Appellate Docket Number: Appellate Case Style: Vs. 12-14-00357-CV Pinecrest SNF, LLC d/b/a Pinecrest Nursing & Rehabilitation Center Tasco Bailey, Nathan Bailey, Carlie Bailey, Roy Bailey, Bill Bailey, James Bailey, Earl Bailey, Mary Dunlap and Licille Martin as Heirs of Archie Bailey Companion Case No.:

Amended/corrected statement: 

### DOCKETING STATEMENT (Civil) Appellate Court: 12th Court of Appeals (to be filed in the court of appeals upon perfection or appeal under TRAP 32) I. Appellant II. Appellant Attomey(s) (choose one) SNF, LLC d/b/a Pinecrest Nursing ❑ Person 0 Organization 0 Lead Attorney Organization Name: Pinecrest First Name: Middle Name: Last Name: Suffix: Pro Se: Q First Name: Nichol Middle Name: L. Last Name: Bunn Suffix: Law Firm Name: Lewis Brisbois Bisgaard & Smith, LLP Address I : 2100 Ross Avenue Address 2: Suite 2000 City: Dallas State: Texas Zipi 4: Telephone: (214) 722-7100 ext. Fax: (214) 722-7111 Email: nichol.bunnAlewisbrisbois.com 75201 7105

SBN: 00790394 III. Appellee IV. Appellee Attomey(s)

x Person I

Organization (choose one) 0 Lead Attorney

First Name: Tasco Middle Name: Last Name: Bailey Suffix: Pro Se: 0 First Name: Robert Middle Name: Last Name: Wharton Suffix: Law Firm Name: McIver Brown Law Firm Address I: 712 Main Street Address 2: Suite 800 City: Houston

Page 1 of 7 ACCEPTED 12-14-00357-CV TWELFTH COURT OF APPEALS

TYLER, TEXAS 12/29/2014 4:35:48 PM

CATHY LUSK CLERK

### State: Texas Zip+4: 77002 Telephone: (832) 767-1673 ext. Fax: (832) 767-1783 Email: rwharton(Onciverbrown.com SRN: 24079562 V. Perfection Of Appeal And Jurisdiction Nature of Case (Subject matter or type of case): Professional Malpractice Date order or judgment signed: November 25, 2014 Type of judgment: Interlocutory Order Date notice of appeal filed in trial court: December 15, 2014 if mailed to the trial court clerk, also give the date mailed: December 15, 2014 Interlocutory appeal of appealable order: If yes, please specify statutory or other basis x Yes ❑ No on which interlocutory order is appealable (See TRAP 28): Civ. Prac. & Rem. Code Sec 51.014(a)( 10) Accelerated appeal (See TRAP 28): If yes, please specify statutory or other basis TRAP 28.1(a) Parental Termination or Child Protection? Permissive? (See TRAP 28.3): If yes, please specify statutory or other basis Agreed? (See TRAP 28.2): If yes, please specify statutory or other basis Ci

(See ❑

❑ Yes on which

TRAP Yes for such
Yes for such ❑

x

x 

### 28.4):

status:

status: No appeal is accelerated:

❑ Yes No No

No

Appeal should receive precedence, preference, or priority under statute or rule: If yes, please specify statutory or other basis for such status: • Yes x 

### No

Does this case involve an amount under $100,000? Judgment or order disposes of all parties and issues: Appeal from final judgment: Does the appeal involve the constitutionality or the validity • ❑
• Yes Yes Yes of 0

x
x 

### a statute, No No No rule, or ordinance? • Yes END VI. Actions Extending Time To Perfect Appeal Motion for New Trial: • Yes x No If yes, date filed: Motion to Modify Judgment: Request for Findings of Fact • ❑ Yes Yes El
Ei 

### No if yes, date filed: No If yes, date filed: and Conclusions of Law: Motion to Reinstate: DYes ❑ Ycs Motion under TRCP 306a: x U No If yes, date filed: No If yes, date filed:
Other: ❑ Yes 0 No If other, please specify:

Page 2 of 7VII:. Indigency Of Party: (Attach file-stamped copy of affidavit, and extension motion if filed.)
Affidavit filed in trial court: ❑ Yes FA No I f yes, date filed: Contest filed in trial court: ■ Yes 

# [J No If yes, date filed: Date ruling on contest due: Ruling on contest: • Sustained ❑ Overruled Date of ruling: VIII. Bankruptcy Has any party to the court's judgment filed for protection in bankruptcy which might affect this appeal? • Yes I=1 No If yes, please attach a copy of the petition.

Date bankruptcy filed: Bankruptcy Case Number:

IX. Trial Court And Record
Court: 114th District Court Clerk's Record: County: Smith County Trial Court Clerk: x District ❑ County Trial Court Docket Number (Cause No.): 14-0856-B Was clerk's record requested? x Yes ■ No Ryes, date requested: December 17, 2014 frial Judge (who tried or disposed of case): If no, date it will be requested: First Name: Christi Were payment arrangements made with clerk? Middle Name: (1 Yes • No Cl 1 ndigent Last Name: Kennedy (Note: No request required under TRAP 34.5(a),(b)) Suffix: Address 1: 100 N. Broadway Address 2 : Room 209 City: Tyler State: Texas Zip I- 4: 75702 Telephone: (903) 590-1625 ext. Fax: Email:

Page 3 of 7

### Reporter's or Recorder's Record: Is there a reporter's record? • Yes 

## 13 No Was reporter's record requested? ❑ Yes 

# ei No Was there a reporter's record electronically recorded? ❑ Yes x No If yes, date requested: If no, date it will be requested: Were payment arrangements made with the court reporter/court recorder? es • No E Indigent

❑ Court Reporter ❑ Court Recorder Official ■ Substitute

First Name: Middle Name: Last Name: Suffix: Address 1: Address 2: City: State: Texas Zip + 4: Telephone: ext. Fax: Email: X. Supersedeas Bond Supersedeas bond filed: / Yes x No If yes, date filed: Will file: ❑ Yes x No

XI. Extraordinary Relief Will you request extraordinary relief (e.g. temporary or ancillary relief) from this Court? • Yes x ❑ No If yes, briefly state the basis for your request:

XII. Alternative Dispute Resolution/Mediation (Complete section if filing in the 1st, 2nd, 4th, 5th, 6th, 8th, 9th, 10th, 11th, 12th, 13th, or 14th Court of Appeal)

be Should this appeal referred to mediation? Yes ❑ 

## © No If no, please specify: Page 4 of 7■ Court Reporter ■ Court Recorder ❑ Official ❑ Substitute

First Name: Middle Name: Last Name: Suffix: Address 1: Address 2: City: State: Texas Zip t- 4: Telephone: ext. Fax: Email: X. Supersedeas Bond Supersedeas bond filed:[] Yes ❑ No If yes, date filed: Will file: ❑ Yes ❑ No

Xl. Extraordinary Relief Will you request extraordinary relief (e.g. temporary or ancillary relief) from this Court? • Yes al No If yes, briefly state the basis for your request:

XII. Alternative Dispute Resolution/Mediation (Complete section if filing in the 1st, 2nd, 4th, 5th, 6th, 8th, 9th, 10th, 11th, 12th, 13th, or 14th Court of Appeal) Should this be to

appeal referred mediation? ❑ Yes ©No If no, please specify: appellate issues not suitable for appeal Has the case been through an ADR procedure? ❑ Yes x No If yes, who was the mediator? What type of ADR procedure? At what stage did the case go through ADR? ❑ Pro-Trial ❑ Post-Trial El Other 1 f other, please specify: Type of case? Professional Malpractice Give a brief description of the issue to be raised on appeal, the relief sought, and the applicable standard for review, if known (without prejudice to the right to raise additional issues or request additional relief): Interlocutory appeal of denial of motion to dismiss under Chapter 74 of the Texas Civil Practice and Remedies Code How was the case disposed of? Summary of relief granted, including amount of money judgment, and if any, damages awarded. If money judgment, what was the amount? Actual damages: Punitive (or similar) damages: Page 4 of 7Attorney's fees (trial): Attorney's fees (appellate): Other: If other, please specify:

Will you challenge this Court's jurisdiction? E Yes 

# ci No Does judgment have language that one or more parties "take nothing"? 

# D Yes 

# El No Does judgment have a Mother Hubbard clause? ❑ Yes Q No Other basis for finality? Rate the complexity of the case (use I for least and 5 for most complex): El 02 E3 E4 E5 Please make my answer to the preceding questions known to other parties in this case. ❑ Yes No Can the parties agree on an appellate mediator? ❑ Yes 

# 17] No If yes, please give name, address, telephone, fax and email address: Name Address Telephone Fax Email
Languages other than English in which the mediator should be proficient: Name of person filing out mediation section of docketing statement:

XIII. Related Matters List any pending or past related appeals before this or any other Texas appellate court by court, docket number, and style.
Docket Number: Style: Vs. Trial Court:

Page 5 of 7XIV. Pro Bono Program: (Complete section if filing in the 1st, 3rd, 5th, or 14th Courts of Appeals) The Courts of Appeals listed above, in conjunction with the State Bar of Texas Appellate Section Pro Bono Committee and local Bar Associations, are conducting a program to place a limited number of civil appeals with appellate counsel who will represent the appellant in the appeal before this Court. The Pro Bono Committee is solely responsible for screening and selecting the civil cases for inclusion in the Program based upon a number of discretionary criteria, including the financial means of the appellant or appellee. If a case is selected by the Committee, and can be matched with appellate counsel, that counsel will take over representation of the appellant or appellee without charging legal fees. More information regarding this program can be found in the Pro Bono Program Pamphlet available in paper form at the Clerk's Office or on the Internet at www.tex-app.org . If your case is selected and matched with a volunteer lawyer, you will receive a letter from the Pro Bono Committee within thirty (30) to forty-five (45) days after submitting this Docketing Statement. Note: there is no guarantee that if you submit your case for possible inclusion in the Pro Bono Program, the Pro Bono Committee will select your case and that pro bono counsel can be found to represent you. Accordingly, you should not forego seeking other counsel to represent you in this proceeding. By signing your name below, you are authorizing the Pro Bono committee to transmit publicly available facts and information about your case, including parties and background, through selected Internet sites and Listsery to its pool of volunteer appellate attorneys. Do you want this case to be considered for inclusion in the Pro Bono Program? ❑ Yes 0 No Do you authorize the PrcWono Cpa No mittee to contact your trial counsel of record in this matter to answer questions the committee may have ( regarding the appeal? 11 Yes L x Please note that any such conversations would be maintained as confidential by the Pro Bono Committee and the information used solely for the purposes of considering the case for inclusion in the Pro Bono Program. If you have not previously filed an affidavit of Indigency and attached a file-stamped copy of that affidavit, does your income exceed 200% of the U.S. Department of Health and Human Services Federal Poverty Guidelines? ❑ Yes 

# p No These guidelines can be found in the Pro Bono Program Pamphlet as well as on the internct at http://aspe.hhs.gov/poverty/06poverty.shtml. Are you willing to disclose your financial circumstances to the Pro Bono Committee? 111 Yes No If yes, please attach an Affidavit of Indigency completed and executed by the appellant or appellee. Sample forms may be found in the Clerk's Office or on the internet at http://www.tex-app.org . Your participation in the Pro Bono Program may be conditioned upon your execution of an affidavit under oath as to your financial circumstances. Give a brief description of the issues to be raised on appeal, the relief sought, and the applicable standard of review, if known (without prejudice to the right to raise additional issues or request additional relief; use a separate attachment, if necessary).

XV. Signature



# ► ,via Lee ,,,„ Signature of counse (or pro se party) Date: December 29, 2014

Printed Name: Nichol L. Bunn State Bar No.: 00790394

Electronic Signature: /s/Nichol L. Bunn (Optional)



### Page 6 of 7XVI. Certificate of Service

rtY) 

### 114.4, , r7 voSignature of counsel (or pro se p Y 

## cteet Electronic Signature: (Optional State liar No.: 00790394

Address 1: Address 2: City: 712 Main Street

Suite 800 Houston The undersigned counsel certifies that this docketing statement has been served on the following lead counsel for all parties to the trial court's order or judgment as follows on December 29, 2014 •

Person Served Certificate of Service Requirements (TRAP 9.5(e)): A certificate of service must be signed by the person who made the service and must state: (1) the date and manner of service;

(2) the name and address of each person served, and (3) if the person served is a party's attorney, the name of the party represented by that attorney
Please enter the following for each person served:

State Texas Zip+4: 77002 Telephone: (832) 767-1673 ext. Fax: (832) 767-1783 Email: rwhartonamciverbrown.com lf Attorney, Representing Party's Name: Tasco Bailey 

### a

Robert Date Served: December 29, 2014 Manner Served: Email F irst Name: Middle Name: Last Name: Wharton Suffix: Law Firm Name: McIver Brown Law Firm

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