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Date: 08-23-2020

Case Style:

Janice Jarman v. HCR Manorcare, Inc.

Case Number: S241431

Judge: Chin, J.

Court: Supreme Court of California

Plaintiff's Attorney: Anthony C. Lanzone and Jay-Allen Eisen

Defendant's Attorney: John Patrick Petrullo, Joanna S. McCallum, Barry S. Landsberg, Caroline J Wu and Grace Ge Song

Description: Health and Safety Code1 section 1430, subdivision (b)
gives a current or former nursing care patient or resident the
right to bring a private cause of action against a skilled nursing
facility for violating certain regulations. The available remedies
include injunctive relief, costs and attorney fees, and “up to five
hundred dollars ($500)” in statutory damages. The question we
address is whether the monetary cap of $500 is the limit in each
action or instead applies to each violation committed.
For reasons that follow, we conclude that section 1430,
subdivision (b)’s $500 cap applies per action, not per regulatory
In early 2008, John Jarman, then 91 years old, fractured
his left hip after slipping and falling as he climbed out of a
swimming pool. After undergoing surgery to place a rod in his
leg, John2 was transferred from the hospital to Manor Care of
Hemet, CA, LLC, a skilled nursing facility of HCR ManorCare,
Inc. (collectively, Manor Care) on March 17, 2008. John could

1 All statutory provisions are to the Health and Safety Code
unless otherwise noted.
2 To avoid confusion, we refer to John Jarman by his first
name when discussing the facts leading up to the lawsuit. (See
post, p. 2 [explaining that John died after filing his lawsuit, and
is now represented by his daughter as successor in interest].)
Opinion of the Court by Chin, J.
not move or get up on his own, and required full assistance with
daily activities, which included dressing, eating, toilet use,
hygiene, and bathing. During John’s three-month stay, Manor
Care staff allegedly often left him in soiled diapers, ignored
nurse call lights, and caused John to suffer other neglect and
indignities. John was discharged from Manor Care on June 16,
On April 26, 2010, John filed a complaint alleging three
causes of action, i.e., violations of the “Patients Bill of Rights”
(Health & Saf. Code, § 1430, subd. (b), citing Cal. Code Regs.,
tit. 22, § 72527); elder abuse and neglect; and negligence. The
complaint alleged that despite knowing that John was at “a high
risk for skin breakdown,” Manor Care failed to take
preventative measures and instead often left him in soiled
diapers; as a result, John suffered from significant skin
excoriation and bedsores which took over a year to heal after he
was discharged. It also alleged that John suffered from other
forms of abuse and neglect. John died before trial began, and
his daughter, Janice Jarman, represented him as his successor
in interest. References to “Jarman” are to both John and Janice
unless otherwise noted.
At the close of Jarman’s case in chief, Manor Care moved
to strike the request for punitive damages from the complaint.
The trial court denied the motion. On June 15, 2011, the jury
awarded Jarman $100,000 in damages and $95,500 in statutory
damages, i.e., $250 for each of the 382 violations. The jury also
answered “yes” to the question whether “[d]efendant engaged in
conduct that caused harm to the plaintiff with malice,
oppression or fraud.” Based on concerns regarding the
sufficiency of the evidence, the trial court later struck the
punitive damages claim.
Opinion of the Court by Chin, J.
Manor Care subsequently made a motion for a partial
judgment notwithstanding the verdict, or alternatively, to
correct the judgment. Based on a complicated procedural
history not relevant to the issue here, the trial court’s judgment
was not entered until over three years later, on September 9,
2014. On remand, the trial court entered judgment against
Manor Care in the amount of $195,500 and subsequently
awarded Jarman $368,755 in attorney fees. Both Jarman and
Manor Care appealed.
The Court of Appeal agreed with Jarman that the trial
court erred in striking the jury’s finding that Manor Care acted
with malice, oppression, or fraud. It rejected Manor Care’s
claim that Jarman was limited to $500 in statutory damages,
and instead reasoned that the $500 cap applied to each cause of
action. The court remanded the matter to the trial court to
conduct further proceedings to determine the amount of
punitive damages Jarman was entitled to based on the 382
regulatory violations. (Jarman v. HCR ManorCare, Inc. (2017)
9 Cal.App.5th 807.) We granted review.
This state has long recognized nursing care patients as
“one of the most vulnerable segments of our population” and “in
need of the safeguards provided by state enforcement of patient
care standards.” (California Assn. of Health Facilities v.
Department of Health Services (1997) 16 Cal.4th 284, 295
(Health Facilities).) To that end, the Legislature enacted the
Long-Term Care, Health, Safety, and Security Act of 1973
(Long-Term Care Act or Act; § 1417 et seq.). Almost a decade
later, the Legislature enacted the Elder Abuse and Dependent
Adult Civil Protection Act (Elder Abuse Act; Welf. & Inst. Code,
Opinion of the Court by Chin, J.
§ 15600 et seq.)), the specific purpose of which is “to protect a
particularly vulnerable portion of the population from gross
mistreatment in the form of abuse and custodial neglect.”
(Delaney v. Baker (1999) 20 Cal.4th 23, 33 (Delaney).)
This case turns on the interpretation of section 1430,
subdivision (b) (section 1430(b)), which is part of the Long-Term
Care Act. “Our fundamental task in interpreting a statute is to
determine the Legislature’s intent so as to effectuate the law’s
purpose. We first examine the statutory language, giving it a
plain and commonsense meaning. We do not examine that
language in isolation, but in the context of the statutory
framework as a whole in order to determine its scope and
purpose and to harmonize the various parts of the enactment.
If the language is clear, courts must generally follow its plain
meaning unless a literal interpretation would result in absurd
consequences the Legislature did not intend. If the statutory
language permits more than one reasonable interpretation,
courts may consider other aids, such as the statute’s purpose,
legislative history, and public policy.” (Coalition of Concerned
Communities, Inc. v. City of Los Angeles (2004) 34 Cal.4th 733,
In relevant part, section 1430(b) provides that a current or
former patient of a skilled nursing facility “may bring a civil
action against the licensee of a facility who violates any rights
of the resident or patient as set forth in the Patients Bill of
Rights in Section 72527 of Title 22 of the California Code of
Regulations, or any other right provided for by federal or state
law or regulation. . . . The licensee shall be liable for up to five
hundred dollars ($500), and for costs and attorney fees, and may
be enjoined from permitting the violation to continue . . . .”
(Italics added.) (Added by Stats. 1982, ch. 1455, § 1, p. 5599
Opinion of the Court by Chin, J.
[adding subd. (b) to § 1430]; amended by Stats. 2004, ch. 270,
§ 2, p. 3139 [adding the term “current or former” patient and the
phrase “any other right provided for by federal or state law or
The parties’ disagreement centers on the phrase, “[t]he
licensee shall be liable for up to five hundred dollars ($500).”
(§ 1430(b).) The statute does not explain how the $500 cap is
calculated. Is the cap applied to each violation committed, or is
$500 the maximum award of statutory damages in each lawsuit
brought? Manor Care argues that section 1430(b) “on its face”
authorizes a single maximum $500 award because the provision
states only that a resident may bring a “civil action,” and
nowhere mentions that the $500 cap applies “per violation” or
“per cause of action.” Significantly, Manor Care contends the
Legislature has included the term “per violation” or “each
violation” in other related contexts (e.g., §§ 1280.1, subd. (a)
[“per violation”], 1317.6, subd. (c) [“each violation”], 1548, subd.
(b) [”each violation”]), which suggests its omission from section
1430(b) was intentional. (See People v. Arriaga (2014) 58
Cal.4th 950, 960.)
For her part, Jarman maintains the provision is
ambiguous, i.e., it does not compel a conclusion that the
maximum award is $500, nor does it foreclose the alternative of
a $500 cap for each violation. Advancing a policy argument, she
asserts that unless the $500 cap is assessed for each violation,
a care facility could commit multiple violations “with impunity”
against a resident, knowing it would be liable for a total of only
$500. Jarman underscores that because the Long-Term Care
Act is a remedial statute, it must “be liberally construed on
behalf of the class of persons it is designed to protect.” (Health
Opinion of the Court by Chin, J.
Facilities, supra, 16 Cal.4th at p. 295.) The respective amici
curiae largely echo these divergent arguments.
We agree that the language of section 1430(b) is far from
clear; even a careful parsing offers little insight. (Cf. Nevarrez
v. San Marino Skilled Nursing & Wellness Centre, LLC (2013)
221 Cal.App.4th 102, 131 (Nevarrez) [finding party’s reliance on
“syntax” of § 1430(b) to be “frustrated by the intervening
reference to ‘costs and attorney fees’ ”].)3
In the face of this
ambiguity, we look to the Long-Term Care Act as a whole, to
determine the legislative intent underlying section 1430(b).
(Dyna-Med, Inc. v. Fair Employment & Housing Com. (1987) 43
Cal.3d 1379, 1387 [“The words of the statute must be construed
in context, keeping in mind the statutory purpose, and statutes
or statutory sections relating to the same subject must be
harmonized, both internally and with each other, to the extent
possible.”].) We are mindful that “ ‘[t]hose who write statutes
seek to solve human problems. Fidelity to their aims requires
us to approach an interpretive problem not as if it were a purely
logical game, like a Rubik’s Cube, but as an effort to divine the
human intent that underlies the statute.’ ” (Burris v. Superior
Court (2005) 34 Cal.4th 1012, 1017.)

3 Although the statutory text does not clearly indicate
whether the Legislature intended a per-lawsuit or per-violation
$500 cap, the statutory text in any event does not support the
Court of Appeal’s conclusion that the cap applies per cause of
action. Further, to the extent the cause of action approach may
raise practical difficulties similar to those posed by the per
violation approach, which we discuss below (see post, at pp. 20–
21), we are persuaded that the $500 cap is better understood to
apply per lawsuit.
Opinion of the Court by Chin, J.
With this perspective, we discuss the statutory scheme in
greater detail below.
A. Long-Term Care Act
The Long-Term Care Act is a “detailed statutory scheme
regulating the standard of care provided by skilled nursing
facilities to their patients.” (Kizer v. County of San Mateo (1991)
53 Cal.3d 139, 143 (Kizer); see § 1422, subd. (a) [legislative
findings and declarations].) The Act establishes a citation
system, an inspection and reporting system, and a provisional
licensing mechanism, all of which the Department of Public
Health (Department) is charged with administering. (§ 1417.1;
see Kizer, at p. 143.) “ ‘Under its licensing authority, the
Legislature has mandated standards to ensure quality health
care. The regulations establish that what the Legislature and
the Department are seeking to impose are measures that protect
patients from actual harm, and encourage health care facilities
to comply with the applicable regulations and thereby avoid
imposition of the penalties.’ ” (Health Facilities, supra, 16
Cal.4th at p. 295, quoting Kizer, at p. 148.)
Citations issued by the Department are “classified
according to the nature of the violation.” (§ 1424; see also
§ 1424.5, subd. (a).) Class “A” violations are violations that the
Department has determined present an imminent danger or a
substantial probability “that death or serious physical harm to
patients or residents of the long-term health care facility would
result therefrom.” (§ 1424, subd. (d).) Class “AA” violations are
Class A violations that are the “direct proximate cause” of a
patient’s death. (Id., subd. (c).) Class “B” violations are those
that “have a direct or immediate relationship to the health,
safety, or security of long-term health care facility patients or
Opinion of the Court by Chin, J.
residents, other than class ‘AA’ or ‘A’ violations.” (Id., subd. (e).)
Class “C” violations are violations “relating to the operation or
maintenance of a skilled nursing facility which the Department
determines has only a minimal relationship to the health, safety
or security” of long-term care patients. (Cal. Code Regs., tit. 22,
§ 72701, subd. (a)(4); see Nevarrez, supra, 221 Cal.App.4th at
p. 131.)
With respect to the Long-Term Care Act’s inspection and
citation process, it operates “to encourage compliance with state
mandated standards for patient care and to deter conduct which
may endanger the well-being of patients.” (Kizer, supra, 53
Cal.3d at p. 150.) In effect, the scheme “serves to punish by
naming and shaming facilities that violate the law.” (State Dept.
of Public Health v. Superior Court (2015) 60 Cal.4th 940, 950; cf.
§ 1422, subd. (a) [legislative finding that inspections are the
“most effective means” to implement protective state policy].)
Although its authorization of civil penalties (see e.g., §§ 1424,
1424.5, 1425, 1428) has a “punitive or deterrent aspect,” the
Long-Term Care Act is nonetheless remedial and its central
focus is “preventative.” (Kizer, supra, 53 Cal.3d at pp. 147–148,
italics omitted.) With this administrative authority to license
and inspect facilities, issue citations, and impose civil penalties,
the Department serves as “the primary enforcer of standards of
care in the long-term care facilities of this state.” (Health
Facilities, supra, 16 Cal.4th at p. 305, fn. 7; see Kizer, supra, 53
Cal.3d at p. 142.)
B. Patients Bill of Rights
In addition to protective standards of care designed to
provide quality health care (see Health Facilities, supra, 16
Cal.4th at p. 295), nursing care patients are entitled to
Opinion of the Court by Chin, J.
“fundamental human rights” set out in the Patients Bill of
Rights. (Cal. Code Regs., tit. 22, § 72527 [regulatory version];
§ 1599.1 [statutory version].) These rights include the right “[t]o
be free from discrimination” and the right “[t]o be free from
mental and physical abuse.” (Cal. Code Regs., tit. 22, § 72527,
subd. (a)(8), (10).) A nursing care patient is “[t]o be fully
informed” of the rights governing patient conduct, of all services
available in the facility and related charges, and of his or her
total health status. (Id., subd. (a)(1), (2), (3).) A patient must
also receive material information related to any proposed
treatment or procedure (id., subd. (a)(5)), and be encouraged to
voice grievances and suggest any changes to policies and
services (id., subd. (a)(7)). Certain rights in the Patients Bill of
Rights are also “expressed as aggregate, facility-wide
obligations.” (Shuts v. Covenant Holdco LLC (2012) 208
Cal.App.4th 609, 620 (Shuts), citing § 1599.1.) For instance, a
facility must employ an adequate staff, provide residents
appropriate food, support an activity program to encourage
residents’ self-care, and maintain an operating nurses’ call
system. (§ 1599.1, subds. (a), (c), (d), (f); see Shuts, at p. 620.)
When adopted by regulation in 1975 and later enacted into
statute in 1979, however, the Patients Bill of Rights did not
include its own mechanism for enforcement with respect to any
violations. (Health Facilities, supra, 16 Cal.4th at p. 302;
§ 1599.1; see Cal. Code Regs., tit. 22, §§ 72527, 72701, subd.
(a)(4); Nevarrez, supra, 221 Cal.App.4th at p. 135.) While
section 1430, subdivision (a) (section 1430(a); formerly section
1430) authorized the Attorney General or other interested party
to initiate private actions for damages or to seek an injunction
against a nursing care facility, its reach was limited.
Opinion of the Court by Chin, J.
As discussed further below (see post, at pp. 16–17), section
1430(a) (formerly section 1430) applied only if the Department
failed to take action based on a facility’s class A or B violation
(§ 1424, subds. (c)–(e)), and the violation was not corrected to
the Department’s satisfaction. (§ 1430(a), added by Stats. 1973,
ch. 1057, § 1, p. 2093; see Health Facilities, supra, 16 Cal.4th at
p. 302.) By its terms, section 1430(a) does not extend to class C
violations. (See Nevarrez, supra, 221 Cal.App.4th at p. 131.)
C. Section 1430(b)
In 1982, the Legislature added subdivision (b) to section
1430 allowing “skilled nursing facility residents themselves to
bring actions to remedy violations of their rights rather than
forcing them to depend upon the [Department] to take action.”
(Shuts, supra, 208 Cal.App.4th at pp. 623–624.) Specifically,
section 1430(b) cross-referenced the Patients Bill of Rights (Cal.
Code Regs., tit. 22, § 72527), which in turn incorporated section
1599.1. (§ 1430(b), added by Stats. 1982, ch. 1455, § 1, p. 5599;
see § 1599 et seq., added by Stats. 1979, ch. 893, § 1, p. 3087.)
Legislative history supports the conclusion that section 1430(b)
was specifically enacted to create an enforcement mechanism for
violations that were not directly related to patient health and
safety. (See Nevarrez, supra, 221 Cal.App.4th at p. 135.) In
2004, the Legislature added language providing that the
violation of “any other right provided for by federal or state law
or regulation” may also be a basis for bringing an action.
(§ 1430(b), as amended by Stats. 2004, ch. 270, § 2.) Because
section 1430(b) “supplements administrative enforcement by
creating a private right of action under statutes and regulations
that do not themselves confer such a right,” it “apparently covers
a broader spectrum of violations than subdivision (a).”
(Nevarrez, supra, 221 Cal.App.4th at p. 132.)
Opinion of the Court by Chin, J.
With this background in mind, we compare the language
of subdivisions (a) and (b) in section 1430.
1. Comparison with section 1430(a)
As a textual matter, while sections 1430(a) and 1424
authorize the imposition of a civil penalty for “each and every”
violation (§ 1424, subds. (d), (e)) and civil damages not exceeding
the civil penalties that could be assessed “on account of the
violation or violations” (§ 1430(a)), respectively, similar
language is tellingly absent from section 1430(b). Instead,
section 1430(b)’s phrase, “The licensee shall be liable for up to
five hundred dollars ($500),” has no unit of measurement to
which the $500 cap applies. This difference in terms between
the subdivisions suggests the Legislature intended to take a
different approach with respect to the $500 cap in section
1430(b). “When one part of a statute contains a term or
provision, the omission of that term or provision from another
part of the statute indicates the Legislature intended to convey
a different meaning.” (Cornette v. Department of Transportation
(2001) 26 Cal.4th 63, 73.)
In that regard, it bears emphasis that section 1430(b) is
“distinct from the administrative enforcement of the Act with
which section 1424 is concerned.” (Health Facilities, supra, 16
Cal.4th at p. 302.) For instance, section 1424 requires that the
Department consider certain “relevant facts” to determine the
amount of each civil penalty. (§ 1424, subd. (a); see State Dept.
of Public Health v. Superior Court, supra, 60 Cal.4th at p. 951
[consideration of specific factors must be made public].) These
specific facts include but are not limited to the “probability and
severity” of the violation’s risk to the patient’s “mental and
physical condition”; the patient’s “medical condition”; the
Opinion of the Court by Chin, J.
patient’s “mental condition” and “history of mental disability or
disorder”; a facility’s “good faith efforts” to prevent violation
from occurring; and the facility’s “history of compliance with
regulations.” (§ 1424, subd. (a)(1)–(5).) Likewise, in a public
enforcement action brought under section 1430(a), the subject
violations and amount of monetary recovery “are expressly tied
to the administrative penalty scheme” under section 1424.
(Nevarrez, supra, 221 Cal.App.4th at p. 131; see § 1430(a)
[recoverable civil damages in private action “may not exceed the
maximum amount of civil penalties that could be assessed on
account of the violation or violations”].) Moreover, an
administrative enforcement action offers a facility certain
protections not found in an action brought against a facility
under section 1430(b). (See, e.g., § 1423, subd. (b) [Department
may issue only one citation for each statute or regulation
violated based on a single incident “[w]here no harm to patients,
residents, or guests has occurred”]; id., subd. (c) [no citation
issued for an “ ‘unusual occurrence’ ” if certain conditions are
In contrast, despite a wide range of patient rights (see
ante, at p. 10), section 1430(b) provides no guidance on how to
determine the monetary recovery for each violation. It does not
distinguish amongst these patient rights in terms of available
remedies for any violation. Unlike class B, A, and AA violations,
which increase in severity and resulting civil penalty according
to the nature of the violation (see Kizer, supra, 53 Cal.3d at
p. 142 [§ 1424, subds. (c), (d), (e)]), a violation of any of the rights
covered under section 1430(b) would be subject to the same $500
cap, the recovery of attorney fees and costs, and injunctive relief.
For example, the same $500 cap would apply if a nursing care
facility prohibits a patient from making private telephone calls
Opinion of the Court by Chin, J.
(Cal. Code Regs., tit. 22, § 72527, subd. (a)(22)), or if the facility
subjects the patient to physical abuse (id., subd. (a)(10)). While
it is true that other provisions of the Long-Term Care Act
require the Department to determine the number of class AA,
A, and B violations a facility has committed (see dis. opn., post,
at pp. 7–9), section 1430(b) contains no indication that the
Legislature intended juries to exercise the same level of
enforcement discretion that the Department exercises in
administering the Act.
Moreover, many of the rights set out in the Patients Bill of
Rights appear to overlap with one another, making it difficult to
parse out what constitutes a separate and distinct violation for
purposes of section 1430(b). For instance, every patient has the
right “[t]o be treated with consideration, respect and full
recognition of dignity and individuality” (Cal. Code Regs., tit. 22,
§ 72527, subd. (a)(12); “[t]o meet with others and participate in
activities of social, religious and community groups” (id., subd.
(a)(15); “[t]o have visits from members of the clergy at any time”
(id., subd. (a)(19); and “[t]o have visits from persons of the
patient’s choosing at any time if the patient is critically ill” (id.,
subd. (a)(20). If a skilled nursing facility denied a resident’s
request to receive a visit from a pastor or priest, would this
denial constitute four separate violations of the rights above,
resulting in a $2000 award?
This difficulty in calculating any monetary award is
further exacerbated by the circumstance that section 1430(b)
“provides no notice as to what evidentiary facts constitute a
single continuing violation or separate violations of a patient’s
right, or whether a practice or a course of conduct gives rise to
one or more violations.” (Nevarrez, supra, 221 Cal.App.4th at
p. 136 [addressing due process concerns].)
Opinion of the Court by Chin, J.
Given the range of rights secured by section 1430(b) and
the difficulty of distinguishing a series of violations from a
continuing violation, it seems fairly improbable that the
Legislature intended the $500 cap to be applied in a sliding-scale
fashion — with damages tied to the severity of the
misconduct — as the dissent suggests. (See dis. opn., post, at
pp. 10–11) Had the Legislature intended to craft section
1430(b)’s remedial provision this way, it likely would have
provided for a higher monetary cap and directed the jury to base
its award on the gravity of the harm, as it has done in other
contexts. (See, e.g., Civ. Code, § 1798.150, subd. (a)(2).)
These deficiencies, including the lack of textual guidance
and specificity, suggest that the Legislature did not focus on
calibrating any monetary relief to the nature of each patient
right and violation articulated in section 1430(b). As we explain
next, section 1430(b)’s legislative history further evinces the
Legislature’s intent that the dollar amount refers to the
recovery of the entire case, not per violation. (See Stats. 1982,
ch. 1455, § 1, p. 5599 [Sen. Bill No. 1930 (1981-1982 Reg.
2. Legislative history of section 1430(b)
When first introduced, Senate Bill No. 1930, which added
subdivision (b) to section 1430, provided that “[t]he licensee
shall be liable for up to two thousand five hundred dollars
($2,500) or three times the actual damages, whichever is greater,
and for costs and attorney fees, and may be enjoined from
permitting the violation to continue.” (Sen. Bill No. 1930 (1981-
1982 Reg. Sess.) as introduced Mar. 17, 1982.) Later, the
italicized language was amended to “damages according to
proof, punitive damages upon proof of repeated or intentional
Opinion of the Court by Chin, J.
violations, and for costs and attorney fees, and may be enjoined
from permitting the violation to continue.” (Id., as amended
May 12, 1982, italics added.) A proposed revision subsequently
sought to allow recovery “ ‘for up to $500.00 or three times the
damages, whichever is greater, and for costs and attorney fees,
and may be enjoined from permitting the violation to
continue.’ ”(Felice Tanenbaum, Assistant to Sen. Nicholas
Petris, Sponsor of Sen. Bill No. 1930, letter to Bruce Yarwood,
Cal. Assn. of Health Facilities, July 7, 1982.) However, this
revision was not adopted. Lastly, the final version of the enacted
bill contains the language we see today, allowing recovery “for
up to five hundred dollars ($500).” (Stats. 1982, ch. 1455, § 1,
p. 5599.)
With little to no legislative material to the contrary,4
revision history suggests that the Legislature did not shift its
intent that the dollar figure in section 1430(b) represent a per
action amount. From the outset, the prescribed dollar amount,
i.e., initially set at two thousand five hundred ($2,500), referred
to the entire action, representing a floor for recovery if the actual
damages when tripled did not add up to $2,500. (Sen. Bill No.
1930 (1981-1982 Reg. Sess.) as introduced Mar. 17, 1982.) The
next revision removed the floor, and replaced it with a provision
for actual damages and the possibility of punitive damages. (Id.,

4 One minority analysis for the Assembly Committee on the
Judiciary stated the following: “For each violation the patient
could recover a maximum of $500 plus attorney fees at cost.”
(Assem. Com. on Judiciary, Minority Analysis of Sen. Bill No.
1930 (1981-1982 Reg. Sess.) as amended August 2, 1982, p. 1.)
Apart from this bare sentence, there is no other legislative
material supporting a per violation approach. (See Nevarrez,
supra, 221 Cal.App.4th at p. 133 [finding minority analysis
Opinion of the Court by Chin, J.
as amended May 12, 1982.) Though the revision was not made,
a subsequent proposal sought to reinstate the recovery floor, at
a lower $500 amount, as well as treble damages. Finally, the
enacted version preserved the $500 figure, but eliminated
recovery of any damages. (Stats. 1982, ch. 1455, § 1, p. 5599.)
Fairly read, each iteration of the remedial provision, for
example, the language “damages according to proof, punitive
damages upon proof of repeated or intentional violations” (Sen.
Bill No. 1930 (1981-1982 Reg. Sess.) as amended May 12, 1982),
was arguably crafted to encompass the entire action.
Contrary to Jarman’s and the dissent’s suggestion (see dis.
opn., post, at pp. 3–4), the inclusion of the term “the violation”
in the singular does not indicate that the $500 cap applied to
each violation, particularly when we consider the general rule of
statutory construction that “[t]he singular number includes the
plural, and the plural the singular.” (§ 13.) More to the point,
despite textual changes to the recovery of damages, every
version of the bill left unchanged language that a facility “may
be enjoined from permitting the violation to continue.” This
suggests that the inclusion of the phrase did not reflect what the
Legislature intended by the particular monetary cap.
Further, when section 1430(b) was added in 1982, section
1430(a) (formerly section 1430) provided (as it does today) that
in a private action involving class A or class B violations, the
amount of recoverable damages cannot “exceed the maximum
amount of civil penalties” that the Department could assess
long-term care facilities “on account of the violation or
violations.” (Stats. 1982, ch. 1455, § 1, p. 5599.) In 1982, the
monetary amounts for these penalties specified that the penalty
for class B violations, i.e., those relating to the health, safety, or
security of nursing care patients, ranged from $50 to $250 for
Opinion of the Court by Chin, J.
“each and every violation.” (§ 1424, as amended by Stats. 1982,
ch. 1597, § 3, p. 6365; Nevarrez, supra, 221 Cal.App.4th at
p. 131, fn. 12; see Lackner v. St. Joseph Convalescent Hospital,
Inc. (1980) 106 Cal.App.3d 542, 547; see also § 1424.5, added by
Stats. 2000, ch. 451, § 25, pp. 3307–3308 [alternative, increased
fines for skilled nursing facilities or intermediate care
If we consider that the recovery for each class B violation
in a private action was at most $250 (§§ 1424, 1430(a)), that
would mean that a less serious class C violation under section
1430(b) — i.e., one that concerned the operation or maintenance
of a facility with only a “minimal relationship” to the health,
safety, and security of a patient — would have been worth twice
as much in terms of monetary redress as a class B violation. We
decline to regard this anomalous construction as one the
Legislature would have intended when it enacted section
1430(b). In that regard, the dissent’s suggestion that a public
enforcement action under section 1430(a) is “encumbered by
procedural constraints and special protections” (dis. opn., post,
at p. 8) makes it more peculiar that a larger award would be
available in private suits brought under subdivision (b). (See
also dis. opn., post, at pp. 12–13.)
Finally, the Legislature’s views on the import of section
1430(b)’s $500 cap, though expressed over 20 years after the cap
was added, are entitled to “due consideration.” (Western
Security Bank v. Superior Court (1997) 15 Cal.4th 232, 244.)
This legislative history reflects that the Legislature has
consistently interpreted the provision to provide a cap of $500
per lawsuit. In 2004, the last time the Legislature amended
section 1430(b), it expanded a nursing care patient’s right to
bring an action to include “any other right provided for by
Opinion of the Court by Chin, J.
federal or state law or regulation.” (Stats. 2004, ch. 270, § 2.) In
adding this admittedly broad language, the Legislature
specifically affirmed that “[e]xisting law, which makes [skilled
nursing facilities and intermediate care facilities] liable for up
to $500 along with litigation costs, has been in effect since 1982.”
(Assem. Comm. on Health, Analysis of Assem. Bill No. 2791
(2003-2004 Reg. Sess.) as amended April 1, 2004, p. 1, italics
added.) Though the declaration is neither binding nor
conclusive in construing the provision, “the Legislature’s
expressed views on the prior import of its statutes are entitled
to due consideration” even if a “gulf of decades separates” the
legislative declaration and the earlier enactment. (Western
Security Bank, at p. 244.)
D. Policy Arguments
Contrary to Jarman’s suggestion, we do not find that
limiting an award to $500 per lawsuit would render the statute
“toothless.” Section 1430(b) already provides “an abundance of
reasons for licensees not to transgress its health and safety
objectives,” which includes “the prospect of paying the other
side’s attorney fees and costs and suffering an injunction with
its attendant fine for contempt of court.” (Nevarrez, supra, 221
Cal.App.4th at p. 135.) Injunctive relief would help to ensure
that violations are not committed going forward, consistent with
the preventative purpose of the Long-Term Care Act. (See Kizer,

5 We observe that this 2004 legislation also proposed but did
not adopt an amendment “raising the maximum financial
remedy for rights violations from $500 to $5000.” (Assem.
Comm. on Health, Analysis of Assem. Bill No. 2791 (2003-2004
Reg. Sess.) as amended April 1, 2004, p. 2, italics added; see
Assem. Bill No. 2791 (2003-2004 Reg. Sess.) as amended May
11, 2004.)
Opinion of the Court by Chin, J.
supra, 53 Cal.3d at pp. 147–148; see also Balisok, Cal. Practice
Guide: Elder Abuse Litigation (The Rutter Group 2019) ¶ 10:26
[“Perhaps the most important remedy specified in § 1430(b) is
injunctive relief”].) Even if a plaintiff’s recovery is limited to
injunctive relief or includes little to no monetary relief, the
potential for attorney fees and costs could still serve as a strong
deterrent. (See Nevarrez, supra, 221 Cal.App.4th at p. 135; see
City of Riverside v. Rivera (1986) 477 U.S. 561, 574 [in civil
rights action, fee award need not be proportionate to damages
amount when vindication of rights “cannot be valued solely in
monetary terms”].)
Nor do we find it absurd that section 1430(b) does not
authorize a nursing care resident to obtain up to $500 for each
violation a facility commits. Section 1430 itself declares that
“[t]he remedies specified in this section shall be in addition to
any other remedy provided by law.” (§ 1430, subd. (c), italics
added.) It “does not foreclose civil actions for damages by
patients who have been injured by a violation.” (Kizer, supra,
53 Cal.3d at p. 143; see id. at p. 150 [private action under
§ 1430(b) is one of several “alternative enforcement
mechanisms” of Long-Term Care Act]; see § 1430(a).) Put
another way, we conclude section 1430(b) was not intended to be
the exclusive or primary enforcement mechanism for residents
of long-term care facilities seeking compensation for harms
suffered in those facilities. (See Lemaire v. Covenant Care
California, LLC (2015) 234 Cal.App.4th 860, 867 [§ 1430(b) “is
not a substitute for the standard damage causes of action for
injuries suffered by residents of nursing care facilities”].) Tort
law has long provided remedies for individuals seeking
compensation for harm. And consistent with the objective to
provide comprehensive measures to protect nursing care
Opinion of the Court by Chin, J.
patients who are often elderly, the Legislature has designed
additional protections that take various forms. (See Kizer,
supra, 53 Cal.3d at p. 150; Health Facilities, supra, 16 Cal.4th
at p. 305.)
For example, the Elder Abuse Act is specifically designed
to identify and address — through the imposition of enhanced
sanctions — the seriousness and frequency of neglect or abuse
committed against elderly individuals. (See Delaney, supra, 20
Cal.4th at p. 32 [Welf. & Inst. Code, § 15657 covers “forms of
abuse or neglect performed with some state of culpability
greater than mere negligence”]; Winn v. Pioneer Medical Group,
Inc. (2016) 63 Cal.4th 148, 160 [Welf. & Inst. Code, § 15657
“explicitly limited to physical abuse and neglect”].) In this case,
Jarman’s allegations of neglect (e.g., Manor Care’s “conduct was
reckless and outrageous” because its staff “acted in conscious
disregard of Mr. Jarman knowing that harm was eminent if it
didn’t change its conduct”) are typical of those that help form
the basis of an action under the Elder Abuse Act. (See Carter v.
Prime Healthcare Paradise Valley LLC (2011) 198 Cal.App.4th
396, 405–406 [compiling cases].) We do not opine on the validity
or likelihood of success of Jarman’s claim under the Elder Abuse
Act, however. We merely note that unlike the Elder Abuse Act
or, for that matter, traditional tort law causes of action like
negligence that are available to nursing care patients, section
1430(b)’s $500 cap does not appear to take into account the
severity of a facility’s misconduct, nor does it appear designed to
provide plaintiffs full compensation for harms suffered in those
As this case amply demonstrates, a per violation approach
under section 1430(b) would present substantial practical
difficulties. The special verdict form here asked the jury, “How
Opinion of the Court by Chin, J.
many times did Manor Care of Hemet violate any rights of
Jarman provided for by federal or state law or regulation?” and
“What is the total amount you find HCR MANOR CARE liable
for as a result of violating John Jarman’s rights?” The form
added that “[t]he amount awarded per right violation cannot
exceed $500 for each right violation occurrence.” (Italics added.)
The record reflects that the jury decidedly struggled with
how to calculate the number of violations Manor Care
committed. Ultimately, the jury answered “382” to the question
“[h]ow many times” Manor Care violated any of John Jarman’s
rights. As to the facility’s monetary liability, the jury concluded
every violation was worth $250 each, thus totaling $95,500.
Critically, there was no enumeration of which specific right (or
how many times each right) was violated.
In concluding that section 1430(b) authorizes a $500 per
lawsuit cap, we see little risk of plaintiffs maneuvering around
this cap by filing multiple lawsuits. To the extent that
industrious counsel may craft pleadings to divide one case into
multiple cases for the sole purpose of recovering multiple $500

6 The dissent, too, does not resolve what counts as a
violation. (See dis. opn., post, at pp. 23–24.) This not only
underscores the difficulty of defining a “violation,” it also
undermines the dissent’s claim that interpreting the $500 cap
to apply per action “will radically reduce the financial incentive
for compliance under section 1430(b) of the Act.” (Dis. opn., post,
at p. 13.) After all, if innumerable violations of the same right
count as only one violation (see id., at pp. 21–22), then even on
the dissent’s view, the award authorized by section 1430(b) is
not “tied to the number and severity of violations” (dis. opn.,
post, at p. 14).
Opinion of the Court by Chin, J.
awards, principles of claim and issue preclusion could limit such
attempts at manipulation. (See DKN Holdings LLC v. Faerber
(2015) 61 Cal.4th 813, 824–825.) Moreover, trial courts would
likely consider “inefficient or duplicative efforts” when
evaluating attorney fee requests. (Ketchum v. Moses (2001) 24
Cal.4th 1122, 1132.)
Undoubtedly, nursing care patients comprise a
particularly vulnerable segment of our population and deserve
the highest protections against any abuse and substandard
care.7 That said, we cannot and must not legislate by grafting
onto section 1430(b) a remedy that the Legislature has chosen
not to include. (See Cornette v. Department of Transportation,
supra, 26 Cal.4th at pp. 73–74 [courts “may not rewrite a
statute, either by inserting or omitting language, to make it
conform to a presumed intent that is not expressed”].) Instead,
we look to the Legislature, which has left the phrase (i.e., a
facility “shall be liable for up to five hundred dollars ($500)”)
unchanged for nearly 40 years, to make any necessary
adjustments or clarifications as it sees fit.

7 As the dissent recounts (see dis. opn., post, at pp. 1–2), a
global pandemic has gripped this state, causing immeasurable
suffering and death. And we have no reason to doubt that the
COVID-19 disease has disproportionately afflicted our state’s
nursing care facilities. That said, this unprecedented situation
does not bear on the question presented in this case, i.e., what
did the Legislature intend since 1982 when it limited a facility’s
monetary liability under section 1430(b) to $500, particularly
given the availability of other remedies. (See ante, at pp. 19–

Outcome: We reverse the Court of Appeal’s judgment,8 and remand for further proceedings consistent with this opinion.

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