Ohio Court Upholds Punitive Damages and Prejudgment Interest Against a Nursing Home That Wouldn't Settle

Published January 27, 2026 · Ohio Appeals Courts

During the worst months of the pandemic, families could only see loved ones in nursing homes through a window. On August 1, 2020, a daughter standing outside her 87-year-old mother's window watched her mother struggle to breathe, with a wad of gauze over the tracheostomy tube in her neck. When the daughter asked the nurse in the room what was going on, the nurse turned and walked away. The daughter's mother did not survive.

A Cuyahoga County jury held the nursing home accountable, including with punitive damages. On January 8, 2026, the Eighth District Court of Appeals affirmed every part of the judgment in McCoy v. Avon Place Skilled Nursing & Rehab. Ctr., 2026-Ohio-36. The decision is worth reading closely for any family whose loved one was neglected in a care facility, because it shows how punitive damages, Ohio's damages caps, and the rules that punish refusing to settle all work in a real case.

What happened

Marianne Andrews was admitted to Avon Place in June 2020 for rehabilitation. She breathed with the help of a tracheostomy and supplemental oxygen. On August 1, her daughter, Karen McCoy, arrived for a window visit and saw that her mother's color was wrong and that she was gasping. The daughter began recording on her phone. According to the trial testimony described in the opinion, the gauze appeared to be covering the trach opening and the oxygen collar had been pulled out of position. A respiratory therapist came in for a routine treatment, and the family's expert testified that his response fell below the standard of care. Paramedics took Ms. Andrews to the hospital, where the family was told she was brain dead.

The family also proved an earlier problem. On July 23, 2020, staff left Ms. Andrews in an awkward, slumped-over position in a chair, and photographs showed it. The trial court found that treatment undignified and disrespectful, in violation of her rights under Ohio's Nursing Home Residents' Bill of Rights.

The verdict and the judgment

The jury found for the family on every claim and awarded $2.3 million in compensatory damages:

• $1,150,000 for wrongful death;
• $300,000 for Ms. Andrews' own pain and suffering on August 1 (the "survivorship" claim, which belongs to her estate);
• $500,000 for the separate July 23 violation of her rights as a nursing home resident;
• $350,000 to her daughter for negligent infliction of emotional distress.

The jury then heard a second phase on punitive damages and awarded $500,000, plus reasonable attorney fees. After applying the statutory caps, the trial court entered judgment of $3,461,349.73, which included $1,061,349.73 in attorney fees and expenses, and awarded prejudgment interest on $1.9 million in compensatory damages.

Punitive damages: why "conscious disregard" was enough

Under R.C. 2315.21(C)(1), punitive damages require proof of malice, and under R.C. 2315.21(D)(4) the family must prove it by clear and convincing evidence. Ohio courts define actual malice to include a conscious disregard for the rights and safety of others that has a great probability of causing substantial harm.

The nursing home argued that its nurse's conduct did not reach that level. The appeals court disagreed. The jury saw the videos and heard the daughter's testimony that she pointed out the blocked airway and the nurse walked out anyway. The trial court had found evidence that the nurse "ignored McCoy's cries to help" a resident who was struggling to breathe. That was sufficient.

The facility also argued, for the first time on appeal, that a corporation can be punished only if its leadership authorized or ratified the employee's conduct. The court held that argument was waived because the facility never raised it at trial, in its jury instructions, or in its post-trial motion.

Two related points matter for families:

• Attorney fees follow punitive damages. When a jury finds punitive damages are warranted, Ohio law allows the family to recover reasonable attorney fees as part of the compensatory award. The court upheld more than $1 million in fees and expenses. Under R.C. 2315.21(D)(2)(c), those fees do not count toward the punitive damages cap.
• The Bill of Rights has teeth. R.C. 3721.17(G) gives a resident whose rights are violated a cause of action against the home, and it makes the punitive damages statute applicable to those claims.

How the caps applied

Because this was treated as a medical claim, the noneconomic damages cap came from R.C. 2323.43(A)(2), which generally limits noneconomic damages to the greater of $250,000 or three times economic loss, up to $350,000 per plaintiff or $500,000 per occurrence. The trial court reduced the August 1 pain-and-suffering award, the July 23 Bill of Rights award, and the daughter's emotional-distress award to $250,000 each. The $1,150,000 wrongful-death award was entered in full.

The nursing home argued that the two estate claims should share a single $250,000 cap. The Eighth District rejected that argument. The July 23 mistreatment and the August 1 emergency were separate events with separate facts, so they were separate occurrences with separate noneconomic damages. That ruling turned on the evidence: the family documented a distinct earlier violation, and it was worth an additional $250,000.

Caps are one of the most important factors in valuing any serious injury or death case. Our guide chapter on what your case is worth explains how they work, and we have written about how courts are scrutinizing the medical-claim cap.

Prejudgment interest: the price of refusing to negotiate

Ordinarily, interest on a verdict runs from the date of judgment. R.C. 1343.03(C)(1) changes that when the court finds, after the verdict, that the defendant failed to make a good-faith effort to settle and the injured party did not. Interest then runs from an earlier date, which in a case that takes years to reach trial can add a significant sum. The parties later stipulated that the interest awarded here came to $347,409.90.

The settlement history told the story. The family demanded $2.5 million about six months after filing suit. According to the family, the facility never responded. Its first offer, $25,000, came at a mediation roughly 17 months later. By the first day of trial the family had come down to $650,000; the facility's best offer was $350,000. The facility's risk manager testified after trial that she thought a defense verdict was more likely than not. The trial court found the facility failed to rationally evaluate its risk and failed to respond in good faith to the family's demands, and the appeals court agreed.

What this means for you

• Neglect can justify punitive damages. When staff see a resident in danger and walk away, a jury can find conscious disregard.
• Document every incident, not just the last one. The daughter's photos of the earlier mistreatment and her video of the emergency were central to this result. Our chapter on preserving documents and records explains how to keep that evidence organized.
• Separate harms can carry separate damages. A pattern of neglect may support more than one claim.
• A facility that stonewalls can pay for it. Ohio's prejudgment interest statute rewards families who negotiate in good faith.

When neglect leads to a death, a wrongful death claim belongs to the family, and the estate keeps its own claim for what the resident suffered before death. Both have deadlines, and the facility's records and video do not keep forever.