You are a plaintiff attorney sitting in front of a woman who says, “My mother is being neglected in a nursing home. Can you help?”
You agree to go to the facility to see her to see if this is a case of nursing home neglect.
Nursing Home Regulations
Long-Term Care facilities that are certified to receive Federal funds to provide nursing, medical or rehab services to residents are required to provide care to residents according to regulations of 42 CFR (Code of Federal Regulations) Part 483. These Federal regulations, individually and as a whole, are designed to ensure that the facility provides care to residents in a manner which “enhances the resident’s highest practicable level of physical, mental, and psychosocial well-being.” The Federal regulations denote neglect as a form of abuse.
As of this writing, the Federal regulations can be found here:
Click here to view Federal regulations
Patients discharged from the hospital, frequently are in need of skilled nursing care and/or rehab (such as physical, occupational, or speech therapy) before returning to their own home. These patients are transferred to long-term care facilities. In the ideal scenario, the patient receives the care as prescribed by the physician, participates in his or her care in preparation for discharge, has an uneventful recovery and returns home. Sometimes the patient’s recovery happens just as smoothly as the ideal, and often there are interruptions along the way.
It is important to remember that not every untoward outcome means someone did something wrong or that there was nursing home neglect. However, the facility is required to promptly and thoroughly investigate any incident or allegation of abuse and notify the State regulatory agency within the designated timeframe.
How do you spot nursing home neglect?
For anyone who visits a long term care facility it is important to be observant of the residents, (not just the one you specifically are there to visit) regarding factors that may denote the quality of care the residents are receiving.
- If it is daytime, are the residents up and groomed, shaven, fingernails trimmed?
- Are they dressed in clean clothes?
- Are they wearing street clothes or hospital gowns?
- Do they appear thin or malnourished?
- Are they in their wheelchair or other chair sleeping deeply? (This may suggest they are awakened at 4 AM to get dressed for 8AM breakfast.)
- Is there an over-whelming body odor or urine odor?
- Are staff and residents having positive interactions in both activity and demeanor?
- Is staff in proximity of residents to provide supervision?
- Are call lights being answered within a reasonable amount of time?
- In general, does it appear that the residents are being well cared for?
- Are any residents in restraints?
One reason it is important to notice residents in addition to whomever you are visiting is that, many residents do not have any visitors and cannot speak up for themselves. They are the ones to whom the provisions of dignity and proper care can most easily fall through the cracks.
Nursing Home Neglect and Resident Abuse
The Federal regulations require facilities to have in place and active practice of policies and procedures for the prevention of nursing home neglect and resident abuse. The procedures include preventative processes such as employment background checks and education of all staff (not only nursing staff) about abuse and abuse prevention.
The Federal regulations intend that facilities keep residents safe from abuse, neglect, misappropriation of resident property, and exploitation including:
- Verbal (includes threats of harm using oral, written or gestured language of disparaging and derogatory terms to residents or their families, regardless of hearing distance, age, level of comprehension, or disability.)
- Sexual (includes sexual harassment, coercion, and assault)
- Physical (includes hitting, slapping, pinching, kicking, threats of corporal punishment)
- Mental (includes humiliation, harassment or threats, and abuse facilitated through the use of technology, including photography and other media.)
- Involuntary Seclusion (for example, separating a resident from others or confining a resident to her room for non-therapeutic purposes)
- Neglect (failure to provide necessary goods or services)
- Misappropriation of Resident Property (essentially theft of a resident’s belongings or money)
All of the conditions you have seen on the television commercials for individuals seeking attorneys for patient care cases have and do occur. Some incidents occur due to a failure of the facility, and some do not. The answers are found by investigating the incident and related factors.
Nursing Home Hotline
Every facility is required to post in a prominent location the 24-hour Nursing Home Hotline information with the phone number. (The phone number will vary from state to state.) Each “complaint” called in to the hotline is investigated by the appropriate State agency. In addition, each facility is required to have available within the resident’s access, a copy of the results of the facility’s Federal and State surveys. In my experience, many facilities keep them in a binder near the entrance. They are to be readily available for anyone to review, including visitors. The surveys document (within HIPAA guidelines) the Annual and Complaint survey results and if necessary, the facility’s correction plan to any problem cited.
Are you investigating a nursing home claim?
Do you suspect nursing home neglect? I can help.
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