How To Build a Successful National Legal Firm With Nursing Home Abuse Cases

Lindsey Busfield: Welcome to the Personal Injury Marketing Minute where we quickly cover the hot topics in the legal marketing world. I’m your host Lindsey Busfield. As personal injury lawyers expand their practices, some have their eyes on a national prize. Doing this requires vision, leadership, and budget. But where do you start? Nationally known for successfully representing clients in personal injury matters, Steve Levin, founding partner of Levin & Perconti, is an outstanding attorney and successful entrepreneur. In addition to representing people seeking better care for their elderly loved ones, he has built a law firm that has become one of the best in the nation at winning substantial verdicts and settlements for people affected by medical malpractice, nursing home neglect, birth injury, and other personal injury cases. Thank you so much for joining us today, Steve.

Steve Levin: Thank you for having me, Lindsey.

Lindsey Busfield: Well, for those who didn’t listen to our earlier episode together or who are unfamiliar with your law firm, tell us a bit about your national practice and how you got started.

Steve Levin: Well, like many things in life, I got started. I mean, I started out with my last paycheck from my sole practitioner office to moving to my own office. And over time we developed a substantial personal injury firm. That process, which had a lot of trial and error, a lot of ups and downs, a lot of failures and successes, was invaluable in structuring how I developed the practice later on. Sometime after I started in the personal injury area, the traditional areas were sort of owned by the big brand-name firms, so I was always hunting in the edges for where there was a need to help people and an opportunity to have substantial personal injury cases where a lawyer could make a living at it. As a result of that, I fell upon nursing home cases. I was referred a case by a mom whose son died a tragic death in a nursing home. He was significantly developmentally disabled when he was allowed to wander around the home and he fell down a flight of stairs.

Steve Levin: So that was my first nursing home case. As I researched that case, the conventional wisdom in personal injury at that time was that this fellow’s life had no meaning; he didn’t have a job, he didn’t really have a lot of medical expenses, and no one was dependent on him for support. The conventional wisdom was PI lawyers wouldn’t take these cases because the outcome wouldn’t merit the work that would go into it. I never believed that, and I always believe that the real damages, the heart of the cases, are the so-called non-economic damages or intangible damages. Those are what have been taken away: your mobility, your ability to enjoy life, your ability to engage in human relationships in the way you want to, and nagging pain every single day. It’s hard to translate those injuries into dollars, which is how our legal system works, but it turns out ordinary citizens can grasp what it means to harm a person and they are comfortable with the concept. Just because someone has significant medical conditions or disabilities, when you harm them, they still suffer, and that suffering, pain, and disability is a compensable injury.

Steve Levin: Going back, we started out in nursing homes on this first case and I learned there was a law in Illinois – an unbelievable law – that was sort of like a civil rights action for nursing home residents that had been on the books for 10 years. No one until I first looked at it had ever used it. It was enacted by the famous Chicago Mayor Daley’s son when he was a legislator. I’m thinking, “Wow, this is like a civil rights action for nursing home residents. It allows for not only ordinary damages but for the recovery of attorney’s fees and, at that point, it allowed for triple damages.” No one had ever used it, and I was thinking, “Am I crazy or has the world missed something that is very significant?” So we filed the suit, and it turned out we prevailed. I went to a national convention for nursing home lawyers at this time and there were about five people there; now those same conventions have 3,000 people. That sort of got me thinking on a national basis.

Steve Levin: Now we have electronic communication to the utmost degree, but representing nursing home residents and their families is a specialty. While the laws of each state are different, you can work around that. The specialty is the way to handle a case, the way to review it, the way to look at records, and the way to decide who to sue and how to prosecute certain injuries. For example, it used to be that if you were in a nursing home and got bad treatment, people said, “What do you expect?” or “Bed sores are just what happens when you get old.” We said, “No, nursing home residents and their families are entitled to a reasonable standard of care.” If you provide that, you will avoid injuries from understaffing and a lack of support. Once we realized that, a whole new field of business opportunity opened up because nursing homes, unfortunately, do not give the care they should, primarily because the desire to make a profit impacts the amount of staff and resources they devote to the home.

Lindsey Busfield: Well, and that is only compounded by the fact that people buy into this lie that nursing homes should all be terrible. Part of the challenge with this particular specialty or niche is that you’re not only combating the legal hurdles but you’re also taking on an educational role, explaining, convincing, and selling to people that no, this shouldn’t be the expectation. You’ve done this so well, and it provides such a great service to the community and the people who are serviced by these nursing homes.

Steve Levin: You really hit the nail on the head. While we haven’t solved all the problems, we have brought attention to them. Personal injury lawyers have policed the field where government has been ineffective, much like they did in tobacco and opioids. It’s an ongoing battle, and hopefully, we’re moving in the right direction.

Lindsey Busfield: The more you do it, the more precedent is set and the more background other attorneys have to rely upon to build their cases and show what the outcome should be, especially on a national level. For attorneys listening who are interested in growing their practices nationally, I mentioned it takes vision, leadership, and budget. Can you talk to me about your vision initially and what has influenced the expansion of this practice area?

Steve Levin: The initial vision was to be the best nursing home law firm representing residents and their families in Chicago and surrounding counties. When I realized these cases would have the same impact and workup anywhere else, we expanded to Illinois. As an early founder, I naturally had a network because there weren’t many other people in Illinois to discuss these cases with. As communication became more sophisticated, I realized that while firms are traditionally organized geographically by state, that may be illogical. Another way of looking at it is to organize it by specialty area. If you forget about states, nursing home cases have a core of the same players, experts, defenses, and a unique body of knowledge. My vision was that this could be transferred to other states.

Steve Levin: As a practical business matter, there are only a couple of ways to get cases in other states. One is to develop a network of lawyers who will bring you in as a specialist. The other way is marketing. Marketing nationally is extremely expensive, so you either have to finance it yourself or do it in partnership with other people. We partner with national marketing law firms who know our name because we’ve done national marketing ourselves. These firms need a quick and thoughtful review of the case because if you’ve never done a nursing home case, you wouldn’t know what to do with a mass of records. Another key is developing a network of competent lawyers to whom you refer cases. There’s a well-known lawyer who envisions the “Google law firm,” where no matter what the case is, a potential client can call and be sure they get to the right person to handle it. A client in Illinois has no way to find a lawyer in Arkansas or California. We find that lawyer for you and monitor them to make sure things are going correctly. We’ve done the due diligence, so you have us to turn to as opposed to someone 1,500 miles away.

Steve Levin: As time went on, we became involved in birth injury cases in Chicago. While I think we were the best trial lawyers, birth injury cases have a specialized body of knowledge involving experts and defense issues that would take us ten times longer to learn. I wanted to hook up with a truly knowledgeable person, so we partnered with Dov Apfel and Seth Cardelli. I believed Dov was the most knowledgeable person in the country in birth injury cases. Combining that with our trial skills created an unbelievable partnership. This partnership takes fortitude because these cases take a long time, involve many experts, and are very expensive to fund. Some lawyers are narrowly focused and don’t want to share a fee, but that’s not how it works.

Steve Levin: In forming any practice, we’ve exploded many myths: that old people’s lives have no value, that you can’t try cases in small counties, and that referring cases takes your piece of the pie. Every partnership we’ve ever formed expanded the pie for everyone. One of the greatest benefits of our partnership with Dov and Seth is knowing that the defense would never, ever know more than us. They can evaluate a case in one-tenth of the time because of their experience and relationships. In nursing home cases, I think I’m better able to evaluate than a doctor or a nurse. You give us the facts, and based on long experience, we can tell you what is or what is not a case. Especially in birth and nursing home injuries, the cases you don’t take are as important as the cases you do take. Taking a case you don’t understand that requires more work and money than you have is a nightmare.

Steve Levin: If you want to start doing nursing home cases, my number one piece of advice is to partner with a lawyer who’s done it before. People say they don’t want to share the fee, but you’ll use that extra time to market other cases and focus on what you’re doing. I’m horrified when I read on listservs that someone just got their first nursing home case and asks what complaint to file or what discovery to use. What would people say if a cardiovascular surgeon got on a listserv and said they were thinking of doing hip surgery and asked what tool to use or which side scalpel? If the malpractice occurred, I would have a field day as a plaintiff’s lawyer reading those texts asking if this was like an experiment. Partnerships are becoming more accepted, and I’ve never been afraid to share with the right people because it makes everyone better and it’s better for the client.

Lindsey Busfield: There’s a higher risk for those attorneys to lose the case entirely. It sounds like a no-brainer to have a “paid apprenticeship” where you learn from the best while still getting a great cut. I think a lot of times ego or the monetary aspect of a “big fish versus a little fish” gets in the way. Transitioning this to a wider net, what can PI attorneys in general apply to their practices as they look to expand nationally?

Steve Levin: Nationally is a tough marketplace. If you are expanding in a unique practice area, it’s different than auto cases, where you’re competing with firms that have hundreds of millions of dollars in advertising. Unless you are fully committed and have millions to spend, you can’t compete. Medical malpractice is also hard because of specific state laws. Birth injury and nursing home cases are somewhere between mass torts and unique single-event cases, they are standardized with the same lawyers and experts.

Steve Levin: If you expand nationally, you have a huge commitment to the screening process. You have to screen a lot of birth injury cases before you find one that will stand up in court. We like to say we’ll look at anyone’s case, but we can’t help everyone, and it’s good news not to put a client through the trauma of a lawsuit that’s not going to turn out correctly. It’s also a myth that you have to take small cases to get big cases. If you take a small case, you’ll have an unhappy outcome and won’t develop future business. While you’re killing yourself on a “small case,” that client may get a relative with a huge case and take it to the lawyer who handles huge cases. I tell referring lawyers to save me for the cases where I’m good at and where we can make an impact.

Lindsey Busfield: That goes back to building referral networks, both for cases you handle and for cases you hand down. Building your network is essential whether you want to expand locally or take on cases in other states.

Steve Levin: 100%. Building relationships is not something you can cram for; it’s something you have to do every single day. Don’t think of it as one pie; the pie can be constantly expanding. People often want an exact quid pro quo, but I recommend building networks by helping someone without the expectation of a return. Ironically, you probably get a better return if you don’t expect one. Don’t be afraid to cast your bread upon the waters.

Lindsey Busfield: And many personal injury attorneys go into this field because they have compassion. Entering relationships with that sense of empathy is good business and good for the client.

Steve Levin: If you do the right thing, it’s best for the client and the relationship. And don’t forget that good settlements are driven primarily by the other side’s knowledge that you will try the case. Period. If they don’t know that, you won’t get the same result. The right way to practice is to try your good cases and settle the bad cases. If you’re under-financed or inexperienced, you might settle a good case for far less than it’s worth.

Lindsey Busfield: I was interviewing a lawyer whose firm exclusively takes cases to trial. Regardless of your philosophy, litigation, settlement, or hybrid, you need to know what it is and attract the right clients for that model.

Steve Levin: That is a very important point. You have to establish that relationship with the client from day one and tell them how you’re looking at it. You don’t spring ideas on them for the first time after two and a half years; you tell them how long the case will take and what’s involved so you are on the same page. I think you made a huge point: you have to know what your business, philosophy, and culture is. Expanding nationally is the same thing. I started with no business background, but I read tons of books on how to develop a culture. Culture is like a well-raised family, it’s a series of micro-encounters you have on a daily basis. A strong base enables you to expand easier because you know what you’re looking for.

Steve Levin: I was talking to a lawyer from a huge national marketing firm, and she said she instinctively knows when she talks to a lawyer in another state if she wants to refer a case. They either talk like a trial lawyer or they don’t. They don’t say, “We settle bed sore cases for $100,000,” because they know every case is different. I had a friend who tried cases in small counties where the courthouse was in the basement of a church. The conventional wisdom was that those people don’t give a lot of money, but he said that if you impact the values they hold dear, that’s not true. He used the McDonald’s spilled coffee case as an example, now everyone knows a bad case is worth millions of dollars. There are no “local jurisdictions” anymore because everyone has the internet.

Lindsey Busfield: It gives equitable access to information and has completely changed the landscape. So with that in mind, what is next on the horizon for Levin & Perconti?

Steve Levin: We are going to continue pursuing what we’re good at: nursing home, birth injury, and medical malpractice. What’s next is to continue to think outside the box. I started to write a book titled The Biggest Risk is Often the One You Don’t Take. Don’t be afraid to move into different areas or rethink your processes. Use the book Moneyball as your example, look at situations differently. Many systems were invented before the internet; now there’s no data that is not accessible to anyone. I used AI today to understand my own medical test results and what questions to ask my doctor before this call.

Steve Levin: Be curious. Don’t be judgmental or reject new ideas about marketing or how to handle a case. Test your assumptions. Read a lot, study a lot. Someone can get the benefit of my knowledge for free by listening to your podcast, and if you’re not doing that, you’re not developing as a lawyer. I pride myself on being ahead of a lot of younger lawyers because I have the inclination and I read. I love what I do.

Lindsey Busfield: Those are the biggest takeaways: grow your network and grow your knowledge. Thank you, Steve, so much for joining us today.

Steve Levin: Thank you, Lindsey.

Lindsey Busfield: Absolutely.