Nursing home and long-term care standards expert

Expert class library · Medical malpractice · Either side

A nurse, director of nursing, nursing home administrator or geriatric physician who says whether a skilled nursing facility met the standard of care in preventing falls, pressure ulcers, infection, malnutrition and other harms to residents, and whether staffing and care planning were adequate. Courts increasingly let registered nurses testify that breaches of nursing standards caused pressure ulcers, a classic nursing problem, but not to complex medical causes such as cause of death, and they exclude physician causation theories that are untested and not generally accepted.

What this expert is retained to answer

• Did the facility assess the resident's risks, such as falls, pressure injury and nutrition, and build a care plan that addressed them?
• Was the care plan carried out, and were changes in condition reported to the physician and family?
• Is the expert testifying to nursing standards, physician standards, or medical causation, and are they qualified for each?
• Did staffing levels allow the care plan to be followed?
• What else, such as the resident's illnesses or refusals of care, could explain the outcome?

Methods

• Care plan and minimum data set review
• Review of fall, wound and skin assessments
• Staffing level analysis
• Comparison with federal and state nursing facility regulations
• Timeline of changes in condition and physician notification

How the testimony is attacked

• Nurse testifying to causation. Defendants argue nurses cannot give causation opinions. In Canton Harbor Healthcare Center v. Robinson the Supreme Court of Maryland affirmed reinstating a pressure ulcer claim, with a plurality holding that a registered nurse may attest that breaches of nursing standards caused a previously diagnosed pressure ulcer, though not to a physician's standard of care.
• Cause of death beyond nursing expertise. Courts draw a line at complex medical causation. In Funk v. Pinnacle Health Facilities the District of Kansas held that a registered nurse and a practical nurse could not testify that a nursing home fall caused a resident's death, though the claim survived on the coroner's death certificate.
• Untested causal theory. Defendants attack physician causation theories that lack general acceptance. In Swanigan v. Avenues Healthcare the Utah Court of Appeals upheld excluding a physician's opinion that untreated foot infections caused a resident's fatal heart attack, because he admitted the theory was untested and not generally accepted.
• Resident refusals and comorbidities. Facilities point to a resident's refusal of care, chronic illnesses and decline as alternative explanations for wounds, falls and death.
• Regulations as the standard. Plaintiffs rely on federal nursing facility regulations and survey deficiencies, while defendants argue regulatory citations do not by themselves establish negligence or causation.

What the public record shows

A deliberately narrow CourtListener search, "nursing home" AND "standard of care" AND expert AND (Daubert OR "Rule 702"), returned 37 opinions filed since 2015, as of October 4, 2026; broader searches return more. Three that show how courts handle this class of testimony:

Each case links to the free opinion text on CourtListener.

Under amended Rule 702

Since December 1, 2023, Rule 702 says expressly that the party offering an expert must show the court it is more likely than not that the testimony meets each requirement: that it rests on sufficient facts or data, uses reliable methods, and reflects a reliable application of those methods to the case. Questions about the basis of an opinion are no longer automatically matters of weight for the jury. For how the circuits have applied the amendment, see the Rule 702 tracker, which follows each court of appeals; for what that means for preparing or attacking this class of expert, see the guide on amended Rule 702.

Related classes

• Hospital nursing standard-of-care expert
• Medical standard-of-care expert
• Life care planner

Guides

• Amended Rule 702 After Nearly Three Years: What Courts Exclude

Simulating this class on a matter

Supreme Mind simulates a class of expert, never a named individual, on your fact pattern and returns the likely opinion, the ranked cross-examination weaknesses, the Rule 702 attack surface and what it means for settlement. Read how it works, or book a demo.

Last reviewed October 4, 2026. How this page is built: rulings are found by searching court opinions on CourtListener, and each one is read in the opinion before it is summarised here; outcomes are labelled by what the court did with the expert's testimony. No individual expert is named. This page summarises public decisions for orientation and is not legal advice; read the opinion before relying on any ruling.