiff's recovery. Id.
at 123, 142. For the reasons set out below, we affirm.
provide background facts as articulated in Larisa's
II. Plaintiff contracted with the Department of Human
Services (DHS) to provide adult foster home services to
patients who qualified for Medicaid. Larisa's
II, 362 Or at 118. For Medicaid-qualified patients, the
rates charged by plaintiff were set by DHS. Id. The
Medicaid rates were substantially lower than the rates that
plaintiff charged to non-Medicaid patients-the "private
pay" patients. Id. at 119. Prichard, who had
been approved to receive Medicaid benefits, resided and
received care in one of plaintiffs facilities and was charged
the Medicaid rate for services, rather than the higher,
private-pay rate. Id. at 118-19.
Or.App. 222] After Prichard's death, her family (and
others) learned that Prichard's son, Gardner, who had had
power of attorney for Prichard, had made a false
representation on Prichard's Medicaid application.
Id. at 119. Another of Prichard's
children-defendant, who was appointed as the personal
representative for the estate-discovered that for years,
Gardner had been transferring Prichard's assets to
himself or using her funds for his own benefit. Id. at
119-20. Gardner had represented on his mother's Medicaid
application, however, that Prichard had not transferred or
given away any cash or other property to anyone in the
preceding 60 months. Id. at 119. "As a result,
[DHS] approved Pritchard for Medicaid benefits."
made a claim against Prichard's estate, which defendant
denied. Id. at 120. Plaintiff then filed this
lawsuit for equitable relief in which it sought payment from
the estate of the difference between a higher private-pay
rate and the lower Medicaid rate that it had charged
Prichard. Id. at 120. The trial court ruled in
plaintiff's favor after concluding that defendant was
unjustly enriched and that Medicaid law did not prevent
plaintiff's recovery. Id. at 120-21. It entered
a judgment in plaintiff's favor in the amount of $48,
477. Id. at 121.
appealed and presented two arguments, which the Supreme Court
characterized broadly as follows: "(1) there was no
unjust enrichment; and (2) regardless, Medicaid-related law
(statutes, rules, and the terms of plaintiffs contract with
the department) prohibited plaintiff from recovering from
defendant." Id. at 121. We held that the record
did not support the unjust enrichment claim and that the
trial court erred in denying defendant's motion to
dismiss. Larisa's I, 277 Or.App. at 820. As
stated above, the Supreme Court reversed our decision
regarding the unjust enrichment ...