A group of for-profit nursing homes -- including two in the central San Joaquin Valley -- have put elderly residents at risk and skirted state law by skimping on staff to make more money, lawyers contend in a class-action lawsuit.

In a trial unfolding in Humboldt County Superior Court, lawyers for nursing home residents say staffing problems have plagued homes operated by Skilled Healthcare Group Inc., the 10th-largest nursing home chain in the country. They hope to collect a multimillion-dollar judgment and improve care.

The nursing homes deny the allegations and say they have maintained adequate staffing levels and provided quality care.

Industry and advocates for nursing-home reform are watching the case closely. It's not the first class-action case nursing homes have faced for staffing problems, but the size of the case means it could have a far-ranging effect on how nursing homes are staffed.

The lawsuit names as defendants 22 nursing homes in California, the company that owns them, Skilled Healthcare Group Inc., and its subsidiary Skilled Healthcare LLC. Willow Creek Healthcare Center in Clovis and Valley Healthcare Center in Fresno are two of the defendants.

More than 32,000 nursing home residents are represented by the class action, lawyers for the plaintiffs say. A retired Fresno postal clerk who received care at Valley Healthcare is one of three named plaintiffs.

The case has been lengthy -- it was filed in 2006, and after four years of pretrial motions and hearings, the trial could be coming to a close this spring. This month, the plaintiffs rested their case and the defense began presenting testimony to jurors.

Millions of dollars could be at stake. In addition to seeking punitive damages, the plaintiffs are suing for statutory damages for each day the nursing homes are found out of compliance with staffing laws. The plaintiffs contend the California homes were under-staffed thousands of days over the six-year period -- 2003 to 2009 -- covered by the lawsuit. Penalties can be up to $500 per resident for each day the law was violated.

Lawyers for the nursing-home residents say they hope not only to win restitution for residents, but also to spur reforms in the industry. "We want to change the corporate culture of the for-profit nursing operators to have them start paying more attention to the nursing of the residents and less attention to shareholders," said Michael Crowley, lead trial counsel for the plaintiffs and a lawyer with the Janssen law firm in Eureka.

The defense declined to comment except in writing.

"The 22 facility defendants work hard every day to provide quality care to their residents, and vigorously dispute the plaintiffs' allegations, before and during the current trial," the defense said in the statement from attorney Kippy L. Wroten.

Chains are watching

Skilled Healthcare Group of Foothill Ranch was the nation's 10th-largest nursing home chain in 2009, based on the number of nursing beds, according to the trade journal Provider Magazine.

The outcome of the trial "will be of big interest to the chains," said Charlene Harrington, a professor of nursing and sociology at the University of California at San Francisco and a national expert on nursing-home staffing.

"I think it would definitely have an impact if [the nursing homes] lose," she said. Harrington testified as an expert witness for the plaintiffs.

At issue is whether the homes violated California Health and Safety Code law by not having enough staff to care for residents. California requires that nursing homes provide at least 3.2 nursing hours per resident per day, which includes care by registered nurses, licensed vocational nurses and certified nursing assistants.