If any one individual can be described as a “holy terror” for nursing home administrators everywhere, it is attorney Jim Wilkes, whose Tampa, Florida-based law firm has spent the past 20 years winning liability judgments against nursing homes totaling hundreds of millions of dollars. Focusing on negligent resident care, often manifested by life-threatening pressure ulcers, falls, fractures, and assaults due primarily to alleged understaffing by large for-profit chains, Wilkes may claim to have materially raised the level of care in American nursing homes out of sheer fear, if nothing else. Nursing homes counter that he is potentially responsible for damaged reputations and overpriced insurance coverage for thousands of conscientious facilities, putting their already shaky existence in even deeper jeopardy. One ironic certainty over the years is that the Wilkes verdicts have inspired tort reform laws in several states limiting judgments and lawyer fees. Nevertheless, the big cases keep coming, with major trials underway in California, Tennessee, and Florida-evidence that Wilkes' fertile field in liability litigation is continuing to produce bumper crops.