## Facts

- Americana Healthcare Center operated a nursing home in Aberdeen, South Dakota, including a unit for residents with Alzheimer’s-related conditions.
- Juanita A. Randall, an elderly resident of South Dakota, was admitted to Americana’s facility in 1990 after an accident and hospitalization.
- Robert L. Randall, Juanita’s only child and a District of Columbia resident, returned to South Dakota to arrange her placement and, acting under a power of attorney, completed and signed admission paperwork.
- Robert made an advance payment from Juanita’s checking account and arranged for monthly statements to be sent to him.
- In 1985, Juanita had executed an irrevocable “maintenance trust” with Robert as trustee and residual beneficiary; Juanita was the income beneficiary, and the trust terms did not authorize invasion of principal for her benefit.
- Juanita’s assets included her house and mutual funds placed into the trust; her income was insufficient to cover ongoing nursing home costs.
- A long-term care Medicaid application was denied because Juanita had not exhausted her assets.
- After Juanita received a bankruptcy discharge eliminating her personal debt to Americana, Americana sought recovery of unpaid charges from Robert, including under South Dakota’s filial responsibility statute, SDCL 25-7-27.

## Issues

1. Whether SDCL 25-7-27 permits a nursing home to recover a parent’s unpaid care costs from an adult child who has financial ability to pay and sufficient notice of the parent’s indigency.
2. Whether SDCL 25-7-27 violates equal protection by imposing support obligations on adult children of indigent parents.
3. Whether applying SDCL 25-7-27 to a nonresident adult child violates due process, including jurisdictional and fair-notice concerns.
4. Whether the adult child preserved for appeal a challenge to the “reasonable costs” of the care charges awarded.

## Decision

- The South Dakota Supreme Court affirmed the judgment for Americana.
- The court held Robert was liable under SDCL 25-7-27 for the costs of his mother’s care.
- The court rejected equal protection and due process challenges to SDCL 25-7-27 as applied.
- The court declined to review the amount of charges as “reasonable costs” because the issue was not raised at trial and was waived on appeal.

## Legal Principles

- SDCL 25-7-27 imposes a duty on financially able adult children to support indigent, aged parents, and a care provider may pursue a direct claim to recover unpaid costs when statutory elements are met.
- Notice and involvement may be shown where the adult child arranged placement, executed admission paperwork under authority, received billing statements, and knew of unpaid charges and the parent’s inability to pay.
- Equal protection challenges to SDCL 25-7-27 are evaluated under rational-basis review; the statute is constitutional if it rationally relates to legitimate state interests such as preventing indigent elderly persons from becoming public charges.
- Due process is satisfied where the nonresident adult child has sufficient contacts with the state connected to the parent’s care and the claim, making application of the statute and the forum’s jurisdiction fair.
- Issues not presented to the trial court are waived on appeal, including challenges to the reasonableness of amounts awarded.

## Conclusion

The court upheld enforcement of South Dakota’s filial responsibility statute against a nonresident adult child who arranged his mother’s admission and managed key financial aspects of her care, concluding the statute authorized a provider’s direct recovery and did not violate equal protection or due process; any dispute over the reasonableness of the awarded charges was waived.


Americana Healthcare Ctr., a Div. of Manor Healthcare Corp. v. Randall, 513 N.W.2d 566 (S.D. 1994)