The "most hated man in the nursing home industry" has filed his first lawsuits in Mississippi, signaling the beginning of a push to expand his practice into the Magnolia State.

Jim Wilkes is a founding partner of Wilkes & McHugh, headquartered in Tampa, Fla.

The firm specializes in nursing home abuse cases, with clients in 12 states and multi-million dollar awards over the last decade in Florida, Arkansas and California. The firm made history in Arkansas in June with a record $78.43 million award involving a nursing home patient who died of dehydration.

The firm announced late last year that there were plans to expand in Texas and Mississippi. The firm now has a Jackson telephone number and is looking for office space. An attorney from Hattiesburg has been hired, and nine other Wilkes & Hughes attorneys are licensed to practice in Mississippi.

Wilkes says his firm has filed 30 to 40 civil lawsuits statewide. To date, three Wilkes & McHugh lawsuits have been filed in Lauderdale County Circuit Court, seeking non-specific damages against Beverly Healthcare-Broadmoor in North Meridian, Benchmark Health Care in Marion and Kings Daughters & Sons Rest Home on Old Poplar Springs Drive.

Mississippi: New Promised Land?

The firm's expansion comes as the Mississippi State Medical Association and the Mississippi Healthcare Association are lobbying for tort reform and limits on punitive damage awards, describing the state as "the new Promised Land for out-of-state trial lawyers."

Spokesmen for the medical and nursing home industries say lawsuits are driving up insurance costs, an expense ultimately passed on to patients.

Dr. Scott R. Anderson of Meridian took part recently in a press conference sponsored by the medical association. "Patients are paying for rate hikes because out-of-state plaintiffs and personal injury lawyers spell Mississippi with dollar signs," Anderson said.

"Trial lawyers say they are in it for the little guy. ... But, people need to know that each time they sue the company looking for deep pockets, the price of medicine increases."

Wilkes & McHugh sues few doctors, but critics say the firm has carved its own deep-pocket niche in a litigious environment, large nursing home chains with healthy cash flows.

Wilkes: 'I welcome the fight'

Wilkes cheerfully accepts his informal designation as the "most hated man in the nursing home industry," pointing out that he would not be winning cases if the allegations were untrue. He said his firm accepts only one in 10 clients and wins awards in 97 percent of the lawsuits it files.

"I welcome the fight in Mississippi," he said.

Wilkes believes nursing homes are a bad way to take care of elderly people. "We took what had primarily been a family duty and socialized it," he said. "In the 1960s, we created Medicare, a limited funding mechanism that would only pay for long-term institutional care. The for-profit industry followed the money and the nursing home industry emerged."

The numbers of nursing home patients increased throughout the 1980s and 1990s, as did the severity of their illnesses. What did not change, Wilkes claims, was the expertise of the nursing home staff providing the care. "They begin to take care of the immediate need or problem, but custodial care took a back seat. You end up with bedsores, malnutrition, dehydration, broken bones, people lying in their own urine, really heart-breaking situations," he said.

Nursing homes and the BBA

Wilkes says nursing homes have responded incorrectly to financial stress caused by the Balanced Budget Amendment of 1997 and corresponding reductions in Medicare and Medicaid reimbursements, cutting staff instead of profits and compromising the quality of care even more.

"Between 1991 and 1995, federal reimbursements to nursing homes went up 300 percent, Wilkes said. The nursing homes had been building up on an influx of cash. In August 1997, the bottom fell out and the industry started going bankrupt."

Wilkes believes emphasis should be placed on alternatives to nursing home care, like foster care, day care, assisted living programs and out-sourced therapy systems.

"There are a lot of programs we could use to keep people in their homes much longer than we do, and have a much higher quality of life," he said.

In the meantime, he perceives himself a guerrilla fighter against a system that "just doesn't work" and hopes to open a fully-staffed office in Jackson by October.

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