Title: Estate of Anne Oros v. Divine Savior Healthcare Inc.

State: wisconsin

Issuer: Wisconsin Supreme Court

Document:

2022 WI 27 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2020AP202 
 
 
 
COMPLETE TITLE: 
Kim M. Andruss, 
          Plaintiff-Appellant, 
Thomas E. Price M.D. , Secretary, Department of 
Health &  
Human Services, 
          Involuntary-Plaintiff, 
Estate of Anne Oros, 
          Plaintiff, 
     v. 
Divine Savior Healthcare Inc. d/b/a Tivoli at 
Divine  
Savior Healthcare, 
          Defendant-Respondent-Petitioner, 
ProAssurance Casualty Company, 
          Defendant, 
Dean Health Plan Inc., 
          Intervenor. 
 
 
 
 
 
REVIEW OF DECISION OF THE COURT OF APPEALS  
Reported at 395 Wis. 2d 676,953 N.W.2d 914 
PDC No: 2021 WI App 8 - Published 
 
 
OPINION FILED: 
May 6, 2022   
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
February 14, 2022   
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit   
 
COUNTY: 
Columbia   
 
JUDGE: 
Andrew W. Voigt   
 
 
 
JUSTICES: 
 
ZIEGLER, C.J. delivered the majority opinion for a unanimous 
Court. 
NOT PARTICIPATING: 
        
 
 
 
ATTORNEYS: 
 
For the plaintiff-appellant there was a brief filed by Drew 
De Vinney and Martin Law Office, S.C. There was an oral argument 
by Drew De Vinney. 
 
 
 
2 
For the defendant-respondent-petitioner there were briefs 
filed by Samuel Leib. There was an oral argument by Samuel Leib 
and Leib, Knott, Gaynor, LLC. 
 
An amicus curiae brief was filed on behalf of the Wisconsin 
Association for Justice by Scott Thompson and Gingras, Thomsen 
and Wachs LLP. 
 
 
2022 WI 27 
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.   2020AP202 
(L.C. No. 
2018CV100) 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
Kim M. Andruss, 
 
          Plaintiff-Appellant, 
 
Thomas E. Price M.D. , Secretary, Department of 
Health & Human Services, 
 
          Involuntary-Plaintiff, 
 
Estate of Anne Oros, 
 
          Plaintiff, 
     v. 
 
Divine Savior Healthcare Inc. d/b/a Tivoli at 
Divine Savior Healthcare, 
 
          Defendant-Respondent-Petitioner, 
 
ProAssurance Casualty Company, 
 
          Defendant, 
 
Dean Health Plan Inc., 
 
          Intervenor. 
 
FILED 
 
MAY 6, 2022 
 
Sheila T. Reiff 
Clerk of Supreme Court 
 
 
 
 
ZIEGLER, C.J., delivered the majority opinion for a unanimous 
court. 
 
 
REVIEW of a decision of the Court of Appeals.  Affirmed.   
 
No. 
2020AP202   
 
2 
 
¶1 
ANNETTE KINGSLAND ZIEGLER, C.J.   This is a review of 
a published decision of the court of appeals, Estate of Oros v. 
Divine Savior Healthcare, Inc., 2021 WI App 8, 395 Wis. 2d 676, 
953 N.W.2d 914, reversing an order of the Columbia County 
circuit court1 that dismissed the plaintiff, Kim Andruss's, 
wrongful death claim.  Andruss brought her claim on behalf of 
the estate of her mother, Anne Oros, and in Andruss's capacity 
as Oros's daughter.   
¶2 
Oros allegedly died as a result of negligence on the 
part of Divine Savior Healthcare, Inc., d/b/a Trivoli at Divine 
Savior 
Healthcare 
("Divine 
Savior"). 
 
Divine 
Savior 
and 
ProAssurance 
Casualty 
Company, 
Divine 
Savior's 
insurer, 
(collectively, "the defendants") argue that Andruss cannot bring 
a wrongful death claim as an adult child of Oros.  According to 
the defendants, the liability protections given to certain 
healthcare providers under Chapter 655 bar Andruss's claim.   
¶3 
Divine Savior owns and operates a medical campus with 
a hospital, nursing home, and a community-based residential 
facility ("CBRF").  When Oros received the injuries at issue in 
this case, she was a resident of Divine Savior's CBRF.  The 
basis of Andruss's claim is alleged negligence on the part of 
the CBRF, and CBRFs, even ones that share common ownership with 
hospitals 
and 
nursing 
homes, 
fall 
outside 
the 
liability 
protections of Wis. Stat. Chapter 655 (2017-18).2  Dismissal 
                                                 
1 The Honorable W. Andrew Voigt presided.  
2 All subsequent references to the Wisconsin Statutes are to 
the 2017-18 version unless otherwise indicated. 
No. 
2020AP202   
 
3 
 
under Chapter 655 of Andruss's wrongful death claim is not 
warranted.  The court of appeals is affirmed.  
I.  FACTUAL BACKGROUND AND PROCEDURAL POSTURE 
¶4 
Oros was admitted as a resident of Divine Savior's 
CBRF in Portage, Wisconsin, in January 2015.  At that time, Oros 
was 88 years old and was diagnosed as having Alzheimer's 
disease.  On the same medical campus as the CBRF, Divine Savior 
owned and operated a hospital and a nursing home.  At various 
points during the time period at issue, Oros received treatment 
at Divine Savior's hospital and nursing home.  
¶5 
Between April and December 2015, Oros had four falls 
at Divine Savior's CBRF.  In April 2015, Oros fell and struck 
her head at the CBRF.  She was taken to Divine Savior's hospital 
for observation and treatment.  In June 2015, Oros fell again 
and hit her head at the CBRF.  She was again taken to Divine 
Savior's hospital.  In October 2015, Oros slipped and fell at 
the CBRF, and she was taken to Divine Savior's hospital.  
Andruss asserts that Divine Savior never informed Oros's primary 
care physician of these falls, nor did they consult with 
administrators, medical professionals, or Oros's family on the 
proper level of care Oros needed. 
¶6 
In December 2015, Oros fell again at the CBRF and 
fractured her wrist.  She was taken to Divine Savior's hospital 
for surgery, and she was discharged over a week later to undergo 
rehabilitation at Divine Savior's nursing home.  While at the 
nursing home, she fell twice.  Also while at the nursing home, 
she was hospitalized for unrelated medical ailments. 
No. 
2020AP202   
 
4 
 
¶7 
In January 2016, Oros was transferred from the nursing 
home to the CBRF.  Within a few days, in February 2016, Oros 
fell for a fifth time at the CBRF.  No injuries were reported, 
and Oros was not taken to the hospital.  Less than a week after 
this incident, Oros fell for a sixth time and hit her head.  
After being transported to the hospital, she was diagnosed with 
a subdural hematoma.  In May 2016, Oros passed away while in 
hospice.  At the time of each of Oros's six falls at the CBRF, 
she was not an admitted patient at either Divine Savior's 
hospital or its nursing home.  
¶8 
In March 2018, Andruss, on behalf of Oros's estate and 
as the adult child of Oros, brought negligence and wrongful 
death claims against the defendants in Columbia County circuit 
court.  Andruss alleged that Divine Savior's employees at the 
nursing home and the CBRF failed to implement a proper plan of 
care, failed to provide adequate and timely treatment, failed to 
sufficiently monitor Oros, and provided medical care falling 
below the professional standard of care.  Defendants filed an 
answer in May 2018.  
¶9 
Over a year passed, and in June 2019, the defendants 
filed a "Motion for the Application of Wisconsin Chapter 655."  
In the motion, the defendants asserted that "the application of 
Chapter 655 [to] this action . . . would result in the dismissal 
of [Andruss's] wrongful death claim."  After briefing, the 
circuit court held a hearing on the motion in August 2019.  The 
circuit court indicated that it believed Chapter 655 applied to 
Andruss's claims against Divine Savior's nursing home.  While 
No. 
2020AP202   
 
5 
 
the circuit court was "not convinced" that Chapter 655 applied 
to CBRFs generally, the circuit court reasoned that it "borders 
almost on nonsensical that different rules would apply to 
different parts of the same legal entity."  Thus, the circuit 
court indicated that Chapter 655 applied to Divine Savior's CBRF 
as well as its nursing home.  Upon a request from Andruss, the 
circuit court stated Andruss could file a motion to amend her 
complaint.  The circuit court explained that the amendments 
could change its analysis on the defendants' motion.  No order 
or judgment was entered after the August 2019 hearing.  
¶10 In September 2019, Andruss filed a document entitled, 
"Motions 
for 
Leave 
to 
Amend 
the 
Complaint 
and 
for 
Reconsideration."  Andruss attached an amended complaint that 
removed all claims brought against Divine Savior's nursing home.  
She argued that the wrongful death claim remaining against the 
CBRF was not barred under Chapter 655, and the circuit court 
should "reconsider" the analysis it provided at the August 2019 
hearing.   
¶11 In November 2019, the circuit court held a hearing on 
Andruss's motion to amend and for reconsideration.  It noted its 
prior analysis that CBRFs were not "necessarily or obviously 
subject to [Chapter] 655," but reiterated that different 
divisions of the same entity cannot have different rules of 
medical malpractice liability.  According to the circuit court, 
Chapter 655 must apply to the entire Divine Savior entity, 
including its CBRF.  In January 2020, the circuit court entered 
an order granting the defendants' Motion for the Application of 
No. 
2020AP202   
 
6 
 
Chapter 655, denying Andruss's motion for reconsideration, and 
dismissing 
the 
claims 
Andruss 
brought 
in 
her 
individual 
capacity.  
¶12 Andruss appealed the circuit court's decision, and the 
court of appeals reversed.  Estate of Oros, 395 Wis. 2d 676, 
¶39.  The court of appeals construed the defendants' Motion for 
the Application of Chapter 655 as a motion to dismiss for 
failure to state a claim.  Id., ¶17.  From there, the court of 
appeals reasoned that CBRFs were not covered by Chapter 655.  
Id., ¶19.  Because Andruss brought her wrongful death claim 
against Divine Savior for its operation of a CBRF, the claim was 
not subject to Chapter 655, and dismissal was not warranted.  
Id., ¶¶21-38.  According to the court of appeals, the result did 
not change simply because Divine Savior operated both a hospital 
and nursing home, nor did it change because Oros received care 
at both the nursing home and hospital prior to her death.  Id.  
¶13 The defendants filed a petition for review with this 
court, and in April 2021, the petition was granted.  
II.  STANDARD OF REVIEW 
¶14 The 
standard 
of 
review 
in 
this 
case 
requires 
clarification.  The focus of this appeal is whether the circuit 
court 
properly 
granted 
the 
defendants' 
Motion 
for 
the 
Application of Chapter 655 and whether Andruss's wrongful death 
claim must be dismissed.  The defendants argue that because 
Divine Savior owns and operates a hospital and nursing home at 
which Oros received care, and those facilities, according to the 
defendants, are covered by Chapter 655, Andruss cannot proceed 
No. 
2020AP202   
 
7 
 
against Divine Savior's CBRF.  But we are aware of no authority 
under 
Wisconsin 
civil 
procedure, 
statutes, 
or 
caselaw 
recognizing a "Motion for the Application of Chapter 655," or 
identifying it as an independent procedural device for dismissal 
of legal claims.  See, e.g., Lornson v. Siddiqui, 2007 WI 92, 
302 Wis. 2d 519, 735 N.W.2d 55 (affirming dismissal of claims 
barred by Chapter 655 under the standards for motions to dismiss 
for failure to state a claim).  The court of appeals construed 
the defendants' motion as a motion to dismiss for failure to 
state a claim.  Estate of Oros, 395 Wis. 2d 676, ¶17.  On 
appeal, both Andruss and the defendants analyze the motion under 
the framework of a motion to dismiss.  Here, the parties 
submitted evidence outside the record, and the motion cannot be 
reviewed as a motion to dismiss.        
¶15 A motion to dismiss for failure to state a claim 
"tests the legal sufficiency of the complaint."  DeBruin v. St. 
Patrick Congregation, 2012 WI 94, ¶11, 343 Wis. 2d 83, 816 
N.W.2d 878.  When reviewing a motion to dismiss, "we accept as 
true all facts well-pleaded in the complaint and the reasonable 
inferences therefrom."  Id.  However, if "matters outside of the 
pleadings are presented to and not excluded by the court, the 
motion shall be treated as one for summary judgment."  Wis. 
Stat. § 802.06(2)(b).  In such instances, "all parties shall be 
given reasonable opportunity to present all material made 
pertinent to [a motion for summary judgment.]"  Id.  
¶16 Before the circuit court, the defendants submitted 
substantial record evidence that was neither mentioned nor 
No. 
2020AP202   
 
8 
 
included 
in 
Andruss's 
original 
complaint 
or 
her 
amended 
complaint.  For instance, the defendants submitted affidavits 
that described in detail Divine Savior's corporate structure, 
the nature of Oros's falls, how she was transported to Divine 
Savior's hospital on several occasions, and how she was moved 
between Divine Savior's CBRF, nursing home, and hospital on the 
same campus.  Those facts were neither stated nor referenced in 
either Andruss's complaint or her amended complaint.  The 
original complaint alleged injuries and health care services 
provided only at the nursing home and CBRF, while the amended 
complaint focused solely on injuries and services at the CBRF.  
Neither the complaint nor the amended complaint alleged that 
Divine Savior owned a hospital.   
¶17 In response to the defendants' motion, Andruss cited 
to her own record evidence.  She described how Divine Savior 
separated the nursing home and CBRF into different divisions, 
and the divisions had separate patients, admissions, and care 
plans.  Andruss also explained the timeline of her mother's 
falls and her movements to different facilities on Divine 
Savior's campus.  This information was also not included in 
either the complaint or the amended complaint. 
¶18 The 
circuit 
court 
received 
this 
evidence 
and 
explicitly relied on it in its decision.  A central aspect of 
the circuit court's reasoning provided in August, 2019 was that, 
according to the circuit court, it would be "nonsensical" to 
apply "different rules" to "the same legal entity."  The circuit 
court reiterated this same reasoning when it reviewed Andruss's 
No. 
2020AP202   
 
9 
 
motion for reconsideration in November 2019.  At that time, the 
circuit court noted that Oros "was back and forth among these 
entities," and questioned "how on earth do you parse" through 
the shifting service providers during a jury trial.   
¶19 The defendants' Motion for the Application of Chapter 
655 is best construed as a motion for summary judgment.  The 
motion relied on facts not included in Andruss's complaints.  It 
was filed over a year after the case began and over a year after 
the defendants answered Andruss's complaint.   The circuit court 
did not exclude the record evidence cited by the defendants, but 
Andruss had the opportunity to present evidence in opposition to 
the defendants' motion.3  See Wis. Stat. § 802.06(2)(b).   
¶20 To 
facilitate 
effective 
and 
efficient 
appellate 
review, circuit courts must properly identify the motion that is 
before them and structure their analysis under the correct, 
applicable standard.  The defendants' motion presented itself as 
a motion for summary judgment, and the circuit court should have 
recognized it as such when it granted the motion and explained 
its reasoning.  See, e.g., Gauger v. Ludwig, 56 Wis. 2d 492, 
496-97, 202 N.W.2d 233 (1972) (explaining that a motion to 
                                                 
3 In addition, the motion cannot be construed as a motion 
for 
judgment 
on 
the 
pleadings, 
which 
motions 
test 
the 
sufficiency of the complaint with reference to any responsive 
pleading.  See Southport Commons, LLC v. DOT, 2021 WI 52, ¶42, 
397 Wis. 2d 362, 960 N.W.2d 17 (explaining the standard of 
review for motions for judgment on the pleadings).  "If, on a 
motion for judgment on the pleadings, matters outside the 
pleadings are presented to and not excluded by the court, the 
motion shall be treated as one for summary judgment . . . ."  
Wis. Stat. § 802.06(3). 
No. 
2020AP202   
 
10 
 
strike can be construed as a motion to dismiss in order to "put 
substance above form"); Schwab v. Timmons, 224 Wis. 2d 27, 34-
35, 589 N.W.2d 1 (1999) (describing how a circuit court properly 
converted a motion to dismiss into a motion for summary 
judgment, despite labels given to the motion by parties).  
Alternatively, the circuit court should have directed the 
defendants to clarify under which type of dispositive motion 
they intended to proceed. 
¶21 The parties on appeal and the court of appeals 
construed the defendants' motion as a motion to dismiss.  This 
was incompatible with the nature of the motion and the circuit 
court's analysis.  In fact, the court of appeals should have 
recognized this discrepancy when it analyzed Divine Savior's 
corporate structure, its ownership of a hospital, and the 
intertwining nature of care provided to Oros between Divine 
Savior's various facilities.  Estate of Oros, 395 Wis. 2d 676, 
¶¶21-38.  A facial view of Andruss's complaints would have 
revealed that none of those facts were properly alleged.  See 
Jamerson v. DCF, 2013 WI 7, ¶¶64-65, 345 Wis. 2d 205, 824 
N.W.2d 822 
(noting 
that 
in 
the 
proceedings 
below, 
an 
administrative law judge and the litigants labeled a motion in a 
manner that was not legally recognized and analyzing the motion 
on appeal under the proper standard).  
No. 
2020AP202   
 
11 
 
¶22 Procedural posture matters.  In many cases, it 
materially impacts the outcome of disputes.4  When analyzing the 
defendants' Motion for the Application of Chapter 655, the 
circuit court and the court of appeals should have construed the 
motion as a motion for summary judgment, and we shall do so 
here. 
¶23 "Whether the circuit court properly granted summary 
judgment is a question of law that this court reviews de novo."  
Racine County v. Oracular Milwaukee, Inc., 2010 WI 25, ¶24, 323 
Wis. 2d 682, 781 N.W.2d 88 (quotations omitted).  Summary 
judgment is appropriate "if the pleadings, depositions, answers 
to interrogatories, and admissions on file, together with the 
affidavits, if any, show that there is no genuine issue as to 
any material fact and that the moving party is entitled to a 
judgment as a matter of law."  Wis. Stat. § 802.08(2).  A party 
opposing 
summary 
judgment 
"'may 
not 
rest 
upon 
the 
mere 
allegations or denials of the pleadings' but instead, through 
affidavits or otherwise, 'must set forth specific facts showing 
                                                 
4 The instant dispute would be easily resolved if analyzed 
as a motion to dismiss.  Material facts supporting the CBRF's 
corporate ownership and the intermixing of care at Divine 
Savior's facilities, laying at the heart of the defendants' 
motion and the circuit court's analysis, were not alleged in the 
amended complaint.  See Data Key Partners v. Permira Advisers 
LLC, 2014 WI 86, ¶19, 356 Wis. 2d 665, 849 N.W.2d 693 ("[A] 
court cannot add facts in the process of construing a complaint" 
for a motion to dismiss); Wis. Stat. § 802.06(2)(b) (requiring 
conversion to a motion for summary judgment when relying on 
"matters outside of the pleadings").   
No. 
2020AP202   
 
12 
 
that there is a genuine issue for trial.'"  Oracular Milwaukee, 
323 Wis. 2d 682, ¶26 (quoting Wis. Stat. § 802.08(3) (2007-08)).  
¶24 This 
case 
also 
presents 
questions 
of 
statutory 
interpretation.  "Interpretation of a statute is a question of 
law that we review de novo, although we benefit from the 
analyses of the circuit court and the court of appeals."  Estate 
of Miller v. Storey, 2017 WI 99, ¶25, 378 Wis. 2d 358, 903 
N.W.2d 759. 
 
"[S]tatutory 
interpretation 
begins 
with 
the 
language of the statute.  If the meaning of the statute is 
plain, we ordinarily stop the inquiry.  Statutory language is 
given its common, ordinary, and accepted meaning, except that 
technical or specially-defined words or phrases are given their 
technical or special definitional meaning."  State ex rel. Kalal 
v. Cir. Ct. for Dane Cnty., 2004 WI 58, ¶45, 271 Wis. 2d 633, 
681 N.W.2d 110 (citations and quotations omitted).  In addition, 
"statutory language is interpreted in the context in which it is 
used; not in isolation but as part of a whole; in relation to 
the language of surrounding or closely-related statutes; and 
reasonably, to avoid absurd or unreasonable results."  Id., ¶46.  
III.  ANALYSIS 
¶25 The defendants argue that Andruss's wrongful death 
claim must be dismissed because it is brought against Divine 
Savior's CBRF.  It is undisputed that Divine Savior owns and 
operates a hospital and a nursing home at which Oros received 
treatment prior to her death.  Oros was transferred between the 
CBRF, the hospital, and the nursing home at various points to 
receive care for Oros's falls between April 2015, when Oros was 
No. 
2020AP202   
 
13 
 
first admitted into Divine Savior's CBRF, and February 2016, 
when Oros fell and was diagnosed with a subdural hematoma.     
¶26 When 
applicable, 
"Chapter 
655 
constitutes 
the 
exclusive procedure and remedy for medical malpractice in 
Wisconsin."  Finnegan ex rel. Skoglind v. Wis. Patients 
Compensation Fund, 2003 WI 98, ¶22, 263 Wis. 2d 574, 666 
N.W.2d 797.  However, Chapter 655 applies only to a specifically 
defined list of health care providers.  Wisconsin Stat. 
§ 655.001(8) defines "health care provider" as "a person to whom 
this chapter applies under s. 655.002(1) or a person who elects 
to be subject to this chapter under s. 655.002(2)."  Wisconsin 
Stat. § 655.002 lists service providers that "chapter [655] 
applies to," as well as a list of providers that "may 
elect . . . to be subject to [the] chapter."    
¶27 An adult child cannot bring a wrongful death claim 
alleging medical malpractice on the part of a health care 
provider covered by Chapter 655.  "The classification of 
claimants entitled to bring a wrongful death suit for medical 
malpractice [covered by Chapter 655] is limited to those 
enumerated in Wis. Stat. § 655.007."  Czapinski v. St. Francis 
Hosp., Inc., 2000 WI 80, ¶2, 236 Wis. 2d 316, 613 N.W.2d 120.  
Wisconsin Stat. § 655.007 states, "any patient or the patient's 
representative having a claim or any spouse, parent, minor 
sibling or child of the patient having a derivative claim for 
injury 
or 
death 
on 
account 
of 
malpractice 
is 
subject 
to . . . chapter [655]."  In light of common law limitations of 
the right of adult children "to recover for loss of society and 
No. 
2020AP202   
 
14 
 
companionship in medical malpractice cases," we have read 
§ 655.007 as excluding adult children from the list of available 
wrongful death claimants in Chapter 655 cases.  Czapinski, 236 
Wis. 2d 316, ¶¶23-25 (rejecting a request to "broaden the 
classification of claimants entitled to recover in such suits to 
include adult children"); Lornson, 302 Wis. 2d 519, ¶20 ("Only 
minor children . . . have derivative claims under Wis. Stat. 
§ 655.007." (Emphasis in original.)).  
¶28 Andruss alleges that Divine Savior was negligent in 
the care and treatment of Oros.  As a result of Divine Savior's 
negligence——specifically, a failure to develop an appropriate 
plan of care and a failure to provide Oros adequate oversight——
Andruss alleges that she experienced injuries such as the loss 
of society and companionship.  Andruss is the adult child of 
Oros, and she can bring this wrongful death claim only if Divine 
Savior falls outside the coverage of Chapter 655.  Czapinski, 
236 Wis. 2d 316, ¶¶23-25; Wis. Stat. § 655.007.  Divine Savior 
is covered by Chapter 655 only if it was a health care provider, 
as defined by Wis. Stat. § 655.002.   
¶29 Andruss's wrongful death claim is not against a health 
care provider covered by Chapter 655.  The claim is based on 
alleged negligence on the part of Divine Savior's CBRF, the care 
plan and treatment provided to Oros at the CBRF, and the 
injuries Oros experienced while residing at the CBRF.  The 
wrongful death at issue was allegedly a result of Oros's fall at 
Divine Savior's CBRF in February 2016, after five prior falls at 
No. 
2020AP202   
 
15 
 
the same CBRF.  Oros does not seek to recover for negligence at 
Divine Savior's hospital or its nursing home.  
¶30 CBRFs are not included in the list of health care 
providers under Wis. Stat. § 655.002.  Reading the plain text of 
§ 655.002, the list contains "hospitals," hospital affiliates 
which "provide[] diagnosis or treatment of, or care for, 
patients of [a] hospital," and "nursing home[s] . . . whose 
operations are combined as a single entity with a hospital," 
among other service providers.  § 655.002(h), (i), (j). The 
legislature 
expressly 
identified 
individuals 
and 
service 
providers covered by Chapter 655 and did not include CBRFs on 
the list.  This is a textbook example of the canon expressio 
unius est exclusio alterius, "[t]he expression of one thing 
implies the exclusion of others."  State v. Dorsey, 2018 WI 10, 
¶29, 379 Wis. 2d 386, 906 N.W.2d 158; Antonin Scalia & Brian A. 
Garner, Reading Law:  The Interpretation of Legal Texts 107-11 
(2012); see, e.g., FAS, LLC v. Town of Bass Lake, 2007 WI 73, 
¶27, 301 Wis. 2d 321, 733 N.W.2d 287 (explaining that an 
ordinance explicitly excluding "public roadways" from lot area 
computation made no mention of navigable streams, thus navigable 
streams were not excluded from the computation).  Section 
655.002 unambiguously places the CBRF services forming the basis 
of Andruss's lawsuit outside the scope of Chapter 655.   
¶31 "[S]tatutory language is interpreted in the context in 
which it is used," and context supports our reading of Wis. 
Stat. § 655.002.  Kalal, 271 Wis. 2d 633, ¶46.  To define 
nursing homes and hospitals, § 655.002 cites to definitions in 
No. 
2020AP202   
 
16 
 
Chapter 50 on medical licensure.  Chapter 655 uses the 
definition of hospital included in Wis. Stat. § 50.33(2)(a) and 
(c): 
 
(2)(a)  "Hospital" means any building, structure, 
institution 
or 
place 
devoted 
primarily 
to 
the 
maintenance and operation 
of facilities for the 
diagnosis, treatment of and medical or surgical care 
for 3 or more nonrelated individuals hereinafter 
designated patients, suffering from illness, disease, 
injury or disability, whether physical or mental, and 
including pregnancy and regularly making available at 
least clinical laboratory services, and diagnostic X-
ray services and treatment facilities for surgery, or 
obstetrical 
care, 
or 
other 
definitive 
medical 
treatment. 
 
 . . .  
 
(c)  "Hospital" includes "special hospitals" or 
those hospital facilities that provide a limited type 
of medical or surgical care, including orthopedic 
hospitals, 
children's 
hospitals, 
critical 
access 
hospitals, mental hospitals, psychiatric hospitals or 
maternity hospitals. 
¶32 The coverage of a hospital under Chapter 655 is tied 
to specific buildings or structures where medical care is 
provided.5  The definition does not mention or include CBRFs.  
Furthermore, hospitals are subject to their own regulations and 
                                                 
5 Notably, in adopting only subsections (a) and (c) of Wis. 
Stat. § 50.33(2) as the definition of hospitals, Chapter 655 
excluded 
subsection 
(b), 
which 
would 
have 
expanded 
the 
definition beyond the more narrow physical scope in subsections 
(a) and (c).  Section 50.33(2)(b) includes all "related 
facilities . . . operated 
in 
connection 
with 
hospitals."  
§ 50.33(2)(b).  The legislature deliberately chose the limited 
definition of hospitals included in Wis. Stat. § 655.002.  See 
State ex rel. Kalal v. Cir. Ct. for Dane Cnty., 2004 WI 58, ¶44, 
271 
Wis. 2d 633, 
681 
N.W.2d 110 
(explaining 
that 
"the 
legislature's intent is expressed in the statutory language"). 
No. 
2020AP202   
 
17 
 
government oversight under Chapter 50, separate from that of 
CBRFs.  See, e.g., Wis. Stat. § 50.36 (describing rules 
governing hospitals).  
¶33 Wisconsin Stat. § 50.01, where nursing homes are 
defined, 
also 
provides 
a 
definition 
of 
CBRFs, 
and 
the 
definitions of nursing homes and CBRFs are distinct.  See Hecker 
v. 
DHHS, 
197 
Wis. 2d 441, 
458, 
541 
N.W.2d 766 
(1995) 
(explaining, when interpreting a prior version of § 50.01, that 
the removal of "intermediate care facilit[ies] . . . created a 
two-tiered scheme:  facilities were now either nursing homes or 
CBRFs").  A nursing home "means a place where 5 or more persons 
who are not related to the operator or administrator reside, 
receive care or treatment and, because of their mental or 
physical condition, require access to 24-hour nursing services, 
including limited nursing care, intermediate level nursing care 
and skilled nursing services . . . ."  § 50.01(3).  By contrast, 
a CBRF 
means a place where 5 or more adults who are not 
related to the operator or administrator and who do 
not require care above intermediate level nursing care 
reside and receive care, treatment or services that 
are above the level of room and board but that include 
no more than 3 hours of nursing care per week per 
resident. 
§ 50.01(1g).  Therefore, while nursing homes require more 
intensive 
oversight 
and 
medical 
care, 
"24-hour 
nursing 
services," CBRFs offer more limited care, "no more than 3 hours 
of nursing care per week per resident."  § 50.01(3), (1g).   
No. 
2020AP202   
 
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¶34 Further, the legislature has enacted provisions in 
Chapter 50 that provide licensing and regulations specifically 
directed toward CBRFs.  Wisconsin Stat. § 50.035 describes 
regulations on CBRF operations such as the extent of personnel 
training and the installation of smoke detectors.  Wisconsin 
Stat. § 50.037 provides specific rules for CBRF licensure and 
fees.  Different provisions govern the licensure and regulation 
of nursing homes.  See Wis. Stat. §§ 50.04, 50.045, 50.095.   
¶35 Thus, it is clear from the plain text of Wis. Stat. 
§ 655.002 and the definition and regulation of service providers 
under Chapter 50, from which Chapter 655 derives its legal 
definitions, that hospitals, nursing homes, and CBRFs are 
different operations with different meanings.  While Chapter 655 
covers hospitals and certain nursing homes, it unambiguously 
does not cover CBRFs.   
¶36 The defendants argue that this plain reading of Wis. 
Stat. § 655.002 must be rejected because Divine Savior also 
operates a hospital and a nursing home.  Yet nowhere in the text 
of § 655.002, nor in any other statutory provision of which the 
court has been made aware, are CBRFs subject to Chapter 655 so 
long as they share common corporate ownership with service 
providers that Chapter 655 does cover.  Instead, § 655.002 
covers hospitals, which are statutorily defined as "building[s], 
structure[s], institution[s] or place[s]" which do not include 
CBRFs, Wis. Stat. §§ 655.002(1)(h), 50.33(2)(a) & (c); hospital 
affiliates that "provide[] diagnosis or treatment of, or care 
for, patients of the hospital," § 655.002(1)(i); and nursing 
No. 
2020AP202   
 
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homes, which are statutorily distinct from CBRFs, Wis. Stat. 
§§ 655.002(1)(j), 50.01(3) & (1g).  Under the facts agreed upon 
by the parties, Divine Savior's CBRF is not a hospital, it did 
not provide Oros treatment or care while she was a hospital 
patient, and it did not operate as a nursing home.   
¶37 The legislature had the ability to cover CBRFs that 
share common operations and corporate ownership with a hospital.  
It expressly did so for nursing homes.  Wis. Stat. § 655.002(j) 
(covering a nursing home so long as its "operations are combined 
as a single entity with a hospital"); see State v. Yakich, 2022 
WI 8, ¶24, 400 Wis. 2d 549, 970 N.W.2d 12 (explaining that the 
legislature "plainly demonstrated the ability" to establish a 
different standard and "declined to do so").  Simply because 
Divine Savior owned a hospital and nursing home, in addition to 
owning a CBRF, is of no moment. 
¶38 The 
defendants 
note 
that 
Oros 
received 
medical 
services from Divine Savior's hospital and nursing home during 
the timeframe at issue.  It is undisputed that after Oros's 
various falls at the CBRF, she was taken to the hospital, and 
after she fractured her wrist upon her fourth fall, she received 
treatment at both the hospital and nursing home.  The hospital, 
nursing home, and CBRF are on the same medical campus. 
¶39 But simply receiving services from a nearby health 
care provider that is covered by Chapter 655 does not in any way 
imply that other individuals and entities, which also provide 
care, are covered by Chapter 655.  Many individuals and entities 
that provide health-related care and treatment are not covered 
No. 
2020AP202   
 
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by Chapter 655.  The chapter covers certain "physicians" and 
"nurse anesthetists," but it does not cover "ambulance service 
providers," "first responder[s]," or "registered nurse[s]."  
Wis. Stat. § 655.002; Phelps v. Physicians Ins. Co. of Wis., 
Inc., 2005 WI 85, ¶51, 282 Wis. 2d 69, 698 N.W.2d 643; Patients 
Comp. Fund v. Lutheran Hosp., 223 Wis. 2d 439, 455, 588 
N.W.2d 35 (1999).  Just as registered nurses do not fall under 
Chapter 655 simply because they help a patient who also received 
care from a physician, CBRFs are not covered by Chapter 655 
simply due to the fact that their residents received treatment 
at a hospital or nursing home, even if those providers share 
common corporate ownership with the CBRF.6  The circuit court 
                                                 
6 The defendants also point to Chapter 655's definition of 
patient.  Wisconsin Stat. § 655.001(10) defines patient as "an 
individual who received or should have received health care 
services from a health care provider or from an employee of a 
health care provider acting within the scope of his or her 
employment."  According to the defendants, Divine Savior is a 
health care provider under Chapter 655 through its operations of 
a hospital, and Divine Savior employed the individuals who 
administered care to Oros at the CBRF.  This logic is too clever 
by half.  Oros is a "patient" under Chapter 655 only if she 
received health care "from a health care provider," as defined 
by Wis. Stat. § 655.002.  See § 655.001(8) (providing the 
definition of health care provider by reference to § 655.002).  
CBRFs 
are 
not 
health 
care 
providers 
under 
§ 655.002, 
notwithstanding their corporate associations.  Further, Chapter 
655 protection extends to "employee[s] of . . . health care 
provider[s]," as defined by Wis. Stat. §§ 655.001(8) and 
655.002, only when they are acting within "the scope of [their] 
employment" 
with 
the 
healthcare 
provider. 
 
Wis. 
Stat. 
§ 655.005(1); see also § 655.001(10) (stating that "patients" 
under Chapter 655 include those receiving care from "an employee 
of a health care provider acting within the scope of his or her 
employment").  Even if Divine Savior hires employees that serve 
multiple facilities, the scope of employment for the employees 
would be limited to the facility where the negligence allegedly 
No. 
2020AP202   
 
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below can make evidentiary rulings and give instructions that 
would properly allow a jury to determine the liability of Divine 
Savior, if any, based on its CBRF operations alone.         
¶40 The plain text of Wis. Stat. § 655.002 demands that 
CBRFs be treated differently than hospitals and nursing homes.  
While Andruss may be prohibited from bringing a wrongful death 
claim against Divine Savior's hospital and nursing home, she is 
not barred from bringing the claim against Divine Savior's CBRF.  
To the extent the defendants believe this is unfair or ill-
conceived, they may present their complaints to the political 
branches which write and enact the law.  See State ex rel. 
Cramer v. Wis. Ct. of Appeals, 2000 WI 86, ¶17, 246 Wis. 2d 473, 
613 N.W.2d 591 (under the proper judicial role, we may not 
"substitute[] 
judicial 
policy 
views 
for 
that 
of 
the 
legislature").  Our task is to apply the law as it is written.  
The defendants' Motion for the Application of Chapter 655, 
construed as a motion for summary judgment, must be denied.    
IV.  CONCLUSION 
¶41 Oros allegedly died as a result of negligence on the 
part of Divine Savior.  The defendants argue that Andruss cannot 
bring a wrongful death claim as an adult child of Oros.  
According to the defendants, the liability protections given to 
certain healthcare providers under Chapter 655 bar Andruss's 
claim.   
                                                                                                                                                             
took place.  Thus, Oros was not a "patient" under Chapter 655 
when she received care at Divine Savior's CBRF, and Andruss's 
wrongful death claim is not barred.  
No. 
2020AP202   
 
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¶42 When Oros received the injuries at issue in this case, 
she was a resident of a CBRF owned and controlled by Divine 
Savior.  The basis of Andruss's claim is alleged negligence on 
the part of the CBRF, and CBRFs fall outside the liability 
protections of Chapter 655, even if they share common ownership 
with hospitals and nursing homes.  Thus, dismissal under Chapter 
655 of Andruss's wrongful death claim is not warranted.  The 
court of appeals is affirmed.   
By the Court.—The decision of the court of appeals is 
affirmed. 
 
 
No. 
2020AP202   
 
 
 
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