Jury Verdict Against the Corporate Manager of an Assisted Living Facility for Understaffing Upheld by Tennessee Supreme Court

The corporate manager of an assisted living facility in Tennessee has been found negligent for failing to provide adequate staffing, resulting in the death of one of its residents.

Mable Farrar was a resident at Celebration Way, an assisted living facility in Bledsoe County. During the summer of 2003, she was hospitalized for four days for constipation and afterwards spent approximately two months in a nursing home regaining her strength. Her physician, Dr. Tamula, prescribed her a daily dose of an over-the-counter medicine for constipation. Dr. Tamula made it “crystal clear” to the staff at Celebration Way that they must immediately notify her if Ms. Farrar became constipated again.

From October 2003 to May 2004, the nursing staff at the assisted living facility did not give the medicine to her as often as prescribed. As a result, Ms. Farrar became constipated and returned to see her doctor. Dr. Tamula notified the nursing staff at the assisted living facility to give Ms. Farrar three to four enemas each day beginning on May 27, 2004. A facility nurse gave Ms. Farrar one enema on the evening of May 27 and none on May 28.

On that day Ms. Farrar told Paula Gann, a caregiver at Celebration Way, that she was not feeling well, she had not had a bowel movement, and “wished she could.” Ms. Gann noticed that Ms. Farrar’s stomach was distended, and Ms. Gann overheard Ms. Steelman remark to Ms. Farrar that “she looked like she was about to have twins.”

Ms. Farrar received an enema on the evening of May 29. Very soon after receiving that last enema, Ms. Farrar died from a perforated colon.

Her daughters filed a wrongful death action against the nurse who gave the enema, the Director of Nursing at Celebration Way, the owner of the facility, and its management company.

The issue presented is whether the jury verdict against the management company of an assisted living facility for negligence based on understaffing is supported by material evidence.

Her daughters filed a wrongful death action against the nurse who gave the enema, the director of nursing at the assisted living facility, the owner of the facility, and its management company, Americare Systems, Inc. The suit alleged that the negligence of the staff, the owner, and its management company caused Ms. Farrar’s death.

After a 10-day trial, the jury returned a verdict finding the nurse 30 percent at fault, the director of nursing 20 percent at fault, and the management company 50 percent at fault based on its failure to provide sufficient personnel at the facility.

The management company appealed. The Court of Appeals reversed the jury verdict against the management company, finding that there was no material evidence that staffing deficiencies proximately caused Ms. Farrar’s death.

On appeal to the Tennessee Supreme Court, the decision of the Court of Appeals was reversed and the $300,000 verdict reinstated.

The testimony of Celebration Way’s Administrator was that “let the people at Americare Systems know that [she] didn’t have enough staff to get the job done right for the patients,” that “there was too much to do and too few staff to get the job done,” and their “workload is overwhelming sometimes.”

Ms. Farrar's daughters also introduced proof from expert witnesses of the understaffing problem at Celebration Way, to show that Americare had deviated from the standard of care. Americare objected to the admission of the expert testimony, but the court explained that it did not need to reach that issue: "Because we hold that the Plaintiffs presented material evidence that understaffing by Americare was a substantial factor in causing Ms. Farrar’s death, we need not address Americare’s arguments that the judgment against Americare should be reversed because Plaintiffs failed to present expert testimony or other evidence to establish the applicable standard of care regarding appropriate staffing levels for an assisted living facility."

The jury had awarded $5 million in punitive damages against Americare. In reversing the decision of the Court of Appeals, the Supreme Court sent the case back to the Court of Appeals to review the punitive damages award.

Wilson v. Americare Systems, Inc., Feb. 25, 2013.

Contact Us

  • Enter security code:
     Security code