On Feb. 27, 2009, plaintiff Ollie Deckard, 89, a retired certified nursing assistant and dependent adult, was admitted to Araville Residential Care Home, located at 744 Palm Avenue in South San Francisco, with a history of skin breakdown. While at the home, she suffered a cerebrovascular accident, also known as a stroke, with right side hemiparesis, dementia and visual impairment on June 21, 2009. Deckard subsequently had a colostomy, was diagnosed with an incontinent bladder, was nonambulatory, and required continuous bed care. As a result, Deckard’s family asked Araville to turn and reposition Deckard every two hours, and a nurse practitioner also wrote the same on an order for Deckard. However, on May 11, 2011, Deckard, then 91, was transferred to a skilled nursing facility due to a stage IV skin breakdown on her tailbone. Deckard sued Araville Residential Care Home and its owners, Lamberto Panzia and Dorie Panzia. She alleged that the defendants failed to turn and reposition her every two hours as per physicians’ orders and her family’s requests, and that this failure constituted elder negligence. The trial ultimately went forward on the claim of general negligence only. Plaintiff’s counsel asserted that Deckard was improperly admitted to Araville with prohibited health conditions, including that she was bedridden and had a pressure sore on her right hip, and that the staff at Araville was inadequately trained, had inadequate number of staff, and kept poor or had missing records. Counsel further asserted that while the Physician’s Report for Residential Care Facilities for the Elderly, dated March 24, 2010, indicated that Deckard was chronically bedridden, Araville’s records did not contain sufficient documentation that it was meeting the needs of Deckard in accordance with the California Code of Regulations. Plaintiff’s counsel argued that as a result, Araville and the Panzias, who were care custodians for Deckard within the meaning of Welfare & Institutions code § 15610.17, failed to turn and reposition Deckard every two hours per physicians’ orders and family requests, even though Deckard was admitted with a history of skin breakdown and subsequently became permanently bedridden. Counsel further argued that Araville failed to meet Deckard’s basic needs, including adequate hygiene, nutrition, hydration, and assessments and reassessments of her need for assistance with activities of daily living. Defense counsel argued that Araville and the Panzias complied with the applicable standard of care and that Deckard’s skin breakdown was unavoidable. Counsel contended that despite the presence of some regulatory violations, the staff was able to meet Deckard’s needs from February 2009 until May 2011, the 26 months she resided there., Deckard claimed that she sustained a stage IV decubitus ulcer, which is alternately termed as a “bedsore” or a “pressure sore,” on her coccyx. She claimed that the ulcer caused her extreme pain, which she was able to express despite her dementia, and was subsequently transferred to St. Francis Pavilion in Daly City in May 2011. Defense counsel noted that though Deckard did not appear at trial, she could show her pain in a 29-second video that was shown to the jury. Defense asserted that Deckard’s right hip wound healed within three months and that Deckard’s skin breakdown was not a pressure sore at her tailbone, but a pilonidal abscess. The defense’s medical expert opined that Deckard’s new skin breakdown was a pilonidal abscess because Deckard had a history of folliculitis, which is aninfection in the hair follicles, in the perianal area several months before. Thus, the expert testified that the timeline accurately fit that of an abscess. Additionally, the expert opined that Deckard’s injury was not to be a pressure sore, as it occurred over the coccyx and not the sacrum.