On Feb. 4, 2011, plaintiff Sui Mee Chiu, 85, noted to have a Stage I pressure sore, which is alternately termed “decubitus ulcer” or “bedsore,” on her coccyx. Chiu was originally admitted into Arcadia Health Care Center on Nov. 19, 2010, for long-term custodial care. She had a history of osteoporosis, hypertension, dementia and Parkinson’s disease. As a result, she required assistance with her daily living at the time of her admission. Arcadia discovered the Stage I pressure sore on Chiu’s coccyx on Feb. 4, 2011. To address the condition, Arcadia and its nursing staff implemented a care plan that included assessing the conditions and documenting those conditions weekly. The plan also required the staff to apply a pressure reducing device, bathe the resident at least two times a week, keep the skin clean and dry, handle the wound gently, make sure there was minor circulation in the affected area, turn and reposition the resident every two hours, expose the pressure sore to air, and otherwise treat the condition as ordered. The plan further required the staff report the progress of the treatment to a physician. By Feb. 23, 2011, Chiu’s pressure sore progressed to Stage II and remained at that stage until March 18, 2011. The pressure sore ultimately developed into a Stage IV pressure sore with bone exposure and necrosis on March 25, 2011. She subsequently was hospitalized on seven separate occasions as a result of infectious complications to various body organs emanating from the Stage IV pressure ulcer. Chiu’s sacral coccyx pressure sore ultimately remained at Stage IV up until her death approximately one year later, on April 2, 2012. The decedent’s daughter, Mary Chiu, acting on behalf of her mother’s estate, sued Arcadia Convalescent Hospitals Inc., which was doing business as Arcadia Health Care Center, and ACH Health Care Property, LLC. The decedent’s daughter alleged that the defendants’ actions constituted elder abuse, negligence and willful misconduct in violation of the decedent’s Bill of Rights pursuant to Health & Safety Code, and that the defendants’ actions caused the decedent’s wrongful death. The matter proceeded to arbitration. Plaintiff’s counsel contended that, prior to being admitted into Arcadia Health Care Center, the decedent had three separate episodes of developing decubitus ulcers in 2007, 2009 and 2010, and that all three ulcers were completely resolved with appropriate care and treatment. However, counsel contended that after being admitted the Arcadia, there was an absence of 12 days of charting of any care or treatment rendered to the decedent by Arcadia staff during the critical period of time of Feb. 4, 2011, when the ulcer was Stage I, to March 25, 2011, when the ulcer developed to Stage IV. Thus, counsel cited Health & Safety Code § 1427(a), which states, “When the administration of medications, treatments, or other care is not recorded, as required by law…it shall be presumed that the required medication, treatment, or care has not been provided.” Defense counsel asserted that the decedent’s pressure sore was the product of her pre-existing condition and that Arcadia staff provided appropriate care and treatment. Counsel contended that the decedent had been a long-term resident at Arcadia and that the decedent had a number of underlying medical conditions that existed prior to her admission. Defense counsel further contended that Arcadia was able to successfully manage those conditions via an effective and consistent process and system, and that the decedent’s family always expressed their satisfaction with the care provided at Arcadia and wanted the decedent to remain at the center., During the last year of the decedent’s life, she was hospitalized seven times for treatment of the Stage IV pressure ulcer that never resolved, recurring urinary tract infections as a result of the placement of a Foley catheter utilized for wound care management, and recurrent aspiration pneumonia, which ultimately caused acute respiratory failure that was identified as the immediate cause of death. The decedent’s estate sought recovery of $135,267 in damages for the defendants’ alleged negligence. The estate also sought recovery of $250,000 in alleged elder abuse damages for the decedent’s pre-death pain and suffering. In addition, the estate sought recovery of $145,000 in bill of rights damages, and $285,000 in attorney fees and costs.