The Supreme Court of California (“California Supreme Court”) stated in its opinion filed on August 17, 2020: “Health and Safety Code section 1430, subdivision (b) gives a current or former Nursing care patient or resident the right to bring a private cause of action against a skilled nursing facility for violating certain regulations. The available remedies include injunctive relief, costs and attorney fees, and “up to five hundred dollars ($500)” in statutory damages. The question we address is whether the monetary cap of $500 is the limit in each action or instead applies to each violation committed. For reasons that follow, we conclude that section 1430, subdivision (b)’s $500 cap applies per action, not per regulatory violation.”

The Underlying Facts

91-year-old John Jarman (“Jarman”) fractured his left hip in 2008 after slipping and falling as he climbed out of a swimming pool. He had surgery to place a rod in his leg after which he was transferred on March 17, 2008 from the hospital to defendant Manor Care of Hemet, CA, LLC, a skilled nursing facility of HCR ManorCare, Inc. (“Manor Care”). Jarman was unable to move or get up on his own and he required full assistance with daily activities, which included dressing, eating, toilet use, hygiene, and bathing. During his three-month stay, Manor Care staff allegedly often left him in soiled diapers, ignored nurse call lights, and caused him to suffer other neglect and indignities. Jarman was discharged from Manor Care on June 16, 2008.

Jarman filed a complaint on April 26, 2010 alleging three causes of action: violations of the “Patients Bill of Rights” (Health & Saf. Code, § 1430, subd. (b), citing Cal. Code Regs., tit. 22, § 72527); elder abuse and neglect; and negligence. Jarman alleged that despite knowing that he was at “a high risk for skin breakdown,” Manor Care failed to take preventative measures and instead often left him in soiled diapers; as a result, he suffered from significant skin excoriation and bedsores which took over a year to heal after he was discharged. He also alleged that he suffered from other forms of abuse and neglect. Jarman died before trial began, and his daughter, Janice Jarman, represented him as his successor in interest.

On June 15, 2011, the jury awarded Jarman $100,000 in damages and $95,500 in statutory damages, i.e., $250 for each of the 382 violations. The jury also answered “yes” to the question whether “[d]efendant engaged in conduct that caused harm to the plaintiff with malice, oppression or fraud.”

Section 1430(b)

In relevant part, section 1430(b) provides that a current or former patient of a skilled nursing facility “may bring a civil action against the licensee of a facility who violates any rights of the resident or patient as set forth in the Patients Bill of Rights in Section 72527 of Title 22 of the California Code of Regulations, or any other right provided for by federal or state law or regulation. . . . The licensee shall be liable for up to five hundred dollars ($500), and for costs and attorney fees, and may be enjoined from permitting the violation to continue . . . .”

The California Supreme Court stated: “We agree that the language of section 1430(b) is far from clear … section 1430(b) contains no indication that the Legislature intended juries to exercise the same level of enforcement discretion that the Department exercises in administering the Act … many of the rights set out in the Patients Bill of Rights appear to overlap with one another, making it difficult to parse out what constitutes a separate and distinct violation for purposes of section 1430(b) … section 1430(b) “provides no notice as to what evidentiary facts constitute a single continuing violation or separate violations of a patient’s right, or whether a practice or a course of conduct gives rise to one or more violations” … These deficiencies, including the lack of textual guidance and specificity, suggest that the Legislature did not focus on calibrating any monetary relief to the nature of each patient right and violation articulated in section 1430(b).”

“Contrary to Jarman’s and the dissent’s suggestion (see dis. opn., post, at pp. 3–4), the inclusion of the term “the violation” in the singular does not indicate that the $500 cap applied to each violation, particularly when we consider the general rule of statutory construction that “[t]he singular number includes the plural, and the plural the singular.” (§ 13.) More to the point, despite textual changes to the recovery of damages, every version of the bill left unchanged language that a facility “may be enjoined from permitting the violation to continue.” This suggests that the inclusion of the phrase did not reflect what the Legislature intended by the particular monetary cap … This legislative history reflects that the Legislature has consistently interpreted the provision to provide a cap of $500 per lawsuit … we conclude section 1430(b) was not intended to be the exclusive or primary enforcement mechanism for residents of long-term care facilities seeking compensation for harms suffered in those facilities.”

The California Supreme Court concluded: “Undoubtedly, nursing care patients comprise a particularly vulnerable segment of our population and deserve the highest protections against any abuse and substandard care. That said, we cannot and must not legislate by grafting onto section 1430(b) a remedy that the Legislature has chosen not to include … Instead, we look to the Legislature, which has left the phrase (i.e., a facility “shall be liable for up to five hundred dollars ($500)”) unchanged for nearly 40 years, to make any necessary adjustments or clarifications as it sees fit.”

Dissenting Opinion

The dissenting opinion stated, in part: “under a per lawsuit cap, the additional pressure to stop violating rights that a facility faces from statutory penalties once it has violated one right is effectively zero. A facility will face the same potential liability whether it violates one right or one hundred. A cap of $500 per lawsuit is clearly “not sufficient to ensure a patient her rights” … The potential for a lawsuit worth as much as $500 per violation is a powerful incentive to adhere to the requirements of the Long-Term Care Act. The majority’s reading severely blunts that incentive, by starkly reducing the financial rationale for compliance under section 1430(b) of the act.”

“Given the purpose of this statute to allow vulnerable nursing home residents to better protect their own rights, the natural conclusion is that the Legislature intended the $500 penalty to serve as an additional deterrent to wrongdoing. The Legislature has similarly added statutory penalties to other enforcement schemes like the false advertising law and unfair competition law where it finds that “the injunctive remedy was . . . an ineffective deterrent against violations” … There is simply no reason to believe the Legislature did not intend the same in creating the $500 penalty for a violation under the act enforced through section 1430(b).”

“The majority’s reliance on a patient’s ability to obtain an injunction and attorney fees under section 1430(b), as well as their contention that other available legal remedies can provide for adequately compensatory damages remedies, prompt the more fundamental question: If all of that is true, what possible purpose does damages of up to $500 per lawsuit serve? If the $500 is a penalty, then a $500 per-lawsuit penalty is clearly insufficient to serve the statute’s goal of deterring regulatory violations. If the $500 is considered compensatory, a per lawsuit approach does not compensate residents for the violations of many rights covered by section 1430(b). We should be extremely wary of statutory constructions that render a word or phrase useless. That is, in practical terms, exactly what the majority’s construction of the $500 limitation achieves here … Per-violation damages support the statute’s deterrent function, and other private and public enforcement mechanisms are not suited to fill the void created by the majority’s decision today.”

Source Jarman v. HCR Manorcare, Inc., S241431.

If you or a loved one suffered injuries (or worse) while a resident of a nursing home in California or in another U.S. state due to a nursing home fall, nursing home aspiration, nursing home neglect, nursing home negligence, nursing home abuse, nursing home under-staffing, or the nursing home failing to properly care for a vulnerable adult, you should promptly find a nursing home claim lawyer in California or in your state who may investigate your nursing home claim for you and file a nursing home claim on your behalf or behalf of your loved one, if appropriate.

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