Twenty-nine of The Ensign Group’s California nursing homes were named as defendants in the lawsuit. Co-plaintiffs The California Alliance for Retired Americans (CARA) and the Service Employees International Union United Healthcare Workers-West joined the suit on behalf of residents, family members, nursing home employees and the citizens of California similarly situated.

The issue at heart is whether the defendants provided their skilled nursing facilities the level of patient staffing and quality of care that is required, at the very minimum, by the State of California and that they billed individuals, their private insurance companies, and government sources, such as MediCare and MediCal, as if they had been providing the care promised. The lawsuit alleges that the reality is that they did not provide this legally mandated minimum care to the elder and infirm residents of their skilled nursing facilities.

A lawyer for the residents states "The California Department of Health Services has cited Ensign repeatedly for inadequacies, which we belief to be caused by short-staffing, leading Ensign to have what we believe to be an unacceptable number of residents who develop bed sores and urinary tract infections, who have unexplained falls, who have an unexpected weight loss, and who suffer medication errors, all often the first signs of inadequate care and elder abuse." He further remarked "Our lawsuit alleges that Ensign ignores the needs of a particularly vulnerable segment of our community: our parents, our grandparents -- and someday maybe ourselves. We wish to ensure that quality patient care by sufficient and qualified staff is the norm, not the exception and that a 'profits over people' mentality becomes a thing of the distant past."

The lawsuit is open to residents or family member of a resident from one 29 nursing homes listed in the complaint.