How The Dickson Firm Turned a Week-Long Fall Chronology Into a Same-Day Task with Legal AI for Nursing Home Litigation
One of Ohio's largest nursing home neglect and abuse practices. Case records that run to tens of thousands of pages.
Blake A. Dickson, Esq.
Published
Interviewed by
Jenny Nguyen, Senior Client Success Manager
To chart 52 falls (prev. took 2 people a week)
to turn 115 fall sheets into witness list
Of personnel files searched
Overview
A Statewide Nursing Home Practice
Our client, The Dickson Firm, L.L.C., has one of the largest plaintiff-side nursing home practices in Ohio. The Dickson Firm, L.L.C. represents nursing home residents and their families in neglect and abuse cases throughout the State of Ohio. Nursing home cases involve tens of thousands of pages of records including nursing home records, medical records, personnel files, surveys, financial documents, job descriptions, in-service documents, audit trails, staffing documents and multiple other documents from different sources. Successfully handling these cases often comes down to finding the key documents among the thousands of documents produced.
Anytime AI, a legal AI platform built for nursing home litigation and plaintiff personal injury firms, can help firms review and analyze these thousands and thousands of pages of documents. It builds fall and medical chronologies with a citation for every entry, it searches personnel files at volume, and it sorts unindexed document productions so the firm knows what it has and what is missing. Anytime AI is part of the firm's daily work across its active nursing home docket.
The Challenge
The Falls Nobody Charted, Buried in Tens of Thousands of Pages
Nursing home litigation runs on records. Often key information is not clearly charted by the staff at the nursing home. There are many nursing home cases that involve falls; however, often the nursing home does not properly document all falls. Anytime AI can analyze the nursing home records and detect every single reference to a fall, enabling the user to compile a complete and accurate fall chronology.
This not only includes falls for which there is a progress note but any reference to a fall. Often in a nursing home chart, there are references to a fall that was not properly documented. There are references to a fall where the staff at the nursing home did not create a progress note for that fall. Anytime AI catches all of these references. It can then organize these references into a detailed fall chronology that lists every fall and then summarizes the documentation of each and every fall. Thereafter it can analyze what was done in response to each fall:
Was there an investigation?
Did the nursing home conduct a root cause analysis?
Was the care plan updated?
Was the family notified?
Was the resident's physician notified?
Anytime AI can also correlate the relevant state and federal laws and regulations with the conduct of the nursing home, helping the client not only create a chronology but create a specific list of breaches of the standard of care.
Anytime AI can also read and process handwritten entries, scans of uneven quality, and pages that resist search even after enhancement. The alternative is hours and hours of painstaking manual review of these thousands of pages of records.
Tens of thousands of pages per case
Nursing home cases involve tens of thousands of pages of records but most cases turn on a small number of key documents. The key is finding those documents.
Fall chronologies built by hand
Before Anytime AI, in order to create a fall chronology, staff had to manually review thousands of pages of records looking for documentation of falls. Often a reference to a fall consists of a single handwritten line. There is no progress note documenting that fall but that information is key to the analysis of the case. The fact that the resident had a fall and the nursing home didn't properly chart it is a key finding. These references are very hard to locate manually.
Prior to Anytime AI, staff had to manually review these records and then manually create a fall chronology. Anytime AI can review these thousands of pages of records and generate a fall chronology.
Productions that arrive without a map
Defense counsel often produce documents as hundreds of separate PDF files with no index and no explanation. It is virtually impossible to manually analyze hundreds of separate PDFs. However with Anytime AI, the program can read all the PDFs and glean the information just as if the records were contained in a cohesive chart. Anytime AI can make a list of what the defendants have produced, and then generate a deficiency letter asking for what has not been produced.
The Turning Point
A Problem the Firm Was Not Shopping For
Blake Dickson belongs to a national nursing home litigation group. At the group's April gathering in Denver, one of its leaders, who had been involved in developing Anytime AI's nursing home product, invited the company to present. Everyone in the room logged in, brought a real case, and ran it.
Right away it was apparent: the incredible potential of Anytime AI. The way it reviewed thousands of pages of documents, the way it found references to falls or bedsores, the analysis that it was able to conduct of the records it reviewed.
The Solution
Finding the Key Documents Among the Thousands Produced
One thing that Anytime AI does a wonderful job of is pulling out information from thousands of pages of records. The Dickson Firm uses Anytime AI to make a list of staff who have provided care to the relevant resident. The Dickson Firm uses Anytime AI to summarize voluminous records.
In one case there were dozens of fall follow-up sheets. Anytime AI was able to create a chart listing the name of every nurse who signed each of those sheets, the date she signed the sheet, and the page of the sheet, which The Dickson Firm was then able to use in a request for production of documents to obtain relevant personnel files.
Through the knowledge base Anytime AI is aware of the laws and regulations that apply to the care of nursing residents in a nursing home, both nationwide and specific to the state where the resident is located. Anytime AI is able to use this knowledge to analyze the records. On a current fall matter, the chronology flagged a Baseline Care Plan that federal regulation requires within 48 hours of a resident's admission (42 C.F.R. § 483.21(a)(1)(i)). It had not been created until more than a week later, and it had then been dated as though it were completed on time.
In another case, The Dickson Firm became suspicious of an insurance policy. While there were no clear redactions, the policy seemed incomplete. The Dickson Firm ran the policy through Anytime AI and Anytime AI identified a number of gaps in the policy. It turned out the defense counsel had actually whited out sections of the policy manually and then scanned the pages. The redactions were purposely concealed. The Dickson Firm brought this matter to the court's attention, and the court ordered the defendants to produce the unredacted policy.
None of this runs on trust. Every finding carries a citation, and The Dickson Firm opens the underlying record. All of the statements that The Dickson Firm makes in motions, briefs, or demand letters are based on the actual records. Anytime AI enables The Dickson Firm to identify the support for the position that it takes from the records.
01
Case analysis at intake
The Dickson Firm loads every case into Anytime AI. Often they run an initial analysis of a case at the intake stage. This analysis often helps them determine whether or not they are going to accept the case.
02
Chronologies
The Dickson Firm creates a chronology for every case. Was the resident properly assessed? Was the care plan appropriate? Were proper interventions put into place? Were they implemented? Was the care plan updated as the resident's condition changes? Anytime AI helps create these detailed chronologies with citations to the records.
Anytime AI also helps the firm analyze the question of proximate cause. What is the link between the negligence of the nursing home and the injury suffered by the client? What is the detailed analysis of the cause of the client's death?
03
Personnel file review at volume
Personnel files are an incredible source of valuable information in every nursing home case. They can be quite voluminous and the key information can come down to a single line in an annual evaluation. The Dickson Firm uploads all the personnel files that they obtain into Anytime AI and Anytime AI scours them for relevant information. In a matter of minutes it can create a summary of key information that the firm then zeroes in on.
04
Making sense of an unindexed production
Defense counsel often produce dozens, if not hundreds, of PDFs without any list of what they are producing and without any indication of what each PDF contains. Without Anytime AI, the manual review of these documents takes days. Anytime AI is able to analyze these documents and create a list of what has been produced and, more importantly, what has not been produced.
The Results
Finding the Key Documents Among the Thousands Produced
One thing that Anytime AI does a wonderful job of is pulling out information from thousands of pages of records. The Dickson Firm uses Anytime AI to make a list of staff who have provided care to the relevant resident. The Dickson Firm uses Anytime AI to summarize voluminous records.
In one case there were dozens of fall follow-up sheets. Anytime AI was able to create a chart listing the name of every nurse who signed each of those sheets, the date she signed the sheet, and the page of the sheet, which The Dickson Firm was then able to use in a request for production of documents to obtain relevant personnel files.
Through the knowledge base Anytime AI is aware of the laws and regulations that apply to the care of nursing residents in a nursing home, both nationwide and specific to the state where the resident is located. Anytime AI is able to use this knowledge to analyze the records. On a current fall matter, the chronology flagged a Baseline Care Plan that federal regulation requires within 48 hours of a resident's admission (42 C.F.R. § 483.21(a)(1)(i)). It had not been created until more than a week later, and it had then been dated as though it were completed on time.
In another case, The Dickson Firm became suspicious of an insurance policy. While there were no clear redactions, the policy seemed incomplete. The Dickson Firm ran the policy through Anytime AI and Anytime AI identified a number of gaps in the policy. It turned out the defense counsel had actually whited out sections of the policy manually and then scanned the pages. The redactions were purposely concealed. The Dickson Firm brought this matter to the court's attention, and the court ordered the defendants to produce the unredacted policy.
None of this runs on trust. Every finding carries a citation, and The Dickson Firm opens the underlying record. All of the statements that The Dickson Firm makes in motions, briefs, or demand letters are based on the actual records. Anytime AI enables The Dickson Firm to identify the support for the position that it takes from the records.
Why It Works
A Team That Answers, and a Platform Anyone Can Run
The training did not stop when onboarding ended. Blake's team can get someone on a Zoom whenever they hit something new, and what he did not expect is how often raising a problem turns into a change in the product. He brings something up, a call follows, and the fix gets built. For a stretch this year the answer to most of his questions was that 3.0 would handle it, and then 3.0 did.
"Every time I come up with something and I reach out to Anytime AI, immediately I get a response. Often we have a Zoom, and you guys are literally programming innovations into the program to adopt and adapt and address the concerns I'm raising. And to date, there's nothing I've raised that the team hasn't been like, okay, and they just fix it."
Blake A. Dickson, Esq.
Principal Attorney at The Dickson Firm, L.L.C.
The second difference is who in the firm can do the work. On 2.0 the firm banked its expertise in saved prompts. On 3.0 that expertise sits inside the agents themselves, which refine their own searches and build on their own answers. A paralegal, an associate, or a summer law clerk can now run a chronology or a case analysis without first having handled a hundred nursing home matters.
The output still comes back to Blake for review. What changed is that nobody waits on someone more senior before they can start.
"Everyone on the team can contribute, because… now in 3.0, where the prompts are internal, the expertise is built in, it's baked in, and so they can do a task. Even if they don't have the expertise to fully understand the nuances of the task, because it's already in there… It's head and shoulders above 2.0."
Blake A. Dickson, Esq.
Principal Attorney at The Dickson Firm, L.L.C.
The Bottom Line
Anytime increases the capacity of The Dickson Firm to handle more cases and help more families
Anytime AI enables the team at The Dickson Firm to analyze cases much more quickly. Detailed chronologies and dozens of personnel files move at a much accelerated rate, and so does the analysis of negligence, proximate cause and damages.
Now that Anytime AI is able to do the work of analyzing thousands of pages of records (something that once took days of manual work), the team at The Dickson Firm is free to focus on the analysis of the case, the strategy of the case, and the damages of the case. In turn, they are also free to help more families.
Is Anytime AI built for nursing home abuse and neglect litigation?
Yes. Nursing home neglect is one of its core practice areas, alongside medical malpractice, catastrophic injury, traumatic brain injury, and trucking cases. The nursing home workflows were developed with input from attorneys who try these cases.
Can AI find falls that were never charted in the progress notes?
Yes. Anytime AI analyzes the nursing home records and detects every single reference to a fall, including a single handwritten line with no corresponding progress note. The fact that a resident had a fall and the nursing home didn't properly chart it is itself a key finding.
What happens when a defense production arrives as hundreds of unlabeled PDFs?
Anytime AI reads all of them and creates a list of what has been produced and, more importantly, what has not been produced. Manually analyzing hundreds of separate PDFs with no index is virtually impossible, and the program can glean the information as if the records were contained in a cohesive chart.
Does Anytime AI replace attorney review?
No. The expertise is built into the platform's agents, so paralegals, associates and law clerks can run chronologies and case analyses themselves. At The Dickson Firm every output goes to an attorney for review before it is used.
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