OPINION

Justice BURKE delivered the judgment of the court, with opinion.

¶ 1 Plaintiff, Scott Stearns, as executor of the estate of Marjorie Stearns, deceased (Marjorie), filed a multi-count complaint under the Wrongful Death Act (740 ILCS 180/0.01 et seq. (West 2010)) and the Survival Act (755 ILCS 5/27-6 (West 2010)) against Ridge Ambulance Service, Inc. (Ridge), Jerry Brooks, and Countryside Care Centre, Inc. (Countryside). Marjorie, who resided in a nursing home operated by Countryside, died as a result of injuries sustained while Ridge transported her back to the nursing home following treatment at an offsite dialysis center. Brooks, who was an employee of Ridge, was driving the medical transport vehicle (medi-van) in which Marjorie's injuries occurred. Countryside's successful motion for summary judgment on the claims against it gives rise to this appeal under Illinois Supreme Court Rule 304(a) (eff. Feb. 26, 2010). We reverse and remand.

¶ 2 The pleadings, along with depositions, affidavits, and exhibits submitted in support of and in opposition to Countryside's summary-judgment motion, establish the following facts. At the time of the incident giving rise to this lawsuit, Marjorie was 89 years old and suffered from dementia. Countryside's records indicate that late in July 2009 Marjorie had been found in a kneeling position wedged between the footrests of her wheelchair. A few weeks later, Marjorie was found lying on the floor of her room. Her care plan called for the use of bed and chair alarms.

¶ 3 Countryside arranged to have Ridge transport Marjorie to a dialysis facility on September 1, 2009, but did not convey any special instructions to Ridge about Marjorie's risk of falling. Brooks was assigned to drive Marjorie on her return trip to the nursing home. Brooks testified at his deposition that he met Marjorie in a waiting area. She was seated in a wheelchair. Brooks wheeled her to the medi-van, loaded her into it using a wheelchair lift, and secured the wheelchair inside the medi-van using floor locks. Brooks then placed a safety belt around Marjorie. According to Brooks, the safety belt was attached to the medi-van's floor and ceiling and ran diagonally from Marjorie's shoulder to her hip. There was no lap belt to secure Marjorie to the wheelchair.

¶ 4 Brooks testified that Marjorie had brought a book with her. During the ride back to the nursing home, Brooks heard the book fall and Marjorie told him that it had fallen. Brooks told Marjorie that he would take care of the book and that she should not worry about it. About two minutes later, Brooks noticed that Marjorie appeared to be reaching for the book. Brooks said something to the effect of "no, don't do that, I'll get it." Seconds later Brooks saw Marjorie start to stand up. At that point another vehicle merged in front of the medi-van, forcing Brooks to brake abruptly. When Brooks did so, Marjorie fell forward and her head struck a metal object. Marjorie died about two weeks later. Ridge's medi-van supervisor, Derrick Johnson, testified at his deposition that Ridge was then (i.e. at the time of the deposition) using a restraint system with a belt that ran around the passenger's torso and the back of the passenger's wheelchair. The buckle was located behind the wheelchair. Johnson believed that this restraint system was available at the time of Marjorie's accident.

¶ 5 The nursing home's administrator, Kimberly Kohls, testified at her deposition that she was responsible for all aspects of the facility's operations, including the selection of vendors to provide transportation services for residents. She testified that chair alarms are used with patients who, for any of various reasons (including cognitive problems), might have difficulty complying with instructions to request assistance before attempting to stand from a chair.

¶ 6 Laura Westergard, a registered nurse with 30 years' experience in the field of long-term care, executed an affidavit stating that she had reviewed various documents pertaining to Marjorie and the accident that preceded her death. Westergard further stated as follows:

¶ 7 Summary judgment is proper where "the pleadings, depositions, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." 735 ILCS 5/2-1005(c) (West 2010). "The purpose of summary judgment is to determine whether a genuine issue of material fact exists, not to try a question of fact." Thompson v. Gordon, 241 Ill.2d 428, 438, 349 Ill.Dec. 936, 948 N.E.2d 39 (2011). Furthermore, "[s]ummary judgment should be granted only when the right of the moving party is clear and free from doubt." Id. An order entering summary judgment is subject to de novo review. Colburn v. Mario Tricoci Hair Salons & Day Spas, Inc., 2012 IL App (2d) 110624, ¶ 32, 361 Ill.Dec. 781, 972 N.E.2d 266.

¶ 8 The elements of a common-law cause of action for negligence are "the existence of a duty of care owed by the defendant to the plaintiff, a breach of that duty, and an injury proximately caused by that breach." Marshall v. Burger King Corp., 222 Ill.2d 422, 430, 305 Ill.Dec. 897, 856 N.E.2d 1048 (2006). In granting Countryside's motion for summary judgment, the trial court concluded that, as a matter of law, Countryside owed no duty to protect Marjorie from the risk of injury resulting from her failure to remain seated in her wheelchair while in transit from an offsite treatment facility. Plaintiff argues that a nursing home has both a common-law and a statutory duty to exercise care to avoid injury to residents and that that duty is not categorically limited to guarding against injuries that occur on its premises. Plaintiff further contends that the trial court "misapprehended the distinction between duty and standard of care and erroneously applied a duty analysis to what is a standard of care issue."

¶ 9 Illinois courts have long struggled with the concept of duty, which has been described as "`very involved, complex and indeed nebulous.'" Id. at 435, 305 Ill.Dec. 897, 856 N.E.2d 1048 (quoting Mieher v. Brown, 54 Ill.2d 539, 545, 301 N.E.2d 307 (1973)). Professor Dan B. Dobbs, a leading authority on tort law, has noted that lawyers and judges sometimes "use duty to refer to a general standard or obligation" whereas at other times they "use duty as a conclusion about whether the defendant's particular act or omission should be actionable, irrespective of any general standard." 1 Dan B. Dobbs, The Law of Torts § 226, at 577 (2001) (cited with approval in Marshall, 222 Ill.2d at 436, 305 Ill.Dec. 897, 856 N.E.2d 1048).

¶ 10 In Simpkins v. CSX Transportation, Inc., 2012 IL 110662, ¶¶ 18-21, 358 Ill.Dec. 613, 965 N.E.2d 1092, our supreme court offered the following summary of the principles governing the determination of whether a duty exists:

¶ 11 These standards do not necessarily resolve the confusion noted by Professor Dobbs and the Marshall court about whether "duty" encompasses rules of broad applicability or is, to the contrary, a highly fact-specific inquiry into whether a particular act or omission is actionable in a particular set of circumstances. In certain settings—motor-vehicle-accident cases, for example—it is not unusual to encounter duty rules of broad applicability. For instance, in Mulloy v. American Eagle Airlines, Inc., 358 Ill.App.3d 706, 713, 295 Ill.Dec. 54, 832 N.E.2d 205 (2005), it was stated that "[t]he operator of a motor vehicle has the duty to use ordinary care to avoid injuring a pedestrian." The Mulloy court did not attempt to tailor a duty rule to the specific circumstances of the case (although the court upheld a directed verdict on the basis that there was insufficient evidence from which the jury could conclude that the driver of the vehicle in question had breached the standard of ordinary care). Id. at 715-16, 295 Ill.Dec. 54, 832 N.E.2d 205.

¶ 12 Lance v. Senior, 36 Ill.2d 516, 224 N.E.2d 231 (1967), reflects a more fact-specific duty analysis. In Lance, the plaintiff was a nine-year-old boy afflicted with hemophilia. In his complaint he alleged that, while he was a guest in the defendants' home, they "`negligently and carelessly permitted and allowed' the plaintiff to play with a needle `which was caused to and did get into the throat of the plaintiff and was thereafter sucked into the inner part of the plaintiff's lung.'" Id. at 517, 224 N.E.2d 231. The trial court dismissed the complaint on the basis that the duty owed by the defendants was only to refrain from willfully or wantonly injuring the plaintiff. The Appellate Court, First District, reversed, holding that ordinary negligence principles applied and that the case presented a question of foreseeability for the jury to decide. Lance v. Senior, 66 Ill.App.2d 41, 213 N.E.2d 616 (1966). Our supreme court reversed the appellate court, reasoning as follows:

¶ 13 In recent years, our supreme court has indicated (at times somewhat indirectly) that the weight to be given to each of the four factors in the duty analysis (foreseeability of the injury, likelihood of the injury, magnitude of the burden of guarding against the injury, and consequences of placing the burden on the defendant) depends on the facts of a given case. See, e.g., Bruns v. City of Centralia, 2014 IL 116998, ¶ 14, 386 Ill.Dec. 765, 21 N.E.3d 684; Simpkins, 2012 IL 110662, ¶ 18, 358 Ill.Dec. 613, 965 N.E.2d 1092. However, in Marshall, our supreme court recognized that purely ad hoc determinations that a defendant has a duty to perform or refrain from performing particular acts improperly conflate the concepts of duty and breach. Marshall, 222 Ill.2d at 443, 305 Ill.Dec. 897, 856 N.E.2d 1048. As the Marshall court observed, "Courts could, after all, `state an infinite number of duties if they spoke in highly particular terms,' and while particularized statements of duty may be comprehensible, `they use the term duty to state conclusions about the facts of particular cases, not as a general standard.'" Id. (quoting 1 Dan B. Dobbs, The Law of Torts § 226, at 577 (2001)).

¶ 14 In Marshall, the plaintiff's decedent was fatally injured when a motor vehicle crashed through the wall of the Burger King restaurant where he was eating. The plaintiff sought recovery both from the Burger King Corporation and from the franchisee that operated the restaurant, alleging that they failed to design the structure to withstand the impact from a motor vehicle or to place concrete pillars or poles outside the structure as protective barriers. The defendants argued that they owed no duty to the decedent to protect him from the risk that an out-of-control motor vehicle would crash into the restaurant and strike him. Our supreme court held that "[b]ased on the allegations in plaintiff's complaint, the duty of care that a business invitor owes to invitees to protect them against the unreasonable risk of physical harm is clearly applicable to this case." Id. at 440, 305 Ill.Dec. 897, 856 N.E.2d 1048. The Marshall court expressly declined to frame the duty in more specific terms, i.e. as a duty to install concrete pillars or poles. Id. at 443, 305 Ill.Dec. 897, 856 N.E.2d 1048 ("the issue in this case is not whether defendants had a duty to install protective poles, or a duty to prevent a car from entering the restaurant, or some such other fact-specific formulation").

¶ 15 Here Countryside argues for a fact-specific formulation of duty. Countryside argues that the first two factors in the traditional duty analysis—the foreseeability and likelihood of the injury—militate against imposing a duty on Countryside. Countryside stresses that the record shows that Ridge had transported Marjorie to and from the dialysis center, without incident, on numerous occasions prior to September 1, 2009. Countryside further argues that the magnitude of the burden of guarding against the injury and the consequences of placing that burden on Countryside also militate against imposition of a duty. Countryside contends that, because Marjorie was injured while returning from offsite dialysis treatment, it had no opportunity either to instruct her driver (Brooks) about any special precautions for Marjorie's safety or to inspect the medi-van. Countryside argues that sending an aide along with Marjorie "would negate the entire purpose of hiring a licensed transportation service with experience and expertise in transporting medical patients and long-term care residents." Moreover, according to Countryside, imposing such a duty "would disrupt the feasibility and cost-effectiveness for businesses utilizing the services of independent contractors providing transportation services, as well as a host of other specialized services." Countryside acknowledges only a duty to exercise care in selecting a vendor to provide transportation services, seemingly renouncing the possibility of liability on any other basis for harm befalling a resident while in transit.

¶ 16 The rule that would emerge from Countryside's analysis is that, where a nursing-home resident has been transported offsite in the past, without incident, by a properly vetted third-party transportation service, the nursing home has no duty: (1) to inspect the vehicle in which the resident will be returning to the nursing home; (2) to instruct the driver of that vehicle about any precautions for the resident's safety; or (3) to have a nursing-home employee accompany the resident. However, as noted, duties are not to be formulated so narrowly. And indeed, even in this context, this court has stated, in far broader terms, that "[t]he proprietors of a convalescent home, somewhat like those of a private hospital, are under a duty to exercise reasonable care to avoid injury to patrons, and the reasonableness of such care is to be assessed in the light of the patron's physical and mental condition." Stogsdill v. Manor Convalescent Home, Inc., 35 Ill.App.3d 634, 662, 343 N.E.2d 589 (1976). We added that "a hospital is required `["]to conform to the legal standard of reasonable conduct in the light of the apparent risk.["]'" Id. (quoting Darling v. Charleston Community Memorial Hospital, 33 Ill.2d 326, 331, 211 N.E.2d 253 (1965), quoting William L. Prosser, The Law of Torts, at 331 (3d ed. 1964)).

¶ 17 Neither Stogsdill nor Darling explained whether the duty was predicated on the four factors discussed in Lance, Marshall, and Simpkins (i.e. foreseeability of the injury, likelihood of the injury, magnitude of the burden of guarding against the injury, and consequences of placing the burden on the defendant) or on a special relationship between the parties.1 In the case of a nursing home, recognition of a duty would appear to be appropriate on either basis. There can be no doubt that nursing-home residents are at a foreseeable risk of, and likely to sustain, any of a variety of injuries if appropriate precautions are not taken. We note that the foreseeability factor focuses on "`the general character of the event or harm * * * not its precise nature or manner of occurrence.'" Marshall, 222 Ill.2d at 442, 305 Ill.Dec. 897, 856 N.E.2d 1048 (quoting Bigbee v. Pacific Telephone & Telegraph Co., 34 Cal.3d 49, 192 Cal.Rptr. 857, 665 P.2d 947, 952 (1983)). Further, it would be incongruous to hold that guarding against the general class of risks faced by nursing-home residents is too great a burden to impose on nursing homes.

¶ 18 In any event, as noted, our supreme court has recognized four special relationships that give rise to a duty of care. Simpkins, 2012 IL 110662, ¶ 20, 358 Ill.Dec. 613, 965 N.E.2d 1092. Although, to our knowledge, Illinois courts have not specifically identified the relationship between a nursing home and one of its residents as a "special relationship," it is possible that, in addition to the four that have been recognized, there may be other special relationships that give rise to a duty. See Fancil v. Q.S.E. Foods, Inc., 60 Ill.2d 552, 559-60, 328 N.E.2d 538 (1975). Moreover, the relationship between a nursing home and a resident can be viewed as a specific instance of the "custodian and ward" relationship. "A special relationship exists where, inter alia, one voluntarily takes custody of another so as to deprive the other of his normal opportunities for protection." Platson v. NSM, America, Inc., 322 Ill.App.3d 138, 146, 255 Ill.Dec. 208, 748 N.E.2d 1278 (2001). The term "custody" is not used in a particularly technical sense. For instance, in Platson, we held that allegations that a high school student worked for a business under a work-study program sponsored by her school were sufficient to show a special relationship giving rise to a duty on the business's part to protect the student from sexually predatory behavior by one of the business's employees. A physically infirm and cognitively impaired nursing-home resident depends upon the staff of the nursing home to prevent injury. The relationship is sufficiently custodial to give rise to a duty.

¶ 19 The fact-specific analysis undertaken by Countryside conflates the issues of duty and breach. See Marshall, 222 Ill.2d at 443, 305 Ill.Dec. 897, 856 N.E.2d 1048. Countryside owed Marjorie a duty of care. What Countryside should or could have done to protect Marjorie bears on the question of whether Countryside breached its duty. And on the record here, that is a question of fact. The factual determination whether Countryside exercised due care is not amenable to artificial and arbitrary rules that insulate Countryside from liability for anything other than negligence in selecting a transportation service. Plaintiff does not seek to hold Countryside vicariously liable for the negligence of the other defendants; he seeks the opportunity to show Countryside's own negligence in failing to properly communicate with those defendants or to provide additional personnel to assist the other defendants in protecting Marjorie from harm while in transit. Plaintiff is entitled to present these theories of negligence to a jury.

¶ 20 Countryside argues that summary judgment was appropriate for the alternative reason that the record shows that plaintiff cannot establish the element of proximate cause. A party seeking summary judgment bears an initial burden of production that can be met in either of two ways: "(1) by affirmatively disproving the plaintiff's case by introducing evidence that, if uncontroverted, would entitle the movant to judgment as a matter of law (traditional test) [citation], or (2) by establishing that the nonmovant lacks sufficient evidence to prove an essential element of the cause of action (Celotex [Corp. v. Catrett, 477 U.S. 317, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986),] test) [citations]." Williams v. Covenant Medical Center, 316 Ill.App.3d 682, 688-89, 250 Ill.Dec. 40, 737 N.E.2d 662 (2000). "Only if a defendant satisfies its initial burden of production does the burden shift to the plaintiffs to present some factual basis that would arguably entitle them to judgment under the applicable law." Id. at 689, 250 Ill.Dec. 40, 737 N.E.2d 662.

¶ 21 Countryside maintains that it is entirely speculative that any of the precautions that plaintiff's expert recommended would have prevented the accident. In this respect, Countryside treats its summary-judgment motion as a Celotex-type motion. The introductory section of Countryside's memorandum of law in support of its motion for summary judgment contained the cursory assertion that "[t]here is no evidence or testimony whatsoever in this case to show that * * * any action or inaction of Countryside or its staff proximately caused [Marjorie's] injury." However, the remainder of Countryside's memorandum of law focused on whether Countryside owed Marjorie a duty of care. The bare assertion that plaintiff could not establish proximate cause was insufficient to shift the burden to plaintiff to come forward with evidence of proximate cause. Id. at 690, 250 Ill.Dec. 40, 737 N.E.2d 662.

¶ 22 For the foregoing reasons, the judgment of the circuit court of Kane County is reversed and the cause is remanded for further proceedings.

¶ 23 Reversed and remanded.

Justices JORGENSEN and HUDSON concurred in the judgment and opinion.