In Pennsylvania, the doctrine of corporate negligence provides that hospitals and certain other medical organizations owe duties of care directly to their patients, and may be liable for the breach of that duty without a showing that any particular doctor or medical professional acted negligently. In a recent decision in Scampone v. Grane Healthcare Co., the Pennsylvania Superior Court extended this concept of corporate negligence to nursing homes.
In Scampone, the plaintiff was a resident of Highland Park Care Center, a nursing home. Op. at 3. In December 2003, she was diagnosed with a urinary tract infection (UI), and subsequently hospitalized, treated and returned to Highland Park. Just over one month later, she was re-admitted to the hospital after being diagnosed with another UI, dehydration, malnutrition, and bed sores. She died just over a week later of a heart attack. The plaintiff’s estate sued the nursing home and its owners, claiming that the UI, dehydration and malnutrition caused the patient’s heart attack, and that those conditions were the product of chronic understaffing and/or substandard care at Highland Park. The case proceeded to trial, and a jury returned a verdict against the nursing home.
On appeal, Highland Park argued that the trial court erred in permitting a claim of corporate negligence against a nursing home. In evaluating Highland Park’s argument, the Superior Court relied heavily on the leading case on corporate negligence – the Pennsylvania Supreme Court’s decision in Thompson v. Nason Hospital, 591 A.2d 703 (Pa. 1991).
Thompson held that hospitals could be subject to liability for claims of corporate negligence. In adopting this rule, the Supreme Court observed that hospitals had evolved “into highly sophisticated corporations operating on a fee-for-service basis” and served as “comprehensive health center[s] with responsibility for arranging and coordinating the total health care of the patient.” 591 A.2d at 706. As a result of its provision of these services, the court found that a hospital owed a duty “to uphold the proper standard of care owed the patient, which is to ensure the patient’s safety and well being at the hospital.” The court further clarified that these duties fell into four specific areas:
(1) A duty to use reasonable care in the maintenance of safe and adequate facilities and equipment; (2) a duty to select and retain only competent physicians; (3) A duty to oversee all persons who practice medicine within its walls as to patient care; and (4) a duty to formulate, adopt and enforce adequate rules and policies to ensure quality care for the patients. Id. (citations omitted).
In Scampone the Superior Court analyzed whether the reasoning of Thompson applied to nursing homes. The court first noted that the rule of Thompson had been extended to health maintenance organizations and medical professional corporations, but not to a physician’s outpatient office. After reviewing this precedent, the court concluded that “a nursing home is analogous to a hospital in the involvement in the patient’s overall health care.” Like the hospital in Thompson, “a nursing home provides comprehensive and continual physical care for its patients.” Moreover, the evidence demonstrated that Highland Park “was responsible for coordinating nearly all the health care of its patients.” Therefore, the court held the doctrine of corporate negligence was properly applied.
The decision in Scampone is not surprising given the prior Pennsylvania precedent on corporate negligence in the hospital context. However, all those operating a nursing home or nursing facilities should be aware that the Superior Court has now spoken clearly on this issue.