When a loved one enters a California skilled nursing facility, families expect two things: medical care when it is needed, and basic day-to-day protection when it is not. For years, MICRA’s cap on noneconomic damages, currently $470,000 for personal injury cases in 2026, has bundled those two very different obligations together. That has forced grieving families to accept a fraction of what a jury believed their loved one’s suffering was worth, simply because the defendant happened to be a healthcare provider.
That changed on July 22, 2026. In a partially published opinion, the California Court of Appeal, Second District, Division Seven, decided Aud v. RRT Enterprises, LP and reinstated a jury’s $1.84 million noneconomic damages verdict against a nursing home. The trial court had slashed the verdict down to $250,000 under Civil Code section 3333.2. The appellate court said that was wrong. The harm here came from a facility failing at its custodial job, not its medical one, and MICRA does not apply to custodial neglect.
For families dealing with pressure ulcers, falls, dehydration, and malnutrition in California nursing homes, this decision is a significant shift. Below, we explain what the court held, why it matters, and how we approach these cases at our firm to protect the full value of a resident’s claim.
What the Court Actually Held in Aud v. RRT Enterprises
The resident in Aud suffered a familiar and heartbreaking pattern of harm inside a skilled nursing facility: repeated falls, worsening pressure ulcers, malnutrition, and dehydration. A jury heard the evidence and awarded roughly $1.84 million in noneconomic damages for the pain and suffering that resulted. The trial judge then applied the MICRA cap under Civil Code section 3333.2 and reduced the noneconomic portion to $250,000, the cap in effect at the time of trial.
The Court of Appeal reversed that reduction. Building on the Holland line of cases, the court drew a sharp line between two very different roles a nursing home plays:
- Healthcare provider role. When staff render professional medical services, administer treatments, or make clinical decisions that require licensure, MICRA can apply.
- Custodian and caregiver role. When the facility is supposed to supervise residents, help them eat and drink, turn and reposition them, keep them safe from falls, and provide basic protective oversight, those are custodial duties. MICRA does not cap noneconomic damages for injuries caused by failures in that custodial role.
The court concluded that the resident’s injuries in Aud arose from breakdowns in supervision, nutrition, hydration, and protective oversight. Those are core custodial obligations, not professional medical services. Because MICRA did not apply, the full jury verdict was restored.
Why This Matters More Than the 2026 MICRA Cap Increase
Earlier in 2026, MICRA’s noneconomic damages caps rose to $470,000 for personal injury and $650,000 for wrongful death as part of the phased statutory increases. Those higher numbers help. But they still cap what a jury can award, no matter how catastrophic the harm.
Aud is a different kind of relief. In the right factual scenario, the cap is not just higher. It does not apply at all. A jury can hear the evidence and set noneconomic damages based on the actual extent of the resident’s suffering, without any statutory ceiling.
Think about what that means practically. In a case involving stage IV pressure ulcers that developed because a resident was left in bed for hours without repositioning, or a fatal fall that occurred because the call light was ignored, the difference between a capped verdict and an uncapped verdict can be seven figures.
How We Tell the Difference Between Custodial and Medical Failures
The dividing line sounds clean in a published opinion. In practice, nursing home defendants work hard to blur it. They will argue that almost every decision inside a facility is a medical decision because a nurse or physician was involved somewhere along the way. Our job is to show the jury what actually happened at the bedside.
John Reardon spent 20 years as a chiropractor before becoming a lawyer, and that clinical background matters here. He has personally examined how pressure injuries progress when a patient is not turned, how dehydration presents on the skin and in vital signs, and how repeated falls point to failures in supervision rather than medical judgment. That perspective helps us look at a chart and identify which entries reflect professional medical services and which reflect custodial breakdowns that any lay caregiver would recognize.
Custodial failures we frequently see in California nursing home cases include:
- Failure to turn and reposition immobile residents every two hours
- Failure to provide adequate food and water, or to monitor intake and output
- Failure to answer call lights within a reasonable time
- Failure to implement a fall prevention plan, such as bed alarms or scheduled toileting
- Failure to keep residents clean, dry, and free of infection
- Chronic understaffing that makes basic care impossible
None of those require a medical license to perform. When they fail and a resident is hurt, Aud says the noneconomic damages should not be capped by MICRA.
What Families Should Document Right Now
If you suspect a loved one has been neglected in a California skilled nursing facility, the evidence you gather in the next few weeks can determine whether your case fits inside the Aud framework. Because we approach these files with a clinician’s eye, here is what we ask families to preserve.
Photographs of the resident’s body. Pressure ulcers, bruises, unexplained cuts, weight loss, dehydrated skin, and poor hygiene tell a story that a jury will remember. Date the photos, and if possible, include a reference for size such as a coin or ruler.
Daily care logs and flow sheets. These are the records that show whether staff actually turned the resident, offered fluids, checked skin, and answered calls. Gaps and copy-paste entries are powerful evidence of custodial neglect.
Staffing rosters and assignments. California requires minimum direct care staffing under Health and Safety Code section 1276.65. When facilities fall below those minimums, custodial care almost always suffers. We can subpoena these records, but personal observations from family visits about which staff were present and when help enormously.
The resident’s care plan. Every skilled nursing resident is supposed to have an individualized care plan addressing risks like falls, skin breakdown, and nutrition. Compare the plan to what actually happened.
Communications with the facility. Text messages, emails, and notes from care conferences where family members raised concerns can defeat later claims that the facility was unaware of the problem.
Hospital and emergency department records. When neglect sends a resident to the hospital, ER notes often contain candid observations about the condition the resident arrived in. Those outside-provider records are often the most credible evidence in the file.
How We Frame Nursing Home Cases After Aud
Pleadings and jury instructions matter. Under Aud, how a case is framed can be the difference between a capped and an uncapped verdict. When we take on a California nursing home case, we approach it with the Aud framework in mind from day one.
That includes:
- Pleading custodial neglect specifically. We plead negligence and elder abuse under the Elder Abuse and Dependent Adult Civil Protection Act, Welfare and Institutions Code section 15600 and following, and identify the custodial duties that were breached.
- Building the medical narrative through a clinician’s lens. John Reardon’s clinical years help us translate charting into plain English so that a jury understands a stage III pressure ulcer did not appear because of a difficult medical decision. It appeared because no one turned the resident.
- Retaining the right experts. Not just physicians, but certified nursing assistants, wound care nurses, and long-term care administrators who can speak to what basic custodial care looks like.
- Fighting the cap early. We anticipate that the defense will invoke MICRA. We prepare our record, our verdict form, and our proposed jury instructions to preserve the Aud distinction and protect the noneconomic verdict from post-trial reduction.
The Bottom Line for California Families
Aud v. RRT Enterprises does not solve every nursing home case. Some claims will still involve genuinely medical decisions where MICRA applies. But for the many families whose loved ones were harmed by understaffing, ignored call lights, missed meals, and untreated pressure sores, the appellate court has confirmed what common sense already told us. Custodial neglect is not medical malpractice, and the pain that results should not be squeezed into a statutory cap.
If you believe a parent, spouse, or grandparent has suffered neglect in a California skilled nursing facility, do not wait for the facility to explain away what you are seeing. Preserve photos, keep notes, and get an attorney involved while the daily care records are still accessible.
At Reardon Injury Law, we combine two decades of hands-on clinical experience with the courtroom experience to hold nursing homes accountable under California law. Consultations are free, and you owe nothing unless we recover for your family. Call us at (657) 522-7122 to talk through what happened and what your options look like under the new Aud framework.