Nursing home negligence cases often begin with a family’s discovery that their loved one suffered preventable harm while under medical care. These discoveries are often not made until after the loved one dies. When this happens, Texas law provides specific procedures for holding healthcare providers accountable.
A cornerstone of these procedures is the expert report requirement—a document that must explain who did what wrong and how it caused harm. But what happens when this report mentions “the facility” and “doctors” generally without specifically addressing what individual physicians did? Is this merely a fixable deficiency, or does it mean there was effectively no report at all against those physicians?
The answer determines whether a plaintiff’s case survives or dies at the outset. The recent case of Copley v. Guidry, 09-24-00046-CV (Tex. App. Apr 10, 2025) provides an opportunity to examine this distinction between a deficient expert report and one so inadequate it constitutes “no report” for certain defendants.
Facts & Procedural History
In July 2021, Guidry was admitted to a nursing facility that lasted almost six-months. During this time, she was treated by three nurse practitioners and five medical doctors. Throughout her stay, Guidry was intermittently in ICU, mostly on a ventilator, immobile, and unable to care for herself.
Guidry later filed a lawsuit alleging negligence and gross negligence against the medical center and its healthcare providers. Her claims centered on four specific failures: accepting and retaining a resident whose needs they could not meet, failing to keep appropriate clinical records, failing to prevent her pressure ulcer, and failing to treat her pressure ulcer appropriately.
As required by Texas law, Guidry attached an expert report from a doctor to her petition. This report primarily discussed standards of care for healthcare facilities. It cited federal OBRA regulations and Texas Administrative Code provisions applicable to nursing facilities.
The defendants objected to this report and filed motions to dismiss, arguing it failed to comply with section 74.351 of the Texas Civil Practice and Remedies Code. Specifically, they contended that the report failed to establish how any alleged breach of the standard of care by them proximately caused Guidry’s injuries.
As part of the nursing home litigation, the trial court overruled these objections and granted Guidry a thirty-day extension to cure any defects in the report. The doctors then filed an interlocutory appeal challenging this decision–which resulted in this court opinion.
Texas Medical Liability Act Requirements
Nursing home negligence cases start with Section 74.351 of the Texas Civil Practice and Remedies Code. This is part of the Texas Medical Liability Act (“TMLA”). It establishes specific requirements for healthcare liability claims, including nursing home facilities. As noted above, this law requires claimants to serve an expert report on each defendant. This has to be done not later than 120 days after the defendant files an answer in the lawsuit.
The Texas Supreme Court has consistently emphasized that “the purpose of the expert report requirement is to weed out frivolous malpractice claims in the early stages of litigation, not to dispose of potentially meritorious claims.” The TMLA attempts to balance two competing concerns: preventing meritless lawsuits while allowing legitimate claims to proceed.
For an expert report to satisfy the TMLA, it must provide a fair summary of the expert’s opinions regarding the applicable standard of care, how the defendant failed to meet that standard, and the causal relationship between that failure and the injury. This information allows both the court and defendants to evaluate whether the claim has merit.
Understanding Extensions for Deficient Reports
When an expert report falls short of meeting these requirements, Section 74.351(c) allows courts to grant a one-time, 30-day extension to cure deficiencies. This provision reflects the legislature’s recognition that technical defects shouldn’t automatically end potentially valid claims.
The extension provision states:
“If an expert report has not been served within the period specified by Subsection (a) because elements of the report are found deficient, the court may grant one 30-day extension to the claimant to cure the deficiency.”
Normally, a defendant cannot appeal a trial court’s order granting such an extension. Section 51.014(a)(9) of the Texas Civil Practice and Remedies Code explicitly states that “an appeal may not be taken from an order granting an extension under Section 74.351.”
When is a Report So Deficient It Becomes “No Report”?
The Texas Supreme Court has recognized an important exception to this rule: when no expert report is served, an interlocutory appeal may be taken from an order granting an extension. This exception, established in Badiga v. Lopez, distinguishes between cases where a deficient report was served and cases where no report was served at all.
But what makes a report so deficient that it constitutes “no report” rather than merely a deficient report? The Texas Supreme Court addressed this question in Scoresby v. Santillan, establishing that a document qualifies as a report eligible for an extension when it:
- Is timely served
- Contains the opinion of an individual with expertise that the claim has merit
- Implicates the defendant’s conduct
This third requirement—implicating the defendant’s conduct—became the central issue in the current court case.
Implicating a Provider’s Conduct: The Core Requirement
For an expert report to properly implicate a healthcare provider’s conduct, it must do more than simply name that provider as a defendant in the lawsuit. The report must specifically address how that provider’s actions (or inactions) breached the applicable standard of care and caused harm.
Texas courts have consistently held that collective references to “defendants” or general statements about “the facility” and its “staff” are insufficient to implicate individual providers. The Ninth Court of Appeals previously explained in Blevins v. Bishai:
“When a plaintiff sues more than one defendant, the expert report must set forth the standard of care applicable to each defendant and explain the causal relationship between each defendant’s individual acts and the injury.”
This requirement ensures that each defendant understands the specific allegations against them and can prepare a defense. It also helps courts determine whether claims against individual providers have merit.
The Distinction Between Facility Standards and Provider Standards
Healthcare facilities and individual providers often have different standards of care. Regulations applicable to nursing facilities—such as those cited in the expert report in this case—may not establish standards for individual physicians practicing within those facilities.
The regulations cited in the expert report primarily referred to “requirements that an institution must meet in order to be licensed as a nursing facility and also to qualify to participate in the Medicaid program.” These included federal OBRA regulations and Texas Administrative Code provisions governing nursing facilities.
When an expert report focuses exclusively on facility standards without explaining how individual providers breached their own applicable standards of care, courts may find that the report fails to implicate those providers at all.
How the Expert’s Report Failed to Implicate the Doctors
In analyzing the expert’s report, the Ninth Court of Appeals identified several key deficiencies with respect to the two doctors who were sued:
- The report primarily cited regulations applicable to “facilities” without indicating how these regulations established standards for individual physicians.
- The report contained only general, collective references to “the Defendant,” “staff,” and “doctors” without specifically identifying the appellant doctors as members of the facility’s staff involved in Guidry’s care.
The court found that the expert’s assertion that “the standard care for the Defendant in this case requires that they provide that level of care and treatment that a reasonable prudent similar facility and staff would provide” was insufficient without additional language identifying the doctors as members of that staff.
Similarly, the expert’s statement that “the facility and its… doctors” failed to meet standards of care was too general to implicate the specific doctors. The court explained that such statements failed to address the standard of care applicable to each doctor (as distinguished from the facility), how they allegedly breached that standard, and how such breaches caused Guidry’s injuries.
The Scoresby Test Applied
Applying the Scoresby test, the court concluded that the expert’s report failed the third requirement: it did not implicate the conduct of the two doctors who were sued. The report did not explain what these specific doctors did or failed to do that breached applicable standards of care or caused Guidry’s injuries.
The court emphasized: “a report served in a medical liability lawsuit does not implicate a particular health care provider’s conduct merely because the provider is a defendant in the lawsuit.” While a report need not identify a defendant by name, it must implicate the defendant’s conduct in some meaningful way.
Because the expert report failed to implicate the doctors’ conduct, it constituted “no report” with respect to them. Under Badiga, this meant the trial court had no discretion to grant an extension, and dismissal of the claims against these doctors was mandatory.
Previous Court Decisions Supporting This Conclusion
The court’s decision aligned with precedent from other Texas appellate courts. The court cited several cases demonstrating that general references to “staff” or “doctors” without specific implication of individual providers constitutes “no report” as to those providers:
In Rivenes v. Holden, the Fourteenth Court of Appeals held that a report’s criticism of a hospital’s staff, without identifying the appellant as a member of that staff, did not implicate the appellant and constituted no report.
Similarly, in Sinha v. Thurston, the same court found that assertions that standards were not met “by the doctors and medical care providers in this case” or by the hospital and “its staff” failed to implicate a specific doctor and constituted no report as to him.
In Laredo Texas Hospital Co. v. Gonzalez, the court held that an expert report that “omits the names of the individual defendants and wholly fails to implicate the conduct of any medical defendant” was legally defective and constituted no report.
These cases demonstrate a consistent principle: to constitute a report regarding an individual healthcare provider, an expert report must specifically implicate that provider’s conduct rather than making collective references to facilities, staff, or doctors generally.
The Takeaway
The Copley decision shows how important an expert report is in nursing home negligence cases. An expert report that makes only general references to “the facility” and its “staff” or “doctors” without specifically addressing individual providers’ standards of care, breaches, and causation may constitute “no report” as to those providers. When this happens, courts must dismiss claims against those providers rather than granting extensions to cure deficiencies.
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