Health & Welfare | Daily Report

What spurs a jury to inflict $671 million in damages against one nursing home chain?

Part of the answer lies in the 250,000 pages of internal company documents that plaintiff attorneys used to make their case.

Last week a Humboldt County jury handed down the historic verdict against Skilled Healthcare Group, an Orange County-based chain. Plaintiffs attorneys in the class-action lawsuit alleged that the chain suggested to patients that it provided adequate staffing, but in fact, did not.

This week jurors will deliberate on punitive damages against the firm. 

To prove their case so far, attorneys for the plaintiffs showed the jury examples of Skilled Healthcare facility managers expressing frustration to corporate executives about staffing and overtime constraints. Attorney Michael Thamer shared several with California Watch, and you can see them below.

The e-mails center around an issue that was key to the plaintiff attorney's case: how the facilities met state-staffing standards. State regulators require that a nursing home employ enough nurses, licensed vocational nurses and nursing assistants to render 3 hours and 12 minutes of care to each patient, each day.

During the case, Skilled Healthcare argued that workers such as business managers, physical therapy technicians and van drivers who were licensed caretakers also counted toward the state-staffing requirement. They plan to "vigorously challenge" the verdict, a company press release says.

In one e-mail submitted as a trial exhibit, a regional vice president calls on administrators to send her overtime reports by 4 p.m. each day.

“I do not like micro-managing,” then-regional vice president Janet Stone wrote, "but this is necessary on a short-term basis until we get this in line."

The then-administrator of Granada Healthcare and Rehab in Eureka, Calif., pushed back, writing that he was meeting budget goals and was exasperated by the request.

But right now it feels … like we’re a three-legged dog whose owner thinks a little finger shaking and kicking will grow that other leg. We (sic) doing some good work here. And I am the first to tell anyone that we’ve got a long way to go.

But by God, we’re pushing this three-legged dog faster than James Brown on espresso shots and Red Bull.

I know this isn't a "happy" e-mail. I apologize for that. … We could do some amazing things with four legs.

A second e-mail strikes the same theme. In this one, a facility administrator from Alta Care Center in Garden Grove, Calif., complains about tight staffing constraints. He notes that he only has a tiny fraction more staffing than the state requires. “That seems like in order to hit my budget target, I have to play with fire, since one call off that takes more than an hour to fill can throw us under [the state minimum]." 

A third message raises more questions than it answers. In it, a payroll manager asks a facility manager how to calculate staffing for a day in 2008 when the rate at the facility fell short of the state-minimum level.

Do you want me to count Aimee’s 5.71 (hours), but the problem was she wasn’t really here?

Attorneys for the plaintiffs never found a reply to that message.