She Was Told to Lift a 300-Pound Patient Alone. A Texas Court Just Made Her Employer Pay $7.1 Million.

Pasadena, Texas — A nursing home that skipped workers’ comp insurance is now on the hook for a $7.1 million verdict, and a Texas appeals court has decided it isn’t coming off.

The case goes back to May 2016, when Nicole Tarpley, a certified nursing assistant at Red Bluff LLC’s nursing and rehabilitation facility in Pasadena, was told to move a patient weighing more than 300 pounds from bed to wheelchair. She had been on the job for three weeks. She did it alone.

The wheelchair’s brakes disengaged mid-transfer. The patient fell onto her leg, and Tarpley hurt her knee, neck and back, according to court records.

What the evidence showed

A jury heard testimony from nursing supervisors and other witnesses that the resident needed at least two people for a safe transfer. Tarpley testified she was instructed to handle it without extra help. She also said she got one day of floor orientation — the facility’s own standard called for three.

The jury found Red Bluff negligent and awarded Tarpley $7.11 million, including $500,000 for future medical care and $2.75 million for past and future physical impairment.

Why the ruling matters beyond one facility

Texas is one of the few states that lets private employers opt out of the workers’ compensation system entirely. But the trade-off is steep: companies that opt out lose most of their legal defenses and can be sued directly for negligence. The appeals court upheld the negligence finding, ruling that Red Bluff still had a duty to provide adequate training and instruction on safe patient transfers — even though Tarpley had prior experience as a nursing assistant elsewhere.

The court did trim one piece of the award. Judges found too little evidence to support the full $500,000 in future medical expenses and ordered a reduction of $264,448, bringing that portion down to about $235,551. Tarpley had 20 days to accept the reduced figure or head back to court for a new trial.

For operators across the state, the message is hard to miss. Dropping workers’ comp coverage doesn’t just shift risk onto employees — it can put a facility in front of a jury with almost no shield. When staffing is thin and training gets cut short, the bill eventually comes due, and it can dwarf the cost of any insurance premium. It’s a pattern regulators have flagged before, with nursing homes across the country paying more than $713 million in federal fines in recent years for safety and staffing failures.

The ruling also lands at a moment when facilities everywhere are struggling to keep direct-care staff, and injuries like this one are a big reason workers walk away. Aide retention has become one of the industry’s toughest problems, and court cases like this don’t exactly help recruitment.