Diversicare General Partner Inc. v. Rubio

"We address for the first time whether the Medical Liability Insurance Improvement Act (MLIIA or the Act) governs a patient's claims that a nursing home's negligence in failing to provide adequate supervision and nursing services proximately caused her injuries from a sexual assault by another patient. We conclude that the nursing home resident's claims in this case are causes of action for departures from accepted standards of professional health care and safety."

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Click here for the full text of this decision FACTS:From Aug. 1, 1994, to Jan. 17, 1999, Maria Rubio was a resident of Goliad Manor nursing home. She suffered from senile dementia of the Alzheimer’s type, rendering her mentally incapacitated for the duration of her stay at Goliad. On July 14, 1999, Rubio’s daughter, Mary Holcomb, as next friend, brought suit on Rubio’s behalf against Diversicare General Partner Inc., Diversicare Leasing Corp., Advocat Inc. and Texas Diversicare Limited Partnership doing business as Goliad Manor (collectively Diversicare) for injuries Rubio sustained in two separate falls while a resident at the facility. She alleged that Diversicare and its staff were negligent in failing to provide adequate supervision and nursing services to meet her fundamental needs; failing to budget for, hire and train a sufficient number of qualified direct health care staff; failing to develop and implement adequate policies and procedures for safety, training and staffing at its nursing homes; and for violations of Texas Penal Code 22.04. Rubio also brought a claim for breach of contract asserting that, as a Medicaid recipient, she was a third-party beneficiary to a contract between Diversicare and the Texas Department of Human Services under the Texas Medical Assistance Program. On Sept. 26, 2000, Rubio amended her petition to include damages arising from the alleged failure of Diversicare and its staff to adequately supervise and monitor Rubio to protect her from sexual abuse and assault by another resident in violation of Texas Penal Code 22.011 and 22.021. She alleges multiple incidents of sexual assault occurring between October 1994 and April 1995. The summary judgment evidence identifies one incident that took place on April 25, 1995. A nurse entered Rubio’s room and discovered a male resident straddling Rubio on the bed. Both Rubio’s daughter and her physician were informed of the incident shortly after it occurred. Rubio remained a resident at Goliad Manor for another three-and-a-half years. Rubio also added in her amended petition a claim for breach of an implied covenant to provide reasonably safe premises in which Rubio was a third-party beneficiary of the contract between Diversicare and the Texas Department of Human Services. Rubio further claimed fraudulent inducement, alleging that the facility represented that it would provide for her safety. Diversicare moved for summary judgment on all of Rubio’s claims arising from the alleged sexual assaults, arguing that the Medical Liability Insurance Improvement Act’s two-year statute of limitations barred recovery on the claims. The district court severed all the claims arising from the assaults and granted Diversicare’s motion for summary judgment. The court of appeals reversed, holding that Rubio’s claims arising from the alleged assaults are claims for common law negligence and are not covered by the MLIIA. The court concluded that Rubio’s mental incapacity tolled the statute of limitations for personal injury claims, as provided by Texas Civil Practice & Remedies Code 16.003. Diversicare petitioned this court for review. HOLDING:Rubio claims that Diversicare failed to provide adequate supervision and nursing services to meet her fundamental needs and to protect her. The Legislature broadly defined health care liability claims in the Medical Liability Insurance Improvement Act, and the definition includes her claims. Accordingly, the statute of limitations is not tolled by Texas Civil Practice & Remedies Code 16.001(b). Because Rubio filed suit in 1999 and the sexual assault occurred in 1995, Rubio’s claims are barred by the two-year statute of limitations in the MLIIA. The court reverses the decision of the court of appeals and renders judgment for Diversicare. OPINION:Wainwright, J. delivered the opinion of the court, in which Hecht, Medina, Johnson and Willett, JJ., joined, and in which Jefferson, C.J., joined as to Part III(B)(3). Jefferson, C.J., filed an opinion concurring in part, dissenting in part and concurring in the judgment. O’Neill, J., filed a dissenting opinion, in which Brister and Green, JJ., joined. CONCURRENCE:Jefferson, C.J. “In defining health care liability claims as it did, the Legislature created a statute with a broad scope. Complaints about the breadth of this statute should be directed to the Legislature, not to this Court, for the courts must”take statutes as they find them.’ [Simmons v. Arnim, 220 S.W. 66, 70 (Tex. 1920)]. Accordingly, I concur in part III(B)(3) of the Court’s opinion and concur in the judgment.” DISSENT:O’Neill, J. “I agree that the MLIIA would govern a claim that the nursing home failed to properly staff the facility. Because a nursing home is required to consider the physical and mental-health conditions of each of its residents in determining its staffing needs, staffing decisions cannot be made without employing medical judgment. Similarly, any safety claim arising from such staffing decisions would be “directly related to health care” and therefore also covered under the MLIIA. However, because the plaintiff’s petition also included an allegation that the facility failed to use ordinary care to protect her from a known sexual offender, it alleged a broader premises liability claim. I therefore respectfully dissent.”

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