TAMPA -- James L. Wilkes II sifts through snapshots of livid sores and rotting flesh, searching for his grisly favorites. He passes one across his desk. "These pictures are worth a thousand words," he says, "and a million dollars."

That's no hollow boast. Exploiting a broadly worded law known as the bill of rights for nursing-home patients, Mr. Wilkes and his colleagues at the small Tampa law firm Wilkes & McHugh have racked up an impressive list of six-figure settlements and multimillion-dollar verdicts on behalf of elderly clients, some only months away from death, who allege negligence by those caring for them.

Indeed, advocates for the elderly and even some regulators say Mr. Wilkes fills a void left by Florida's traditionally lax oversight of nursing homes. "He's done more to get nursing homes to improve resident care" than the state-run ombudsman program, says Florida Secretary of Elder Affairs Bentley Lipscomb, who oversees that watchdog effort.

Fueling Inflation

But his critics -- among them, some defense lawyers, as well as the nursing-home industry -- say the lawsuits he pursues don't help improve long-term care for the elderly as much as they help drive up the already high costs of care through higher insurance rates. The industry complains that Mr. Wilkes's zeal, combined with a law that it says encourages litigation, leaves all nursing homes vulnerable.

"The effect of Jim Wilkes, it's almost like lightning," says Lumarie Polvika-West, policy director at the Florida Health Care Association, the state's nursing-home lobby, which for years has been pushing to have the patients' bill of rights scaled back. "You never can tell when it's going to hit. It's an uncertainty that's not based on any proven scale of expectation."

Adds James M. Griffith, senior vice president for public relations at nursing-home giant Beverly Enterprises Inc.: "This ends up being a very expensive way to make trial lawyers wealthy." It could be very expensive for Beverly. Last month, a Wilkes client suing the Fort Smith, Ark., company for alleged mistreatment of her husband won a $2.7 million verdict in state circuit court in Ocala. Beverly is petitioning for a retrial or a directed verdict.

Now, Mr. Wilkes is focusing on filing class-action lawsuits on behalf of clients of facilities that fail to meet their contractual obligations. In the process, he hopes to bag his biggest client yet -- the state of Florida, which is the $2.6 billion nursing-home industry's biggest customer, doling out more than $1.5 billion in Medicaid money to nursing homes each year.

Mr. Wilkes already has approached the Agency for Health Care Administration about joining his effort. A spokeswoman says only that the agency is weighing his proposal.

Regardless of the outcome, nursing-home litigation will probably continue to flourish in Florida. As recently as the late 1980s, attorneys often passed on nursing-home cases, mainly because the elderly plaintiffs lacked the life expectancy and earnings potential that drive big awards. Thanks largely to Mr. Wilkes, a balding 45-year-old former mobile-home salesman, jingle writer and lounge singer, nursing-home litigation is now considered a gold mine for trial lawyers in Florida.

"Wilkes is the guru of nursing-home cases," says T. Patrick Ford, a Miami lawyer increasingly specializing in patient-rights cases. "People are waking up, seeing there's money in this thing, and they're getting into it."

David Gallagher, a lawyer who these days finds himself defending nursing homes against lawsuits brought by Mr. Wilkes and others, says: "If I were a plaintiffs' lawyer, I'd be a nursing-home lawyer." He adds that Mr. Wilkes has made suing nursing homes seem "like shooting fish in a barrel."

Mr. Wilkes wasn't so busy 11 years ago, when he founded Wilkes & McHugh with Tim McHugh, a classmate from Stetson University College of Law in St. Petersburg. Until the early '90s, the two were so eager for business that they could be beeped every time a potential client called their toll-free number. Now, they oversee a seven-lawyer practice and fly to courts around the state on the firm's Cessna Citation jet. About 90% of their business involves suing nursing homes, Mr. Wilkes says.

"Everybody has their niche in life," he says, "and Tim and I have found ours."

Mr. Wilkes, who spent a three-year Army tour as an actor and producer, came to law school after failing to win a recording contract or find success as a stand-up comic. Graduating a semester before Mr. McHugh, he began his law career by handling mostly small-time or long-shot medical-malpractice cases.

A solid student and a star in mock trials at Stetson, Mr. Wilkes is the firm's front man and lead trial attorney, as well as a well-connected political fund-raiser. The more subdued Mr. McHugh, 37, serves as the firm's manager, handling personnel and other business matters.

The firm's big break came in 1989. The family of a woman who had died while in the Padgett Nursing Home in Tampa came to them alleging that the woman had received insufficient care. They took the case, though they figured it wouldn't be a big money maker. They filed suit against the nursing home in circuit court in Hillsborough County.

But Mr. McHugh's older brother, Jim, who was clerking while attending law school himself, dug into Florida's then-obscure nursing-care law. The statute set out broad, demanding standards for nursing homes and allowed the plaintiff to sue to recover legal fees.

After Mr. Wilkes began to cite the law, the nursing home agreed to settle for an undisclosed sum. Mr. Wilkes "demanded a lot of money and got the case ready for trial, and [the nursing home] wrote the check," recalls Jim McHugh.

Similar cases began trickling in, and the settlements piled up. Soon, the firm was pitching its nursing-home expertise on television. The ads, though frowned on by many lawyers, have served the firm well. The ad budget now exceeds $500,000 a year.

Capital Warfare

Meanwhile, Mr. Wilkes works the state capital to defend the patients' bill of rights against the nursing-home industry's efforts to have it scaled back. He also has become a generous political donor and a top fund-raiser for the Florida Academy of Trial Lawyers. In the first three months of this year alone, Wilkes & McHugh and its partners donated more than $18,700 to Florida political causes, including $10,000 to the Republican Party in February and $1,500 six days later to the Democrats.

In the day-to-day practice of law, the firm has developed a reputation for quick work. "Things really get moving" fast, says Vincent Morelli, a recent client whose case is in settlement negotiations. Angry about the care his 62-year-old wife received in a Brooksville home, the mortgage broker dialed the firm one afternoon. By the next day, lawyers had placed his wife elsewhere and investigators were following up his complaints.

Once hired, Mr. Wilkes spares little expense -- in part, defense lawyers contend, because successful plaintiffs can recover fees and costs even if the judgment is small. In a case where most lawyers would take 15 depositions, Mr. Wilkes takes 50, says Tampa defense lawyer Greg Frazier, a frequent adversary. (Mr. Wilkes disputes that.) The Andrew Michael Agency keeps nine private investigators on staff to work almost exclusively for the Wilkes firm.

In settlement talks, Mr. Wilkes holds a hard line. "It's impossible to negotiate with him," complains Mr. Frazier, the Tampa defense lawyer. "He'll offer to settle for $1 million. You say no. He counters with $2 million. He goes backwards."

Some adversaries say Mr. Wilkes takes many cases to trial that others might settle. He doesn't disagree. "The key is to get these cases to trial," says Mr. Wilkes. "If you settle a lot, if they know you'll settle, they'll keep paying less and less." Even so, most of the firm's nursing-home lawsuits have been settled out of court.

Last month's exception was the $2.7 million verdict against Beverly Enterprises -- a record amount among lawsuits against Florida nursing homes. In the case, Marilyn Lowe was suing Beverly's Stonegate Rehabilitation & Nursing Center in Ocala for mistreating her husband, James Earl Lowe. The 59-year-old truck driver arrived in a vegetative state after a stroke in the hospital, then died of a second stroke nine months later. Beverly's lawyers figured Mr. Wilkes couldn't prove that Stonegate's care was a factor in the death.

Mr. Wilkes had his own worries. In conservative Ocala, he feared, a jury might hold Mr. Lowe's widow responsible because she had visited her husband regularly but didn't file the lawsuit until after his death.

But Mr. Wilkes quickly gained the advantage. He teamed up with Ken Connor of Tallahassee, a one-time conservative candidate for governor and top trial attorney. They conducted two mock trials, at a cost of about $7,000 each, to gauge how the case might play with local jurors.

Meanwhile, Mr. Wilkes's investigators tracked down former nurses and aides as far as Nebraska, uncovering testimony about roach infestation, how staffers had nicknamed the sometimes demanding Mrs. Lowe "the Lowe bitch," and how they had developed a code to warn each other when she arrived.

Sifting through stacks of medical charts, Mr. Wilkes found inconsistencies in such arcane details as how nurses had administered oxygen flows to Mr. Lowe. "He caught it," says Joe Casson, one of the defense attorneys. "Candidly, we missed it, and I was really impressed."

What shocked Mr. Wilkes, though, was that the Beverly lawyers let the case go to trial at all. Mr. Casson says the company would have settled, but "nobody focused on Lowe early enough."

Mr. Wilkes is now looking at ways to bring class-action suits against several nursing homes on behalf of clients, possibly including the state government. If it works, it would make the biggest assault yet on the industry. He also is considering underwriting an advocacy group for nursing-home patients.

To press his case on these strategies, Mr. Wilkes recently hired Ron Sachs, a former communications director for Gov. Lawton Chiles, as his public-relations agent. Success isn't guaranteed. While the Agency for Health Care Administration looks at his proposal on class-action lawsuits, Deputy Attorney General Peter Antonacci already has rejected an earlier pitch to join him in legal action "unformed."

Question of Commitment

Other lawyers say Mr. Wilkes's class-action idea has merit, but won't be easy because it's unprecedented in the nursing-home industry. "I think it can be done," says Miami attorney Philip Freidin, a former president of the Florida Academy of Trial Lawyers who handles nursing-home cases himself. But, he adds, "it would take a lot of resources. It's a question of whether you'd want to commit them."

Mr. Wilkes says he is committed. He has assigned a top associate full time to the class-action effort and is building a new nursing-home data base. The first motions for class-action status for cases, pending or anticipated, could appear in the next few months, he says.

The prospect of class-action lawsuits chills the industry. The nursing-home lobby's Ms. Polvika-West frets that a class-action suit "will drive providers out of Florida."

Personally, she would rather see Mr. Wilkes out. "He said a few years ago [that] once he got it going and made his money, he'd retire and become a singer in Nashville," says Ms. Polvika-West. "Well, we're still waiting."

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