West Palm Beach nursing home abuse lawyer
Shalhoub Law Injury & Accident represents nursing home residents and their families in West Palm Beach and throughout Palm Beach County. That includes claims for neglect and abuse, including the presuit period that has to run before a case can be filed. Attorney Paul R. Shalhoub spent years defending insurance companies before he began representing injured people, and he handles every case himself, from the first call through trial.
A nursing home claim in Florida does not work like any other injury claim. You cannot simply file it. The law requires a formal notice to every facility and company you intend to sue, a 75-day period in which no suit may be filed at all, a written response, and mediation — before a case is ever opened.
That is not red tape to be endured. It is the stage at which most of these claims are actually resolved or lost, and it is the reason a family who waits to see whether the facility will “do the right thing” frequently arrives at a lawyer with the clock much further along than they realize.
There is also a second deadline nobody mentions: however late you discovered what happened, a nursing home claim generally cannot be brought more than four years after the incident.
What Paul Shalhoub does on a nursing home claim
Most of this happens before a lawsuit exists, which is what makes these claims different.
| Gets the complete chart, not the summary | The facility’s records are the case: care plans, nursing notes, treatment administration records, wound assessments, weight logs, fall and incident reports, hydration and repositioning records, and the staffing schedules that show who was actually on the floor. Requested formally and early, because what arrives voluntarily is rarely complete |
| Identifies every company behind the facility | Section 400.023 allows claims against the licensee, its management or consulting company, managing employees, and direct caregivers whether employees or contractors. The sign over the door is frequently not the entity with the money or the control |
| Serves the presuit notice properly | Certified mail, return receipt, to each prospective defendant, identifying the rights violated and the negligence alleged, with the certificate of counsel the statute requires. Getting this wrong wastes the one window you have |
| Works the 75 days rather than waiting them out | That period is for investigation, expert review and building the position you take into mediation. A notice served and then forgotten about for 75 days is a wasted quarter |
| Prepares for mandatory mediation | It happens within 30 days of the response. Facilities arrive with counsel and a valuation; a family should arrive with records, photographs, an expert opinion and a number that can be defended |
| Separates nursing failures from medical ones | A licensee is not liable for a physician’s medical negligence, but section 400.023(7) is explicit that this does not protect it for failures in nursing care. Which bucket a failure falls into decides who is responsible, and it is argued hard |
| Preserves what disappears | Photographs of wounds, the resident’s own belongings, and the accounts of other families and former staff. Memories and staff turnover both move quickly |
| Files when presuit ends, if the number is not fair | Same attorney through depositions and trial |
What you do: photograph everything you can see, write down dates, names and what was said, and keep your own notes separate from anything the facility gives you.
Why choose attorney Paul Shalhoub
Paul R. Shalhoub is the sole attorney at Shalhoub Law Injury & Accident, and he began his career at a Florida insurance-defense firm. Nursing home claims are defended by sophisticated institutional insurers who treat presuit as the main event, and knowing how they value a file — and what makes them move off a number — comes from having been on that side of it.
He has recovered policy limits of $500,000 and $250,000 and taken a case to a jury verdict at sixteen times the last pre-trial offer. Past results do not guarantee or predict a similar outcome, and no two cases are alike.
He is admitted to The Florida Bar (number 88300, admitted 22 March 2011) and to the United States District Court for the Southern District of Florida. He is also a former Mayor of Lake Clarke Shores and served three terms on its Town Council, and he serves as treasurer of the Cancer Alliance of Help & Hope.
The practical difference is access. Families in these cases are usually making care decisions at the same time as legal ones, and they need the same person on the phone each time rather than a case manager.
More about Paul R. Shalhoub · Case results · All practice areas
Do you need a lawyer for nursing home neglect?
An honest answer, including when it is no.
Where you probably do not. Your complaint is about laundry, meals, a missing hearing aid, rudeness or a billing dispute. Those are real and worth raising — with the facility’s administrator, with the Agency for Health Care Administration, which licenses and inspects, or with Florida’s Long-Term Care Ombudsman Program, which advocates for residents without charge. A damages claim is the wrong tool.
Where you almost certainly do. A pressure injury that developed or worsened in the facility. A fall with a fracture, particularly a second or third fall. Dehydration, malnutrition or unexplained weight loss. Sepsis. An untreated or unreported infection. Medication given wrongly or not at all. An unexplained injury nobody can account for. A resident who wandered off. Any allegation of physical or sexual abuse. Or a death the family does not accept the explanation for.
And in every one of those: the presuit clock and the four-year outer limit are already running, so the free consultation is worth having now rather than after the records request comes back.
The practical details
| Attorney | Paul R. Shalhoub, the sole attorney at the firm |
| License | The Florida Bar number 88300, admitted 22 March 2011. Verify it yourself |
| Office | 1011 N Olive Ave, West Palm Beach, FL 33401. He will meet you at the facility, at your home, or wherever is easiest |
| Hours | Monday to Friday, 8:30 a.m. to 5:30 p.m. Calls and messages answered 24 hours |
| Cost | The consultation is free. The firm advances case costs, and you owe no attorney’s fee and no reimbursement of those costs unless it recovers compensation. These cases need a nursing expert and often a physician before presuit even closes |
Presuit: the 75 days before a case can exist
This is the part that surprises every family, and the part that decides most of these claims.
Under section 400.0233, before suit is filed:
| Notice to each prospective defendant | By certified mail, return receipt requested, identifying the rights alleged to have been violated and the negligence alleged, and briefly describing the injuries reasonably identifiable at the time (subsection (2)) |
| A certificate of counsel | Stating that a reasonable investigation gave rise to a good faith belief that grounds exist for an action against each prospective defendant (subsection (2)) |
| No suit for 75 days | “No suit may be filed for a period of 75 days after notice is mailed to any prospective defendant” (subsection (3)(a)) |
| A written response by day 75 | The defendant or its insurer “shall provide the claimant with a written response” rejecting the claim or making a settlement offer (subsection (3)(b)). Silence is deemed a rejection (subsection (3)(c)) |
| 15 days to accept an offer | An offer is deemed rejected unless accepted by written notice within 15 days of receipt (subsection (9)) |
| Mediation within 30 days | Within 30 days of the claimant receiving the response, the parties “shall meet in mediation” on liability and damages, extendable by stipulation (subsection (11)) |
| The limitations clock stops | Tolled during the 75 days and any stipulated extension (subsection (4)), and during mediation and any extension of it (subsection (11)) |
| Then the window to file | 60 days, or the remainder of the limitations period, whichever is greater, after termination of negotiations or the conclusion of mediation (subsections (4) and (11)) |
Two things follow. First, the notice has to be served within the limitations period, so discovering the problem late does not simply push everything back. Second, 75 days of enforced delay is only an advantage to the side that uses it, and the facility’s insurer certainly will.
The deadline, and the four-year wall
Section 400.0236 gives these claims their own limitations period, and it is not the general two-year negligence rule:
- Two years from the incident, or from when it was discovered or should have been discovered with due diligence.
- But in no event more than four years from the date of the incident. That outer limit is a statute of repose, and the discovery rule does not extend it.
- Fraudulent concealment or intentional misrepresentation that prevented discovery extends the period to two years from discovery with due diligence — capped at six years from the incident.
The discovery rule matters here more than almost anywhere, because nursing home harm is routinely discovered late: a pressure injury is described to the family as “a little redness”, a fall is recorded as unwitnessed, a decline is attributed to age. The four-year wall matters just as much, because a family that finds the records two years after a death can be out of time regardless of what those records show.
Who can bring the claim, and against whom
Under section 400.023:
| The resident or their guardian | Or a person or organization acting on the resident’s behalf with their consent (subsection (1)(a)) |
| A deceased resident’s personal representative | And this is the provision families most often do not know: the personal representative may bring the action regardless of the cause of death. The claim does not evaporate because your relative ultimately died of something else (subsection (1)(a)) |
| The licensee | Directly or vicariously |
| Its management or consulting company | Where the operating entity is separate from the company that actually runs the place |
| Managing employees | Named individually where appropriate |
| Direct caregivers | Whether employees or contractors, which closes the common defense that the person involved was agency staff |
What has to be proved
By a preponderance of the evidence: that the defendant owed a duty, breached it, that the breach was a legal cause of loss, injury, death or damage, and that the resident sustained damage as a result (subsection (4)). Reasonable care is “that degree of care which a reasonably careful licensee, individual, or entity would use” in like circumstances (subsection (5)), and a nurse is held to the prevailing professional standard of care for a nurse (subsection (6)).
The nursing-versus-medical line
Subsection (7) provides that a licensee is not liable for the medical negligence of a physician — but expressly states that this does not protect the licensee from liability for failures in nursing care. Whether a failure is characterized as medical judgment or nursing care therefore decides who is responsible, and it is argued in almost every case. A pressure injury that developed because repositioning did not happen is a nursing failure. That distinction is the whole battleground in a significant share of these claims.
Damages, and an honest word about fees
Actual and punitive damages are available for rights violations or negligence (subsection (1)(c)). On attorney’s fees, the statute is narrower than it is often made to sound: a resident who prevails in seeking injunctive or administrative relief may recover costs and reasonable fees against the defendant up to $25,000, and those fees are solely for that relief — not for a damages claim, except as provided under section 768.79 or the rules of procedure (subsection (1)(d)). Anyone implying the facility simply pays your legal fees on a damages case is overstating it.
Comparative fault still applies: under section 768.81(6), a party found more than 50 percent at fault for their own harm recovers nothing.
What the records actually show
These cases are won in the chart. Knowing which documents exist is most of knowing what happened.
| Pressure injuries | Skin assessments on admission and after, the care plan, turning and repositioning records, wound measurements and photographs over time, nutrition and hydration logs, and whether a specialist was ever consulted |
| Falls | The falls risk assessment, the care plan that followed it, incident reports, whether interventions were ordered and whether they were documented as done, and whether the plan changed after the first fall |
| Dehydration and malnutrition | Weight records over time, intake and output, dietary notes, and whether anyone escalated a trend that is obvious in hindsight |
| Medication | The administration record, pharmacy records, and the gaps in them |
| Infection and sepsis | Vital sign trends, nursing notes, when a physician was notified and when the resident was actually transferred |
| Elopement | Wandering risk assessment, door alarm and security records, and the staffing schedule for that shift |
| Staffing | Schedules and assignment sheets against the census. Many of these failures are not individual cruelty, they are arithmetic |
Separately from any claim, the Agency for Health Care Administration licenses and inspects Florida’s nursing homes and accepts complaints, and Florida’s Long-Term Care Ombudsman Program advocates for residents at no cost. A family can use both while a claim is being evaluated, and inspection history is public.
Where these claims sit locally
Palm Beach County has one of the largest older populations of any county in Florida, and a correspondingly large number of licensed nursing homes and assisted living facilities. Two practical local points matter.
Where the resident was taken when things went wrong. A transfer out of a facility to the hospital is often the first independent record of what was actually happening, because the receiving hospital describes what it found on arrival: the stage of a wound, the degree of dehydration, the infection. Palm Beach County has exactly two state-approved trauma centers, both Level I — Delray Medical Center and St. Mary’s Medical Center — and for a resident transferred in extremis those admission records are frequently the most valuable document in the case.
Where a suit is filed. The Fifteenth Judicial Circuit, main courthouse at 205 North Dixie Highway in downtown West Palm Beach, with branches at PGA Boulevard in Palm Beach Gardens, West Atlantic Avenue in Delray Beach and State Road 15 in Belle Glade. Where a facility is owned by an out-of-state operator and the amount in dispute is large enough, the case can be removed to the United States District Court for the Southern District of Florida, which sits at 701 Clematis Street.
A note on assisted living. An assisted living facility is licensed under a different chapter than a nursing home, with a different residents’ rights scheme. The analysis changes, so it is worth establishing at the outset exactly what kind of facility your relative was in rather than assuming.
What these cases look like in practice
Three situations and what tends to decide each. These are illustrations of how the rules above apply. They are not case results, and nothing here predicts what any particular claim is worth.
The pressure injury described as “a little redness”
The family is told there is some skin irritation. Weeks later the wound is deep and the resident is hospitalized. The case is made on the admission skin assessment, the repositioning records, the wound measurements over time, and whether the care plan was ever changed. The defense will characterize it as medically unavoidable; section 400.023(7) is the reason the nursing side of it still matters. The discovery rule is usually what keeps the claim alive, and the four-year wall is what can end it.
The second fall
A resident falls, is assessed as a falls risk, and falls again weeks later with a fracture. The first fall is rarely the case. What decides it is whether the care plan changed after that first fall, whether the interventions it specified were documented as actually performed, and what the staffing sheet shows for the shift in question.
The death with an accepted explanation
A resident dies and the family is told it was age, or pneumonia, or a decline. Months later a relative obtains the chart and finds a different story. The personal representative may bring the action regardless of the cause of death, which is the provision that makes these claims possible at all — but by that stage the presuit sequence has to be run inside whatever remains of the limitations period.
Common questions
Why can we not just file a lawsuit?
Because Florida requires a presuit process first. Section 400.0233 requires certified-mail notice to each prospective defendant with a certificate of counsel, then bars filing for 75 days, then requires a written response and mediation within 30 days of it. The limitations clock is tolled while that runs, and afterward you have 60 days or the remainder of the period, whichever is greater.
How long do we have?
Two years from the incident, or from when it was discovered or should have been discovered with due diligence — but in no event more than four years from the incident, under section 400.0236. Fraudulent concealment extends it to two years from discovery, capped at six years. The notice must be served within the limitations period, so late discovery does not simply push everything back.
My relative died of something else. Is there still a claim?
Possibly, and this is the provision families most often do not know. Section 400.023(1)(a) allows the personal representative of a deceased resident to bring the action regardless of the cause of death. A claim for what happened in the facility does not disappear because the eventual cause of death was unrelated.
Who can actually be sued?
The licensee, directly or vicariously, its management or consulting company, managing employees, and direct caregivers whether they were employees or contractors. That last point matters, because “she was agency staff” is a standard response and the statute addresses it.
The facility says it was the doctor, not them.
That is a real distinction and it is argued in almost every case. Section 400.023(7) says a licensee is not liable for a physician’s medical negligence — but it expressly adds that this does not protect the licensee for failures in nursing care. A wound that developed because repositioning did not happen is a nursing failure, whatever the physician did or did not order.
Will the nursing home pay our legal fees?
Not in the way it is often described. Section 400.023(1)(d) allows costs and reasonable fees up to $25,000 against the defendant, but only for a resident who prevails in seeking injunctive or administrative relief, and solely for that relief — not for a damages claim, except as provided under section 768.79 or the rules of procedure. On a damages case you are represented on a contingency fee here, and this firm advances the costs.
How do we get the records?
They are requested formally, and in these cases that is a job rather than a formality. What arrives voluntarily is often a summary rather than the chart. The documents that decide the case — repositioning records, assignment sheets, incident reports, staffing schedules — are rarely in the first production.
Should we report it to the state as well?
You can do both. The Agency for Health Care Administration licenses and inspects Florida’s nursing homes and takes complaints, and Florida’s Long-Term Care Ombudsman Program advocates for residents at no cost. Inspection history is public and is often useful background. A regulatory complaint is not a damages claim and does not stop the limitations clock.
What if the facility is an assisted living facility, not a nursing home?
Then it is licensed under a different chapter with its own residents’ rights scheme, and the analysis changes. It is worth establishing exactly what kind of facility your relative was in at the outset rather than assuming, because the procedural route is not identical.
We signed an arbitration agreement on admission. Does that end it?
Not automatically. Admission paperwork frequently includes an arbitration clause, and whether it binds this claim depends on what was signed, who signed it, whether they had authority to, and the terms. It is a question to put in front of a lawyer rather than to concede, and it should be raised at the first conversation.
What does it cost to hire a lawyer?
Nothing. The consultation is free and confidential, with Paul. The firm advances case costs, and you owe no attorney’s fee and no reimbursement of those costs unless it recovers compensation for you. On these cases that matters, because a nursing expert is usually needed before presuit even closes.
Related claims
Other claims handled by the same attorney in the same office. See every practice area
What happens if you call
You speak to Paul, not an intake screener. The consultation is free, and he will tell you honestly whether you need a lawyer at all — some claims do not. If he takes the case, the preservation letters and the notices to the insurers go out that day, and the calls to you stop. You treat; he deals with the other side. Nothing is settled without your decision, and you see the net figure before you sign anything.
Talk to Paul about what happened
Free, confidential, and with the attorney who would handle the case. Because of the presuit sequence and the four-year outer limit, these are claims where waiting costs more than it does elsewhere.
Call (561) 208-5058 Free case review
Shalhoub Law Injury & Accident, 1011 N Olive Ave, West Palm Beach, FL 33401. This page describes Florida law as of 22 October 2026 and applies to claims in Florida. It is general information, not legal advice, and reading it does not create an attorney-client relationship. Past results do not guarantee or predict a similar outcome.