Jim Wilkes doesn't mince words when it comes to expressing his contempt for the nursing home industry.

"There is no such thing as a good nursing home, just as there was never such a thing as a good orphanage," the 49-year-old lawyer and Tampa, Fla., native said. "How many orphanages do you see around these days?"

Wilkes is a virtual nightmare for the corporate-owned nursing homes that now dominate long-term care for the elderly.

The law practice that he helped begin in 1985 has experienced explosive growth thanks to a string of multimillion-dollar verdicts the firm has won in lawsuits against nursing homes.

The law firm of Wilkes and McHugh now has offices in six states, including one in Birmingham. The firm has 30 lawyers and 1,000 active case files on nursing homes, 85 percent of them wrongful death lawsuits, he said.

Ask anyone associated with nursing homes about Wilkes and their reaction ranges from scorn to grudging respect.

"We refer to him in Alabama as a migratory predator," said Bruce Thevenot, executive director of the Alabama Nursing Home Association. "I have to give him some credit. He has talent in marketing and promoting himself."

It might be easy to dismiss Wilkes as an opportunist looking to exploit misery for his own gain. But when it comes to nursing homes there's no denying his passion, whether it's real or, as his critics charge, just part of his marketing plan.

"The whole concept of nursing homes is to institutionalize," he said. "Old people are not just some product that we warehouse."

Alabama currently has about 24,000 nursing home beds. The nursing home industry has strong influence in Montgomery, donating more than $100,000 to Gov. Don Siegelman before the 1998 election.

Because of differences in state law, it's a lot easier to sue nursing homes in Florida than Alabama, Wilkes said. But Wilkes and McHugh has a number of cases pending in Alabama, including one in which a Birmingham nursing home is accused of allowing a woman's bedsores to go untreated and leaving her malnourished.

Wilkes admits he has made an extremely good living by suing for-profit chains but claims his real goal is to force drastic reform. He often cites his own grandmother, who suffered neglect in a nursing home, as a source of inspiration for his work.

"I spend a lot of time trying to put myself out of business," he said. "There's a better way of taking care of elderly folks."

Wilkes believes that it's a waste of time to try to "fix" nursing homes.

"You can't fix nursing homes," he said. "It's time we got rid of nursing homes. I don't think nursing home operators have the same respect for life everybody else does."

For-profit nursing home chains have come under increasing criticism in recent years, including lawsuits and federal investigations of Medicare and Medicaid fraud.

While nursing home chains enjoyed high profits in the early '90s, many of the largest chains, such as Vencor Inc. and Integrated Health Services, have filed for bankruptcy. Changes in the way the government reimburses nursing homes came in 1997 through federal budget changes, which drastically cut the amount of Medicare money paid to homes for their services.

And nursing homes have come under increasing attack from lawyers such as Wilkes.

Wilkes has been profiled in many national newspapers and magazines, and regularly appears on television news shows. Wilkes does not hesitate to divert his private jet in order to meet with reporters.

"He's flamboyant and he's an opportunist," Thevenot said. "His positioning himself as a reformer is part of his marketing strategy."

Thevenot acknowledges problems with nursing homes. But he said the solution is not to do away with them altogether or sue them into oblivion.

"I don't think it's helpful for people like Wilkes to suck precious resources out of the industry that could be used for staffing," he said. "It costs four to five times more now than three years ago for our insurance premiums. Many insurance companies don't want to insure nursing homes at all because of the success of people like Wilkes."

Indeed, rising liability costs is one of the primary problems cited by financially troubled nursing home operators.

Two of the largest nursing home companies in the nation, Sun Healthcare Group Inc. and Mariner Post-Acute Network, have filed for bankruptcy protection from creditors in the past year.

Wilkes predicts nursing homes will be out of business in 10 years. He said the majority of people working in the industry are well meaning, but believes the concept of "warehousing" the elderly is outdated.

Wilkes said alternatives such as group homes or more family-based care is preferable.

"There are a lot of great people working in nursing homes," he said. "It's the system that's wrong."

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