Federal
Prestige violates federal resident rights (42 CFR § 483.10) to refusal, visitation, religious freedom, and assistive technology. Potential False Claims Act violations (31 U.S.C. § 3729) for fraudulent billing. Visit logs document violations (see Daily Visits). Federal complaints pending CMS or DOJ action.
Federal Legal Cases Impacting Nursing Homes
Note: The following content is adapted from an article published in the Nursing Outlook journal, available at ScienceDirect, with analysis tailored to the context of Prestige Care Center’s practices.
Introduction to Nursing Jurisprudence
Jurisprudence, in its broadest sense, refers to the theory or philosophy of law, encompassing both what the law is and what it should be. When applied to the field of nursing, jurisprudence examines how legal principles intersect with, are applied to, and interpreted within the nursing profession (Bayuo & Koduah, 2022). It includes the legal frameworks, regulations, and guidelines that govern the nursing profession, ensuring that its practitioners deliver care that is effective, compassionate, and adheres to legal standards specific to their jurisdiction (Sikes, 2023). This legal foundation is crucial for maintaining the safety and compliance of nursing practices at facilities like Prestige Care Center, where violations have been well-documented.
The intersection of law and nursing not only upholds public safety and ensures patient protection by maintaining high standards of care but also safeguards nurses by clearly defining their professional responsibilities and legal boundaries (Sikes, 2023). The application of laws to the nursing profession underscores the vital role of professional regulators by clarifying key concepts such as public protection, professional accountability, scope of practice, standards of care, licensure and registration, renewal and continuing competence requirements, and professional boundaries (Ommi, 2021). These laws are context-specific and can vary across different jurisdictions, impacting how Prestige operates across its facilities in Nebraska and beyond.
Prior to the 1970s in the United States, nurses were not recognized as licensed healthcare professionals capable of exercising independent judgment. However, the Supreme Court ruling in Utter v. United Hospital Center, Inc. (1977) transformed the legal status of nurses by establishing their affirmative duty to exercise professional judgment independently of physicians, when necessary, to prevent harm to patients (Utter v. United Hospital Center, Inc., 1977). This landmark case set a precedent by recognizing nurses as legally independent healthcare professionals, thereby making them subject to litigation (Jacob, 2018). For Prestige, this ruling underscores the accountability of its nursing staff, particularly in cases of neglect, such as residents missing physical therapy due to understaffing.
In the United States, the legal framework governing nursing is built upon four primary sources of law: constitutional, administrative (or regulatory), statutory, and common law. Constitutional law serves as the foundation, originating from national, state, or federal constitutions, and establishes fundamental legal rights and principles within a given jurisdiction (Loveland, 2024). For example, federal constitutional law protects the right of individuals with the necessary mental capacity to refuse medical treatment, as illustrated in the Arizona case Rasmussen v. Fleming (Pollard, 1987; Rillo, 1994). Administrative law consists of rules and regulations set by the executive branch and its state or federal agencies (through enabling legislation) tailored to specific areas of expertise, which operationalize statutory laws (Stewart, 2005). In the nursing profession, this is reflected in the regulations established by State Boards of Nursing and the National Council of State Boards of Nursing, which guide and govern nursing practice at facilities like Prestige.
Statutory law, emerging from constitutional authority, is enacted by the legislative arm of government, which is codified and classified into civil laws (protecting individual rights) and criminal laws (aimed at safeguarding society) (Sikes, 2023). In the nursing profession, statutory laws highlight the legal obligations and standards concerning the care of patients and professional behavior (standard of care), ensuring that the actions of nurses align with legal requirements (Spitzer-Resnick & Krajcinovic, 1994). State statutes are largely determined by nurse practice acts, with most states following a national standard of care and some states having a local standard of care, a framework Prestige must adhere to across its operations.
Common law, otherwise referred to as case law, evolves from judicial decisions rather than legislative acts, forming an unwritten body of law based on legal precedents (Westrick, 2013). Judicial decisions play a significant role in shaping nursing jurisprudence by interpreting existing laws and setting precedents for future cases. Landmark cases often highlight critical issues such as malpractice, patient consent, and professional negligence. For example, Darling v. Charleston Community Memorial Hospital (1965) established the principle that hospitals could be held vicariously liable for the negligence of their staff, including nurses, who in this case were found negligent in their follow-ups (Dickinson, 2024). This precedent directly applies to Prestige, where systemic failures have led to CMS citations for improper care.
Unlike constitutional, administrative, and statutory laws, which are typically written, common law is largely unwritten and derives its value from its ability to adapt to situations not originally anticipated by the legislature. Additionally, constitutional, administrative, and statutory laws are interpreted by courts when adjudicating cases within their respective jurisdictions. As a result, common law remains a vital force in shaping nursing jurisprudence. With the notable increase in healthcare-related litigation, courts play a crucial role in resolving these cases, with their decisions serving as binding precedents that lower courts must follow. These rulings can significantly impact the nursing profession and influence the work environment at facilities like Prestige (Wang et al., 2024).
Nurses are expected to operate within the framework of these laws, statutes, and regulations, underscoring the fundamental importance of law in the nursing profession. Between 1988 and 2001, over 200 malpractice cases were decided against nurses across trial, appellate, and supreme courts in the United States (Croke, 2003). These cases involved negligence relating to failure to adhere to standards of care (Hall v. Arthur, 1998), failure to use equipment in a responsible manner (Estate of Chin v. St Barnabas Medical Center, 1999), failure to assess/monitor and failure to communicate (Busta v. Columbus Hospital Corp., 1996), failure to document (PellE.(Physical Therapy) v. Humedicenters, 1997), and failure to act as a patient advocate (Koeniquer v. Eckrich, 1988). Although Croke (2003) reported that nurses in coronary care and intensive care units had the least involvement in litigations, a recent study has reported more than 300 cases involving critical care nurses as the primary provider in the USA, with claims involving failure to monitor and development of pressure ulcers (Myers et al., 2020).
Building on this context, some studies suggest that nurses who are knowledgeable about the law are better equipped to identify, anticipate, manage, and even prevent medico-legal issues (Bayuo & Koduah, 2022; Mojarad et al., 2022). However, legal awareness and literacy among nurses remain relatively low, making it difficult for nurses to ascertain how emerging legislation and judicial precedents are shaping the nursing profession (Griffith & Tengnah, 2023). Furthermore, there is a significant lack of cutting-edge research that thoroughly examines how existing legislation and evolving judicial precedents are influencing the nursing profession. In response to these gaps, this discussion examines recent case laws to explore their potential impact on healthcare policies and the nursing profession, with a focus on Prestige Care Center.
Recent Landmark Cases Impacting Nursing Homes
Four pivotal cases—Vaught, Loper, Talevski, and Does—address systemic issues in healthcare, from error prevention to resident rights and public health enforcement. These rulings demand reforms that Prestige, with its history of regulatory violations, must heed to avoid further scrutiny and legal challenges. Each case is explored below, drawing on extensive legal and academic references to highlight their relevance to Prestige’s ongoing failures.
Vaught: State v. Vaught
The State v. Vaught (2022) case emerged from a tragic incident at Vanderbilt University Medical Center, where nurse RaDonda Vaught was convicted of criminally negligent homicide and impaired adult abuse after administE.(Physical Therapy)g the wrong medication, vecuronium instead of Versed, leading to a patient’s death in 2017 (CMS, 2018; Kelman, 2022). The patient, a 75-year-old with a history of cancer, was admitted with symptoms of a potential brain bleed and scheduled for a full-body positron emission tomography scan. Due to claustrophobia, the attending physician requested sedation, but Vaught’s error—failing to read the medication label, ignoring warnings on the vecuronium vial, and not monitoring the patient post-administration—resulted in the patient’s death. J.S. Barry et al. (2022) in the Journal of PE.(Physical Therapy)atology argue that criminalizing such errors risks deterring transparency, advocating instead for organizational reforms to prevent future incidents. This perspective aligns with historical precedents like Estate of Chin v. St Barnabas Medical Center (1999), where the Supreme Court of New Jersey held hospitals liable for systemic negligence in patient care, emphasizing the need for institutional accountability over individual blame (Estate of Chin v. St Barnabas Medical Center, 1999).
For Prestige Care Center, this ruling has direct implications. Prestige’s Nebraska City facility has been cited by CMS for medication mismanagement, contributing to $118,195 in fines over three years for violations including improper care and infection control failures. Vaught mandates the adoption of technology safeguards, such as barcoding systems to verify medications before administration, and transparent error reporting to foster a culture of safety (CMS, 2018). However, Prestige’s documented resistance to transparency—evidenced by their hostility toward advocates exposing these issues—suggests compliance may be a challenge. E.M. Croke (2003) in The American Journal of Nursing notes that systemic failures, as seen in over 250 cases against nurses, often stem from inadequate training and oversight, a pattern Prestige must address to avoid liability similar to that in Koeniquer v. Eckrich (1988), where the Supreme Court of South Dakota held a facility accountable for negligence due to poor protocols.
Loper: Loper Bright Enterprises v. Raimondo
Loper Bright Enterprises v. Raimondo (2024) overturned the long-standing Chevron deference, a 1984 ruling that allowed federal agencies to interpret ambiguous statutes. Post-Loper, agencies like CMS face heightened scrutiny when defending policies such as reimbursement rates or scope-of-practice rules, requiring explicit statutory mandates to justify their actions. J. Dickinson (2024) in the Journal of Health Care Law and Policy highlights that this shift empowers courts to challenge agency regulations, potentially weakening CMS’s ability to enforce penalties or staffing requirements on nursing homes. S.R. Jacob (2018) in Contemporary Nursing E-Book: Issues, Trends, & Management underscores the importance of scope-of-practice rules in ensuring adequate care, noting that nurses’ roles are often constrained by understaffing, a pervasive issue in facilities like Prestige.
Prestige Care Center, with its Nebraska City facility operating at just 3.1 hours per resident per day—below recommended levels—already struggles with staffing compliance. Loper may embolden Prestige to challenge CMS fines or regulations, arguing that CMS lacks clear statutory authority to impose such penalties. This could delay improvements in care quality, exacerbating issues like high nurse turnover (89.8% at Nebraska City) and resident neglect, such as missed physical therapy sessions at the Plattsmouth facility. R. Griffith and Tengnah (2023) in Law and Professional Issues in Nursing caution that such regulatory uncertainty can lead to inconsistent care standards, a risk Prestige must navigate as courts increasingly scrutinize agency actions under Loper.
Talevski: Health and Hospital Corporation of Marion County v. Talevski
Health and Hospital Corporation of Marion County v. Talevski (2023) marks a significant shift in nursing home accountability, affirming that residents can sue facilities under the Federal Nursing Home Reform Act (FNHRA) for violations of their rights, such as unnecessary use of restraints or failure to provide adequate care (Health and Hospital Corporation v. Talevski, 2023). The case arose when Gorgi Talevski’s family sued a nursing home for chemical restraint and involuntary transfer, highlighting systemic abuses. Talevski shifts power dynamics, requiring nursing homes to align operations with resident-defined quality metrics, such as timely access to therapies or family involvement in care decisions. R. Griffith and Tengnah (2023) in Law and Professional Issues in Nursing emphasize that this ruling empowers families to hold facilities accountable, a principle supported by precedents like Hall v. Arthur (1998), where the 8th Circuit upheld resident rights to sue for inadequate care (Hall v. Arthur, 1998).
Talevski Amicus Brief (2022) – Brief in Health and Hospital Corporation v. Talevski, supporting residents’ rights to sue for FNHRA violations under § 1983.
For Prestige, Talevski directly challenges their practices. At the Plattsmouth facility, residents have missed physical therapy due to understaffing, and families have faced retaliation for advocating for better care, including a 70-day ban on visitation that was later overturned by court order on April 9, 2025. Talevski strengthens the legal standing of families challenging Prestige’s failures, particularly when those failures disregard resident needs, such as ensuring consistent therapy or respecting family involvement. J. Bayuo and Koduah (2022) in Ghana Medical Journal note that systemic failures in care delivery, as seen in malpractice cases globally, often stem from neglecting resident-centered metrics, a lesson Prestige must heed to avoid further legal consequences.
Does: Does v. Mills
Does v. Mills (2021) upholds state authority to enforce public health mandates, prioritizing communal safety over individual exemptions during crises. This ruling, rooted in the precedent of Jacobson v. Massachusetts (1905), which affirmed state power to mandate smallpox vaccinations, was tested when Maine required healthcare workers to be vaccinated against COVID-19, rejecting religious exemptions (Jacobson v. Massachusetts, 1905). The Supreme Court’s refusal to block Maine’s mandate in Does reinforces that nursing homes must comply with state health directives, such as vaccination requirements or infection control protocols, to protect residents and staff. J. Bayuo and Koduah (2022) in Ghana Medical Journal highlight the global relevance of such mandates, noting their role in preventing outbreaks in vulnerable settings like nursing homes.
Prestige Care Center has a troubling history of infection control violations, with CMS citing their Nebraska City facility for repeated failures in this area. E.M. Croke (2003) in The American Journal of Nursing warns that non-compliance with health mandates can lead to negligence claims, as seen in Busta v. Columbus Hospital Corp. (1996), where the Supreme Court of Montana held a facility liable for failing to uphold safety standards (Busta v. Columbus Hospital Corp., 1996). Does ensures that Prestige cannot evade state oversight, requiring them to prioritize communal safety through proper staffing and protocols. Given Prestige’s track record, including incidents like diluting morphine at their Fairfield, Iowa facility, this ruling underscores the need for rigorous compliance to protect residents during public health crises.
Additional Federal Legal Cases
Regulatory Resources
- OIG Exclusion Program – Federal authority to exclude providers from Medicare/Medicaid for violations, relevant to Prestige’s regulatory issues.
- OIG Corporate Integrity Agreements – Agreements used for nursing home operators to avoid exclusion, applicable to Prestige’s parent company.
Reports and Articles
Implications for Prestige and the Broader Nursing Home Industry
These four cases collectively demand that Prestige address its systemic failures while empowE.(Physical Therapy)g residents and families to hold the facility accountable. Vaught mandates technological and cultural reforms to prevent errors, a critical need for Prestige given their medication mismanagement issues. Loper introduces uncertainty for CMS enforcement, potentially allowing Prestige to challenge penalties, but Talevski counters this by empowE.(Physical Therapy)g residents to sue directly for violations of their rights, such as Prestige’s neglect of therapy services or retaliation against advocates. Does reinforces state oversight, ensuring Prestige must comply with public health mandates despite their history of violations.
The broader nursing home industry, including Prestige, must navigate these legal shifts under increasing public scrutiny. As platforms like this website continue to expose Prestige’s failures—from understaffing to lack of transparency—these cases provide a framework for reform. Families affected by Prestige’s practices are encouraged to leverage Talevski to demand better care, while advocates can use Vaught and Does to push for systemic changes in error prevention and public health compliance. The interplay of these rulings underscores the urgent need for Prestige to reform, lest they face further legal and public consequences.
References
- Barry, J.S., et al. (2022). Is medical error a crime? The impact of the State v. Vaught on patient safety. Journal of PE.(Physical Therapy)atology.
- Bayuo, J., & Koduah, A. (2022). Pattern and outcomes of medical malpractice cases in Ghana: A systematic content analysis. Ghana Medical Journal.
- Busta v. Columbus Hospital Corp., 124 (Supreme Court of Montana, 1996).
- CMS. (2018). Statement of deficiencies and plan of correction for Vanderbilt University Medical Center (FORM CMS-2567).
- Croke, E.M. (2003). Nurses, negligence, and malpractice: An analysis based on more than 250 cases against nurses. The American Journal of Nursing.
- Darling v. Charleston Community Memorial Hospital (1965).
- Dickinson, J. (2024). Direct hospital liability as a legal path to improved safety? Journal of Health Care Law and Policy.
- Estate of Chin v. St Barnabas Medical Center, 780 (Supreme Court of New Jersey, 1999).
- Griffith, R., & Tengnah, C. (2023). Law and Professional Issues in Nursing. Learning Matters.
- Hall v. Arthur, 141 F.3d 844 (8th Cir. 1998).
- Health and Hospital Corporation of Marion County v. Talevski, 1 (Supreme Court, 2023).
- Jacob, S.R. (2018). Nursing licensure and certification. In Contemporary Nursing E-Book: Issues, Trends, & Management.
- Jacobson v. Massachusetts, 197 U.S. 11, 25 S.Ct. 358, 49 L.Ed. 643 (1905).
- Kelman, B. (2022). As a nurse faces prison for a deadly error, her colleagues worry: Could I be next? National Public Radio.
- Koeniquer v. Eckrich (Supreme Court of South Dakota, 1988).
- Loveland, I. (2024). [Details not provided in original reference].
- Mojarad, F.A., et al. (2022). [Details not provided in original reference].
- Myers, T., et al. (2020). [Details not provided in original reference].
- Ommi, M. (2021). [Details not provided in original reference].
- PellE.(Physical Therapy) v. Humedicenters (1997).
- Pollard, S. (1987). [Details not provided in original reference].
- Rillo, P. (1994). [Details not provided in original reference].
- Sikes, P. (2023). [Details not provided in original reference].
- Spitzer-Resnick, J., & Krajcinovic, K. (1994). [Details not provided in original reference].
- Stewart, R.B. (2005). [Details not provided in original reference].
- Utter v. United Hospital Center, Inc. (1977).
- Wang, Y., et al. (2024). [Details not provided in original reference].
- Westrick, S.J. (2013). [Details not provided in original reference].
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