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Closing arguments begin in Skilled Healthcare case

Times Standard
By Matt Drange
June 15, 2010

The longest Humboldt County trial in recent memory continued on Monday, with attorneys delivering closing arguments in the civil suit against Skilled Healthcare Group Inc. -- one of the largest nursing home chains in the country.

Lawyers for the plaintiffs detailed for the jury stories of a handful of patients being represented in the suit. Patients who they contend did not receive showers on a regular basis, walked around with catheters leaking and dragging on the ground, had wounds left untreated and were forced to sit in soiled bed sheets for hours or, in some cases, even days.

Attorney Michael Thamer specializes in fighting corporate abuse, and represented the plaintiffs in the closing arguments.

He made it clear to the court that the suit does not take any issue with how hard the staff members at various Skilled Healthcare facilities are working -- but that the number of them is simply not enough to provide the necessary care for patients.

"In my opinion, they (staff members) are set up to fail before they even start," said Thamer.

Once the closing arguments are complete, the jury will deliberate and decide if Skilled Healthcare is guilty of intentional misconduct. The suit, which spans from 2003 to 2009, represents some 32,000 patients who lived at various Skilled Healthcare facilities statewide.

The issue at the heart of the case is whether or not the nursing homes maintained the staffing levels required by the state.

California law mandates that nursing homes provide a minimum of 3.2 hours of care per resident, per day. This is only the services defined as direct patient care, and includes work by registered nurses, licensed vocational nurses and certified nursing assistants.

Michael Crowley, a Eureka attorney who has worked on the case with Thamer since last November, said that Skilled Healthcare routinely failed to meet these levels.

"Each person represented in the case did not get what they paid for," said Crowley, who added that this includes taxpayers who pay into the Medicare and medical system. "They (Skilled Healthcare) are taking money for something they did not provide."

Crowley said up to 80 percent of funding for patients living in the facilities comes from Medicare. He said that in investigating the daily work logs at various facilities, the attorneys for the plaintiffs found a pattern of understaffing.

Along with subsidiary Skilled Healthcare LLC, Skilled Healthcare Group Inc. is being named as the defendant in the case, with 22 of its nursing homes currently under close scrutiny.

This includes Eureka facilities Granada, Seaview, Pacific and Eureka Healthcare and Rehabilitation, as well as St. Luke Healthcare Rehabilitation Center in Fortuna. In the first quarter of 2010 alone, Skilled Healthcare reported over $188 million in revenue.

"We are trying to send this corporation a message," said Crowley. "They need to care more about their patients and less about their bottom profit line."

More than 32,000 people are represented in the case, including two locally who were named on the case and have since passed away. Vinnie Lavender was 102 when she died at the Grenada facility in Eureka; and Robert Vilchinsky was a patient at St. Luke Healthcare and Rehabilitation before he died from complications associated with multiple sclerosis. Both were represented in court by family members.

The Humboldt County District Attorney's Office intervened in the lawsuit, and has been largely a bystander in the case from the start. District Attorney Paul Gallegos said that his office is planning to file an injunction against the defendant later this week that would order Skilled Healthcare to be in compliance with the law in the future.

Gallegos said the penalties, depending on how the court interprets them, could amount to up to $2,500 for each infraction. If you multiply this by the number of patients represented in the case, Skilled Healthcare is looking at a possible 1.4 million violations.

"It's been a long-term problem," said Gallegos. "There is overwhelming evidence that the law has been broken."

Skilled Healthcare officials say the allegations that their facilities are understaffed are false, and that staffing levels should be set by each individual facility.

Kippy Wroten, an attorney with Wroten and Associates based out of Irvine in Southern California, is representing Skilled Healthcare in the case. Wroten said that she can't comment on specifics of the case because it is still ongoing.

"Our client strives to meet the individual needs of their patients," said Wroten. "They do a wonderful job under extremely difficult circumstances."

Wroten will have a chance to make her closing arguments today, which marks the 106th day in court for the trial.

Matt Drange can be reached at 441-0514 or