CARLTON F. BENNETT*JOHN E. ZYDRON**C. STEWART GILL, JR.

ERIC K. WASHBURN**KEVIN D. SHARP

*Board Certified in Civil Trial Advocacy,and also member of Florida Bar**Also member of North Carolina Bar

BENNETT and ZYDRON, P.C.ATTORNEYS AND COUNSELORS AT LAW

120 SOUTH LYNNHAVEN ROADSUITE 100VIRGINIA BEACH, VIRGINIA 23452

POST OFFICE BOX 2577VIRGINIA BEACH, VIRGINIA 23450-2577

TELEPHONE (757) 486-5454TELEFAX (757) 486-8910

VIRGINIA BEACH, VIRGINIA 23452(757) 486-5454

NORTH CAROLINA(800) 562-4657

WWW.BANDZLAW.COM

L

November 12,2014Sharon N. Jones, ClerkIsle of Wight Circuit CourtCivil Division

17000 Josiah Parker CircleP.O.Box 110Isle of Wight, VA 23397

Re: Debra Lou Mann, Administrator of the Estate of Georgie Elizabeth Williams,deceased v. Windsor Facility Operations, LLC

Dear Ms. Jones:

Enclosed please find:

(1) The original and one copies of the Civil Cover Sheet and Complaint;

(2) Our firm check, payable to Clerk, Isle of Wight Circuit Court, in the amount of$349.00; and

(3) An additional copy of the Civil Cover Sheet and first page of the Complaint to betime/date stamped as filed and returned to me in the enclosed postage paid,

addressed envelope.

We are not asking for this Complaint to be served at this time.

If you have any questions or concerns, please contact us.

Thank you for your attention to this matter.Very truly yours,

sfETT and

CFB/bncEnclosures

cc: Stephen C. Swain, EsquireDebra Lou Mann

.arlton F. Bennett

COVER SHEET FOR FILING CIVIL ACTIONS Case NoCOMMONWEALTH OF VIRGINIA (CLERK'S OFFICE USE ONLY)

Isle of Wight n. . fi Circuit CourtDebra Lou Mann, Administrator of the Estate of y /Jn re. Windsor Facility Operations, LLC

PLAINTIFF(S)Georgie Elizabeth Williams, deceased

DEFENDANT(S)

I, the undersigned [ ] plaintiff [ ] defendant [ ] attorney for [ ] plaintiff [ ] defendant hereby notify the Clerk of Court that I am filingthe following civil action. (Please indicate by checking box that most closely identifies the claim being asserted or relief sought.)

GEINERAL CIVILSubsequent Actions

[ ] Claim Impleading Third Party Defendant[ ] Monetary Damages[ ] No Monetary Damages[ ] Counterclaim

[ ] Monetary Damages[ ] No Monetary Damages] Cross Claim] Interpleader] Reinstatement (other than divorce or

driving privileges)[ ] Removal of Case to Federal CourtBusiness & Contract

[ ] Attachment[ ] Confessed Judgment[ ] Contract Action

] Contract Specific Performance] Detinue[ ] GarnishmentProperty

[ ] Annexation] CondemnationWr] Ejectment

] Encumber/Sell Real Estate] Enforce Vendor's Lien[ ] Escheatment[ ] Establish Boundaries[ ] Landlord/Tenant

[ ] Unlawful Detainer] Mechanics Lien] Partition] Quiet Title] Termination of Mineral RightsTort

] Asbestos Litigation] Compromise Settlement] Intentional Tort] Medical Malpractice] Motor Vehicle Tort] Product Liability[X] Wrongful Death

] Other General Tort Liability

[X] Damages in the amount of $ .MOO.'OO.9:.99...November 12, 2014

DATE

^^^ Carlton F. BennettW PRINT NAME

BENNETT and ZYDRON, P.C., 120 S. Ly

ADMINISTRATIVE LAW[ ] Appeal/Judicial Review of Decision of

(select one)[ ] ABC Board[ ] Board of Zoning[ ] Compensation Board[ ] DMV License Suspension[ ] Employee Grievance Decision[ ] Employment Commission[ ] Local Government[ ] Marine Resources Commission[ ] School Board[ ] Voter Registration[ ] Other Administrative Appeal

DOMESTIC/FAMILY[ ] Adoption

[ ] Adoption - Foreign[ ] Adult Protection[ ] Annulment

[ ] Annulment - Counterclaim/ResponsivePleading[ ] Child Abuse and Neglect - Unfounded

Complaint[ ] Civil Contempt[ ] Divorce (select one)

[ ] Complaint - Contested*[ ] Complaint - Uncontested*[ ] Counterclaim/Responsive Pleading[ ] Reinstatement-

Custody/Visitation/Support/EquitableDistribution[ ] Separate Maintenance

[ ] Separate Maintenance Counterclaim

WRITS[ ] Certiorari[ ] Habeas Corpus[ ] Mandamus[ ] Prohibition[ ] Quo Warranto

are claimed ^/ j

[ ] PLAINTIFF [ ] DEFENDANT []

nnhaven Road, Ste. 100ADDRESS/TELEPHONE NUMBER OF SIGNATOR

Virginia Beach, VA 23452 (757) 486-5454

PROBATE/WILLS AND TRUSTS[ ] Accounting[ ] Aid and Guidance[ ] Appointment (select one)

[ ] Guardian/Conservator[ ] Standby Guardian/Conservator[ ] Trust (select one)

[ ] Impress/Declare[ ] Reformation[ ] Will (select one)

[ ] Construe[ ] Contested

MISCELLANEOUS[ ] Appointment (select one)

[ ] Church Trustee[ ] Conservator of Peace[ ] Marriage Celebrant[ ] Bond Forfeiture Appeal[ ] Declaratory Judgment[ ] Declare Death[ ] Driving Privileges (select one)

[ ] Reinstatement pursuant to 46.2-427[ ] Restoration - Habitual Offender or 3rd

Offense[ ] Expungement[ ] Firearms Rights - Restoration[ ] Forfeiture of U.S. Currency[ ] Freedom of Information[ ] Injunction[ ] Interdiction[ ] Interrogatory[ ] Judgment Lien-Bill to Enforce[ ] Law Enforcement/Public Official Petition[ ] Name Change[ ] Referendum Elections[ ] Sever Order[ ] Taxes (select one)

[ ] Correct Erroneous State/Local[ ] Delinquent[ ] Vehicle Confiscation[ ] Voting Rights - Restoration[ ] Other (please sgecifyK.

ATTORNEY FOR [] PLAINTIFF[ ] DEFENDANT

"Contested" divorce means any of the following matters are indispute: grounds of divorce, spousal support and maintenance,child custody and/or visuauon, cnna suppon, property aisinoutionor debt allocation. An "Uncontested" divorce is filed on no faultgrounds and none of the above issues are in dispute.

FORM CC-1416 (MASTER) PAGE ONE 10/12

VIRGINIA: IN THE CIRCUIT COURT OF ISLE OF WIGHT COUNTY

DEBRA LOU MANN, ADMINISTRATOR OFTHE ESTATE OF GEORGIE ELIZABETH WILLIAMS,DECEASED

Plaintiff,

v. CASE NO.:PLAINTIFF DEMANDS TRIAL BY JURY

WINDSOR FACILITY OPERATIONS, LLC,T/A CONSULATE HEALTHCARE OF WINDSOR

Defendant.

Serve: Windsor Facility Operations, LLCc/o, Corporation Service Company, Registered AgentBank of America Center

1111 East Main Street, 16th FloorRichmond, Virginia 23219

COMPLAINT

COMES NOW the Plaintiff, Debra Lou Mann, Administrator of the Estate of Georgie

Elizabeth Williams, deceased, files her Complaint against the Defendant, Windsor Facility

Operations, LLC, trading as Consulate Healthcare of Windsor, in the sum of $2,000,000.00 (TWO

MILLION DOLLARS), together with the cost of this action and pre-judgment interest from

February 16, 2013, for the following, to-wit:

1. On or about November 12, 2014, the plaintiff, Debra Lou Mann, duly qualified in the

Clerk's office in the Circuit ofthe City of Portsmouth, Virginia, as Administrator ofthe

Estate of Georgie Elizabeth Williams, and as such is her personal representative under

Virginia Code 64.2-454. A copy of the Clerk's Certificate/Letter of Qualification is

hereto attached and marked Exhibit "A."

2. Defendant, Windsor Facility Operations, LLC, is a Virginia Limited Liability

Company and trades as Consulate Healthcare of Windsor (hereafter the "nursing

home"). Consulate Healthcare of Windsor is at all times material herein a long-term

nursing healthcare nursing facility located at 23352 Courthouse Hwy, Windsor,

Virginia 23487.

3. At all times material herein, the nursing home was a healthcare provider within the

meaning of 8.01-581.1, Code of Virginia, 1950, and was acting by and through its

agents and/or employees, all of whom were acting within the scope of their

employment.

4. At all times material herein, the nursing home had the duties, among others, of

supervision of healthcare of Georgie Elizabeth Williams (hereafter "Williams"),

including her care and supervision by the staff providing direct care to Williams; and

the duty to make sure that the care plan was carried out and reviewed and revised as

needed for Williams' well-being; and for Williams' safe environment.

5. At all times material herein, Windsor Facility Operations, LLC regularly conducted

and still conducts substantial business in Isle of Wight County, Virginia.

COUNT 1(NEGLIGENCE/SURVIVORSHIP)

6. Paragraphs 1-5 as set forth above, are herein re-alleged and incorporated by reference,

as if fully set forth herein.

7. On or about May 24, 2010, Williams was admitted to the nursing home with a diagnosis

of dementia.

8. On or about October 27, 2012, the nursing home progress note provided planning for

Williams, which included "Alzheimer's with behavioral disturbances - continue safe

environment...."

9. On or about November 5, 2012, the nursing home progress note provided planning for

from Williams, which included "depression - increased aggression, not leaving bed,

will start Lexapro and Dementia - continue with safe environment...."

10. Because of her dementia condition, which was known to the defendant, Williams was

highly vulnerable to the foreseeable risk of physical assault, and she was unable to

protect herself or look out for her own safety and/or well-being.

11. On or about February 16, 2013, a nursing home employee heard something in

Williams' room and upon entering the room found another male resident (hereafter

"John Doe") sitting on Williams' bed with his fists drawn back over Williams.

Williams was noted to have multiple bruises on her face and arms and skin tears to her

left cheek and left arm. A photograph depicting the injuries to Williams is hereto

attached and is marked as Exhibit "B."

12. On February 16, 2013, Williams was admitted to Sentara Obici Hospital for evaluation

of the injuries from the assault described in paragraph 10 above. Her injuries included

contusions all over her face as well as bruises.

13. Williams was treated at Sentara Obici Hospital on February 16, 2013 through February

21, 2013, for the injuries described in paragraph 10 above and was discharged to

long-term nursing care at Sentara Nursing Center - Portsmouth on February 21, 2013.

14. John Doe was also a resident of the nursing home. John Doe had a known history of

serious mental illness, as well as a history of violence and assaultive behavior, which

3

was known or should have been known to the staff of the nursing home; or in the

alternative, the defendant failed to investigate and/or discover available information

pertaining to John Doe's history of serious mental illness, and/or violent assaultive

behavior.

15. Based on John Doe's background it was foreseeable that John Doe would pose a

substantial and imminent threat of physical harm to other resident at the nursing home,

especially those residents like Williams, who were vulnerable because of their age,

physical and mental condition.

16. Among other things, the staff and employees of the nursing home attending to

Williams, breached the standard of care, including but not limited to, the following

particulars:

A. Failed to adequately staff the nursing home in a manner responsive to the needs

of its residents, and in particular, the needs of Williams;

B. Failed to adequately staff the nursing home so as to provide sufficient

protection and supervision for its residents, including Williams;

C. Failed to adequately staff the nursing home so as to provide a safe environment

and security measures for its residents, including Williams;

D. Failed to provide a safe and secure environment for its residents, including

Williams;

E. Failed to provide adequate or competent staff training and development so that

the personnel would be trained to provide for the needs of the residents,

including Williams;

F. Failed to provide adequate or competent staff training and development so that

the personnel would be trained to provide for the needs of the residents with

serious cognitive impairments who might be a danger to themselves or others,

including John Doe;

G. Failing to hire, train, and supervise sufficient and/or competent staff that were

trained to provide for the needs of the residents, including those with serious

cognitive impairments;

H. Failing to have staff adequate in knowledge, skills, and abilities and sufficient

in numbers to provide services to maintain the physical, mental, and

psychosocial well-being of each of its residents, including Williams and John

Doe;

I. Failing to ensure that all direct care staff had training in methods for dealing

with residents with a history of aggressive behavior or dangerously agitated

states, including training and/or experience in self-protection, protection of

other residents, and in the preventions and de-escalation of aggressive

behavior;

J. Ensuring the development, implementation and monitoring of an

individualized service plan for each resident to meet the assessed needs of its

residents, including Williams and/or John Doe;

K. Failed to properly assess the psychological, behavioral and emotional

functioning of its residents, including those with serious cognitive impairments,

that might be a danger to themselves or others;

L. Failure to properly complete and/or update assessments on its residents,

including those with serious cognitive impairments, once a significant change

in the resident's condition was apparent;

M. Admitting or retaining a resident to the nursing home when the defendant

(and/or its agents or employees) knew or should have known that it could not

provide or secure an appropriate level of care for the residents and/or when the

defendant (and/or its agents or employees) knew or should have known that the

facility did not have staff in appropriate numbers and with appropriate skill to

provide the care and services needed by the resident;

N. Admitting or retaining a resident to the nursing home when the defendant

(and/or its agents or employees) knew or should have known that the

perspective resident displayed behaviors, behavioral patterns, and/or

behavioral and/or psychological disorders, that would cause, or continue to

cause, concern for the health, safety, or welfare of the prospective resident or

others who could be placed at risk of harm by that individual;

O. Failing to discharge a resident form the nursing home when the defendant

(and/or its agents or employees) knew or should have known that it could not

provide an appropriate level of care for the resident(s);

P. Failing to discharge a resident from the nursing home when the defendant

(and/or its agents or employees) knew or should have known that the resident

displayed behaviors, behavioral patterns, and/or behavioral and/or

psychological disorders, that would cause, or continue to cause, concern for the

health, safety, or welfare of the prospective resident or others who could be

6

placed at risk of harm, by that individual;

Q. Admitting, retaining, or failing to discharge a resident from the nursing home

when the facility (and/or its agents or employees) knew or should have known

that the individual presented an imminent threat of danger to themselves or

others.

17. The nursing home is vicariously liable for, but not limited to, the negligence of its

nursing staff and employees, including but not limited to, the Administrator,

Administrative Staff, Registered Nurses, Licensed Practical Nurses, and Certified

Nursing Assistants who provided direct care and treatment to Williams. All of such

agents, servants, and employees were acting with the scope of their respective

employment at all times material herein.

18. As a direct and proximate result of the breaches of the applicable standard of care by

the nursing home as described above, Williams suffered severe and debilitating and

permanent injuries; was caused to suffer great physical pain and mental anguish; was

caused to incur medical and hospital expenses for treatment of her described serious

injuries; and was caused to suffer deformity and disfigurement; and was greatly

inconvenienced.

COUNT II(WRONGFUL DEATH)

19. Paragraphs 1-17, as set forth above, are herein re-alleged and incorporated by

reference, as if fully set forth herein.

20. As a direct and proximate result of the aforesaid negligence and breaches of the

standard of care by the nursing home, Williams died on April 27, 2013.

21. Williams is survived by the following statutory beneficiaries: Her daughter, Debra Lou

Mann of Suffolk, Virginia, and her granddaughter Jessica Leigh Williams of

Chesapeake, Virginia and grandson, Gary Brandon Williams, of Windsor, Virginia

(children of her son, Gary Dock Williams, deceased).

22. As a direct and proximate result of the breaches of the standard of care and negligence

of the defendant nursing home, Williams' surviving statutory beneficiaries sustained

damages including expense for her care, treatment and hospitalization; funeral

expenses; and has further suffered sorrow, severe mental anguish, solace, loss of

society, companionship, comfort and guidance.

WHEREFORE, the Plaintiff, Debra Lou Mann, Administrator of the Estate of Georgie

Elizabeth Williams, deceased, demands judgment against the defendant, Windsor Facility

Operations, LLC, in compensatory damages in the amount of $2,000,000.00 (TWO MILLION

DOLLARS), plus pre-judgment interest from February 16, 2013, and the costs of this action.

PLAINTIFF HEREBY DEMANDS TRIAL BY JURY.

DEBRA LOU MANN,ADMINSTRATOR OF THE ESTATE OF

GEORGIE ELIZABETH WILLIAMS, deceased.

By:Of Counsel

Carlton F. Bennett, EsquireVSBNo. 18453BENNETT and ZYDRON, P.C.

120 South Lynnhaven Road, Suite 100Virginia Beach, VA 23452

(757) 486-5454 (Telephone)(757) 486-8910 (Facsimile)

Stephen C. Swain, EsquireVSB No. 12924

SHUTTLEWORTH, RULOFF, SWAIN, HADDAD,MORECOCK, P.C.4525 South Boulevard, Ste. 300Virginia Beach, VA 23452(757) 671-6000 (Telephone)(757) 671-6004 (Facsimile)

CERTIFICATE/LETTER OF QUALIFICATIONCOMMONWEALTH OF VIRGINIAVA. CODE 6.2-893, 6.2-1171, 6.2-1365, 6.2-1367, 64.2-2011, 64.2-506, 64.2-607

Court File No. WILLIAMS. GE

Portsmouth Circuit Court

I, the duly qualified clerk/deputy clerk of this Court, CERTIFY that on November 12, 2014DATE

Debra Lou MannNAME(S) OF PERSON(S) QUALIFYING

duly qualified in this court, under applicable provisions of law, as Administrator under Va. Code 64.2-454of the estate of

Georgie Elizabeth WilliamsE3 DECEASED U MINOR INCAPACITATED

The powers of the fiduciary(ies) named above continue in full force and effect.

$100.00 bond has been posted.

Given under my hand and the seal of this Court on

November 12,2014DATE

Cy orrteon , Clerk

, Deputy Clerk

FORM CC-1625 MASTER 10/12

m3