Morrison Mahoney associates Kevin Buono and Lauren Denault briefed, argued, and secured two back-to-back summary judgments from different associates justices of the Massachusetts Superior Court, whose written decisions rejected theories by the plaintiff in each case that state and federal health care regulations imposed legal duties on the part of nursing home administrators to individual patients. The plaintiff estates in each case had prosecuted various claims against Massachusetts skilled nursing facilities as well as their individual administrators under the state Wrongful Death Statute. The plaintiff in Lauren’s case had alleged the administrator’s negligent stewardship of the nursing home had led to the staff’s neglect of its decedent, who allegedly died of the combined effects of pressure ulcers, severe dehydration, acute kidney injury, and sepsis. In Kevin’s case, the plaintiff alleged that omissions by the administrator in implementing and enforcing facility policies had led to a fatal mechanical patient-lift accident involving the plaintiff’s decedent, who died of internal bleeding.

The plaintiffs in both cases maintained that under Massachusetts Department of Public Health regulations and certain other federal regulations promulgated by the Centers for Medicare and Medicaid Services under the Social Security Act, which make administrators responsible for implementation of policies and overall management of skilled nursing facilities, administrators have legal duties to individual patients of facilities enforceable by patients in private civil actions. Lauren and Kevin convinced the judges in each case to adopt the approach taken by appellate courts in Arkansas, Louisiana, Mississippi, and Tennessee, which rejected interpretation of federal nursing home regulations as establishing legal duties by administrators to individual nursing home patients.

The judges in both cases also rejected as a matter of law the plaintiffs’ theory that the administrators had permitted their respective facilities to become chronically understaffed, finding the summary judgment records lacking in any support for the proposition that the administrators had any clinical control over the patient-to-staff ratio in the administrators’ facilities, and refusing to accept anecdotal evidence of understaffing by former employees who the judges found unqualified to render such opinions.