James M. Berklan, Editor

Those rumblings you might have felt recently from the West Coast had nothing to do with earthquakes. They’re the stuff of potential nightmares if you’re a nursing home operator.

The first big jolt emanated out of Humboldt County Superior Court of California when a jury there unloaded a $671 million award July 6 against Skilled Health Group for short-staffing. The amount exceeded the company’s insurance policy limits—and that was without punitive damages.

Skilled Healthcare, which strongly disputed the outcome, nonetheless agreed to pursue mediation with plaintiffs, which could be key as to whether the company—the 11th largest nursing facility company in the country, with nearly 10,000 skilled nursing beds—ultimately files for bankruptcy.

Lost in the dust cloud of that verdict’s aftermath was an aftershock that also came from northern California, and also featured a negative court finding in a nursing home staffing case.

Horizon West Healthcare’s request for a new trial or significantly reduced damages was heartily rejected by Judge Roland Candee July 13 in Sacramento Superior Court. Candee upheld a $29 million verdict against Rocklin, CA-based Horizon West, which owns 33 nursing homes.

Horizon still was able to appeal or seek a settlement, but the message was clear: A jury, and subsequently a judge as well, found that staffing was insufficient and ultimately led to death. Candee said the evidence was “overwhelming” and that retrying the case would be a “travesty.” Among the testimony against Horizon were allegations that illegal understaffing included “overworked, untrained and uncaring” employees.

Not heartening words if you’re a provider.

There is little doubt in my mind that the penalties in both of these cases will feature smaller amounts when all is said and done. But the implication should be clear: California, which was the first to pass nurse-staffing level laws, has taken it to the next level.

And just as other states have started to follow California’s lead by pursuing staffing mandates, you can be sure that plaintiff’s attorneys in other states will be drooling at the prospect of being able to sue providers for understaffing whenever an opportunity arises.

Bank your sleep now, providers. The rumblings are liable to come closer.