NURSING HOME ACCIDENT LAWYERS

WHAT IS NURSING HOME ABUSE?

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Approximately 1 in 10 Americans aged 60+ have experienced some form of elder abuse. Some estimates range as high as 5 million elders who are abused each year. As elderly abuse often goes unreported, these numbers may be even higher than projected. Additionally, we believe that injuries from falls, drops, and serious bedsores should not happen with proper precautions and training.

Nursing home or assisted living facility abuse include the following:

• Assault or battery of the resident, such as slapping, threatening the resident, and unauthorized physical contact
• Financial abuse like embezzlement, theft, or manipulation to change terms in the elderly person’s will
• Unlawful sexual contact with the elderly resident or patient
• Negligent caretaking, such as not providing medication as needed or not meeting the resident’s caretaking needs

 

SIGNS AND INDICATORS OF NURSING HOME ABUSE OR NEGLECT

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If you suspect your loved one is suffering from nursing home abuse or neglect, there are certain red flags to watch for. For starters, look for any unexplained bruising, welts on the body, or scars. Emotional abuse may present itself in the form of unusual behavior in the elderly resident. You may overhear belittling, threatening, or controlling behavior by the caretaker, which is also emotional abuse. Signs of sexual abuse include unexplained STDs or infections as well as bruising on the thighs or genitals.

Caregiver neglect is a common form of nursing home or assisted living facility neglect. Some signs of caregiver neglect include unhealthy living conditions such as a dirty, unclean room. Bedsores are another indication of nursing home neglect, as these may occur when the resident is left for too long in one position. Failure to properly bathe the elderly individual is also a form of caregiver neglect. Signs of financial exploitation include unexpected changes to a will, unusual ATM withdrawals, and missing cash from the elderly person’s room.

THE NURSING HOME REFORM ACT

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The U.S. Congress and state legislatures took action to hold nursing homes accountable. The federal Nursing Home Reform Act states that a nursing home must provide "services and activities to attain or maintain the highest practicable physical, mental, and psycho-social well-being of each resident in accordance with a written plan of care."

While helpful, this law is not enough to fully prevent nursing home neglect and abuse. Sadly, many nursing homes, rehab centers, and assisted living facilities put profit ahead of people resulting in horrific neglect and abuse.

HOW LONG DO I HAVE TO FILE A NURSING HOME ABUSE/NEGLECT CLAIM?

The deadline to file a nursing home neglect/abuse claim depends on the time when the abuse or neglect was discovered. A number of other complicated legal factors impact how the statute of limitations applies to these claims. Therefore, if you suspect neglect and abuse, you should contact us immediately.

 

THE STAFF AT THE FACILITY CONCERNS ME, WHAT ARE THE LAWS REGARDING STAFFING?

MICHIGAN LAW

A nursing home, its owner, administrator, employee, or representative shall not discharge, harass, retaliate, or discriminate against a patient because a patient has exercised rights protected by law. (Michigan Public Health Code, MCL 333.20201)

FEDERAL LAW

The facility must:

• Maintain sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psycho-social well-being of each resident, as determined by resident assessments and individual plans of care (42 CFR 483.30)
• Ensure that the medical care of each resident is supervised by a physician and must provide or arrange for the provision of physician services 24 hours a day, in case of an emergency (42 CFR 483.40)
• Be administered in a manner that enables it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident (42 CFR 483.75)
• Maintain clinical records on each resident in accordance with accepted professional standards and practices that are complete, accurately documented, readily accessible, and systematically organized (42 CFR 483.75)

 

 

HOW MUCH IS A NURSING HOME CLAIM WORTH?

Each case is unique. Several factors impact the value of a case, including the type and extent of injury, the actions or omissions of the nursing home, and the evidence of negligence and causation. Therefore, contact us to evaluate the individual circumstances of your claim.

 

WHAT SERVICES ARE FACILITIES REQUIRED TO PROVIDE?

MICHIGAN LAW

From the Michigan Public Health Code, MCL 333.20201, the resident is entitled to:

• Obtain a copy of, or inspect his/her medical records, and a third party shall not be given a copy without authorization of the patient except as required by law and third party contract
• Receive and examine an explanation of his/her bill. He/she also is entitled to know who is responsible for, and who is providing, his/her care

 

FEDERAL LAW

The facility must:

• Ensure that the resident has the right to choose activities, schedules, and health care consistent with his or her interests, assessments, and plan of care (42 CFR 483.15).
• Provide, if a resident is unable to carry out activities of daily living, the necessary services to maintain good nutrition, grooming, and personal and oral hygiene (42 CFR 483.25)
• Ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities (42 CFR 483.25)
• Provide appropriate treatment and services to incontinent residents to restore as much normal bladder functioning as possible and prevent urinary tract infections and to restore as much normal bladder function as possible (42 CFR 483.25)
• Provide pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all prescriptions) to meet the needs of each resident (42 CFR 483.60)

 

 

WILL MY MEDICAL BILLS BE COVERED FOR LIFE?

At The Sam Bernstein Law Firm, it’s our goal to equip our clients with the knowledge and resources they need to succeed. Below, browse our Sam Bernstein blog and resource library to educate yourself about your case and Michigan law at large.

 

CAN I RECOVER LOST WAGES?

At The Sam Bernstein Law Firm, it’s our goal to equip our clients with the knowledge and resources they need to succeed. Below, browse our Sam Bernstein blog and resource library to educate yourself about your case and Michigan law at large.

 

WHAT QUALITY OF LIFE STANDARD IS REQUIRED BY LAW?

MICHIGAN LAW

From the Michigan Public Health Code, MCL 333.20201, the resident is entitled to:

• Be free from mental and physical abuse and, except as authorized by a physician, or as necessitated by an emergency to protect the patient, free from physical and chemical restraints
• Receive adequate and appropriate care and information about his/her medical condition, proposed treatment and prospects for recovery, unless medically contraindicated by the physician in the medical record
• Associate and have private communication with his/her physician, attorney or any other person, and to send and receive personal mail unopened, unless medically contraindicated
• Retain and use personal clothing and possessions as space permits. At the request of a patient, a nursing home shall provide for safekeeping of personal property and funds, except that a nursing home shall not be required to provide for the safekeeping of property, which would impose an unreasonable burden on the nursing home
• Each patient shall be provided with meals that meet the recommended dietary allowances for the patient’s age and sex and that conform to the individual’s special dietary needs

 

FEDERAL LAW

The facility must:

• Care for its residents in a manner and in an environment that promotes maintenance or enhancement of each resident’s quality of life (42 CFR 483.15)
• Promote care for residents in a manner and in an environment that maintains or enhances each resident’s dignity and respect in full recognition of his or her individuality (42 CFR 483.15)
• Conduct initially (no later than 14 days after admission) and periodically (after a significant change in the resident’s physical or mental condition and, in no case, less often than once every 12 months) a comprehensive, accurate, standardized, reproducible assessment of each resident’s functional capacity (42 CFR 483.20)
• Develop a comprehensive care plan for each resident that includes measurable objectives and timetables to meet the medical, nursing, mental, and psychosocial needs identified in the comprehensive assessment. The care plan must be developed within 7 days after completion of the comprehensive assessment and describe the services that are to be furnished. In addition, qualified persons must review, and if necessary revise, the care plan prepared after each assessment (42 CFR 483.20)
• Prevent the deterioration of a resident’s ability to bathe, dress, groom, transfer and ambulate, toilet, eat, and to use speech, language or other functional communication systems (42 CFR 483.25)
• Ensure that residents do not develop pressure sores and, if a resident has pressure sores, must provide the necessary treatment and services to promote healing, prevent infection and prevent new sores from developing (42 CFR 483.25)
• Ensure that a resident maintains acceptable parameters of nutritional status, such as body weight and protein levels (42 CFR 483.25)
• Provide each resident with sufficient fluid intake to maintain proper hydration and health (42 CFR 483.25)
• Ensure that residents are free of any significant medication errors (42 CFR 483.25)

 

 

WHAT ARE SIGNS OF NURSING HOME NEGLECT?

Neglect means "the negligent failure by any person with care or custody of an elderly or a dependent adult to exercise that degree of care that a reasonable person in a similar position would exercise."

Bedsores are one of the most common signs of neglect. They are also known as pressure ulcers, pressure sores, and decubitus ulcers.

The primary cause of bedsores is unrelieved pressure to a particular part of the body. They also may result from friction, like rubbing against something like a bed sheet, cast, brace, etc., or from prolonged exposure to cold.

Other examples of neglect include, but are not limited to:

• Failure to provide food, clothing, shelter, or help with personal hygiene
• Failure to provide medical care for physical and mental health needs
• Failure to protect from health and safety hazards
• Failure to prevent malnutrition or dehydration
• Failure to provide the necessities of daily living
• Failure to provide sanitary conditions
• Failure to prevent infections

 

 

WHAT ARE THE SIGNS OF NURSING HOME ABUSE?

Nursing home abuse victimizes the most vulnerable individuals. Though most facilities provide good care, some cause needless suffering and death. Sadly, many nursing home residents are starved, dehydrated, over-medicated, and suffer painful pressure sores. In addition, they may be isolated, ignored, and deprived of social contact and stimulation.

Although many residents can report mistreatment, some cannot even describe what happened. For this reason, it is important to look carefully for any evidence of abuse.

TWO OF THE MOST COMMON SIGNS OF ABUSE ARE:

Suffocation and Strangulation
A frail nursing home resident can suffocate or strangle to death in a hospital bed if ignored or neglected by nursing home staff. Approximately 1 in 10 Americans aged 60+ have experienced some form of elder abuse. Some estimates range as high as 5 million elders who are abused each year.
The design of the side rails on a nursing home bed may contribute to the danger. Many side rails have slats that are spaced six or more inches apart. That space may trap an elderly person’s head, causing him or her to strangle, or allow a thin individual to squeeze between the rails and fall to the floor. If the mattress on a nursing home bed does fit properly in the bed frame, a patient may become trapped and strangle in a gap between the mattress and side-rails.

Broken Bones or Fractures
For the elderly, falling is the most frequent cause of fractures. Nursing home staff must regularly evaluate each patient, determine his or her risk for falling, and provide safety devices and services that each individual needs to minimize the risk of injury.

Below is a list of other common types and/or signs of abuse:

• Assault and battery
• Sexual assault and battery
• Rape
• Unreasonable physical constraint
• Prolonged deprivation of food or water
• Use of a physical restraints, like straps or belts
• Use of chemical restraints, like sedatives or sleeping medications
• Use of psychotropic or other medications for any purpose not authorized by a physician
• Excessive dosages of medication
• Withholding needed medication
• Confinement to a room or fixed location
• Unexplained injuries
• Inability of nursing home staff to give an adequate explanation of a resident’s condition
• Open wounds, cuts, bruises, welts, or bedsores
• Slapping, pushing, shaking or beating
• Non-verbal signs from the nursing home resident that something is wrong, such as:
  • Unusual emotional outbursts or agitation
  • Extreme withdrawal or lack of communication
  • Unusual behavior, like sucking, biting, rocking, etc.
  • Humiliating, insulting, frightening, threatening or ignoring behavior towards family and friends
  • Desire to be isolated from other people

 

 

HOW CAN I PROVE A CASE IF MY LOVED ONE CANNOT TESTIFY ABOUT ABUSE?

Often, nursing home neglect or abuse cases involve a victim who has trouble communicating. Sometimes, that individual passed away. However, this does not stop a lawsuit against the nursing home that caused injury or death. An experienced attorney may scour the medical records, consult medical experts, question witnesses, and take other steps to establish a proper claim.

 

WHAT IF I’M AFRAID THE FACILITY WILL HURT MY LOVED ONE MORE?

If you do not make a claim, it is possible that the neglect or abuse will continue — or get worse. Moreover, other residents of the nursing home may be at risk of similar treatment. Contact us about natural concerns of retaliation. We will discuss the best way to protect your loved one.

 

HOW DO I KNOW IF MY LOVED ONE IS GETTING ENOUGH NUTRITION?

Nursing homes are required by law to provide good nutrition and hydration to residents. Poor diet and lack of water are among the most common forms of nursing home neglect or abuse.

SIGNS THAT A RESIDENT IS MALNOURISHED:

 

• Clothes fitting more loosely than usual
• Cracks around the mouth
• Pale looking lips or mouth
• Dentures that no longer fit
• Hair thinning or getting sparser
• Wounds that take longer to heal
• Confusion (which is unusual for that individual)
• Skin breaking down
• Sunken eyes
• Weight loss

 

THE FOLLOWING QUESTIONS MAY HELP YOU PINPOINT THE REASON FOR A PARTICULAR PERSON’S PROBLEMS WITH NUTRITION OR HYDRATION:

 

• Can the resident feed him/herself?
• What is the resident’s favorite meal of the day?
• When and where does the resident prefer to have meals served?
• Does it take a long time for the resident to eat?
• Is the resident rushed through meals?
• Is the resident unable to finish meals?
• Does the resident seem to eat more when someone is there to help with the meal?
• Does the resident seem uninterested in food?
• Has the resident lost his/her appetite?
• Does the resident like the food at the facility?
• Can the resident choose from a menu?
• Are snacks readily available to the resident?
• Is the resident on a special diet?
• Has the resident started taking any new medications?
• Is the resident’s weight monitored on a regular basis?
• Has the staff informed family members of weight loss?
• Has staff asked family members for assistance?

 

SOME HEALTH PROBLEMS ASSOCIATED WITH MALNUTRITION AND/OR DEHYDRATION INCLUDE:

 

• Increased risk of infections
• Confusion
• Muscle weakness (possible immobility and increased risk of falls)
• Pressure ulcers or bedsores
• Pneumonia
• Increased risk of becoming ill from exposure to bacteria or viruses

 

Nursing homes should conduct regular nutritional assessments and provide residents with well-balanced, palatable meals. When you consider a nursing home for a loved one, you may wish to ask to sample a random meal at the facility. Also, ask to speak to the staff dietician about the factors he or she uses to develop meal plans for the facility.

THE FOLLOWING IS A LIST OF REASONS WHY AN INDIVIDUAL MAY SUFFER FROM MALNUTRITION AND/OR DEHYDRATION:

Personal causes of malnutrition:

• Illness
• Adverse drug effects such as nausea, vomiting, diarrhea, cognitive disturbances, or sleepiness
• Food and drug interactions that decrease the ability of the body to absorb vitamins and minerals
• Depression
• Swallowing disorders
• Mouth problems such as tooth loss, dentures that do not fit properly, mouth sores, and mouth pain
• Tremors or shakiness, which affect residents’ ability to feed themselves

 

Environmental causes of malnutrition:

• Inadequate staff attention for residents who need help to eat
• Staff who lack training about malnutrition and the proper ways to feed residents who need help
• Reliance on liquid supplements
• Special diets

 

 

WHAT ARE BEDSORES?

According to the Centers for Disease Control and Prevention, in 2004, 159,000 nursing home residents, or more than 1 in 10, had a pressure ulcer. Long-term residents were more likely to have pressure ulcers than those who had been in nursing homes for less than a year, and residents under the age of 64 years were more likely than older residents to have bed sores. 1 in 5 nursing home residents with recent weight loss suffered from a bed sore.

Bed sores are also known as pressure sores or pressure ulcers. They are a common sign of nursing home neglect, since the elderly, wounded, and ill often rely on nursing home staff for repositioning because it is not easy for them to move on their own.

Bed sores occur when injuries to the skin and underlying tissues result from prolonged pressure on the skin. Bed sores commonly afflict people who are confined to bed, wheelchair users, and people who suffer medical conditions that impede their ability to change positions. People who are in poor health or are weak, paralyzed, recovering after surgery, in a coma, or sedated, are also at increased risk for bed sores.

Bed sores most commonly develop over bony areas of the body, such as the heels, ankles, hips, and tailbone. They are caused by pressure against the skin, which limits blood flow to the skin and nearby tissues. Limited mobility makes the skin vulnerable to damage, as does age, since the skin becomes thinner, more fragile, elastic, and drier with time. For wheelchair users, watch for bed sores on areas of the body that press against the wheelchair, like the tailbone, buttocks, shoulder blades, spine, and the backs of arms and legs. For those who are confined to bed rest, look for bed sores on the head, the rims of the ears, shoulders and shoulder blades, hips, low back, tail bone, heels, ankles, and the skin behind the knees.

The four classifications of bed sores, ranging from the least severe (stage 1) to the most severe (stage 4) as follows:

• Stage 1: A persistent area of skin redness (without a break in the skin) that does not disappear when pressure is relieved
• Stage 2: A partial thickness is lost and may appear as an abrasion, blister, or shallow crater
• Stage 3: A full thickness of skin is lost, exposing the subcutaneous tissues-presents as a deep crater with or without undermining adjacent tissue
• Stage 4: A full thickness of skin and subcutaneous tissues are lost, exposing muscle or bone

 

For wheelchair users and those who are confined to a bed, frequent repositioning to avoid stress on the skin is the best way to prevent bed sores. Taking care of one’s skin, good nutrition, exercise, and not smoking can also decrease the risk of bed sores.

It is important to remain alert and always carefully observe nursing home residents for signs of abuse, including bed sores. Your observation of warning signs could make a huge difference in an elder person’s life.

 

WHAT CIVIL RIGHTS ARE NURSING HOME RESIDENTS ENTITLED TO?

Under the Michigan Public Health Code, MCL 333.20201:

• Residents are entitled to privacy, to the extent feasible, in treatment and caring for personal needs with consideration, respect, and full recognition of his/her dignity and individuality
• A patient’s civil and religious liberties shall not be infringed. The nursing home shall encourage and assist in the exercise of these rights
• Each patient shall not be denied appropriate care based on race, religion, national origin, sex, age, handicap, marital status, sexual preference, or source of payment

 

 

HOW TO FIND THE BEST NURSING HOME

Even at well-known, fully licensed facilities, there is the possibility of neglect or abuse. That is why you need to make sure that every facility will provide your loved one with quality care.

Touring a facility is only the first step. A scheduled visit is unlikely to reveal everything that is happening beneath the surface when no one is visiting.

We recommend that you take the following steps before selecting a nursing home:

• Talk with other residents at the nursing home that you are considering. We suggest simply walking the corridors of the facility. Speak with residents, including those who are bedridden
• Look around! Do the residents appear well groomed? Do any of them have visible wounds or sores? How is their oral care? Is water easily available to all residents at the facility? If some residents are incapable of helping themselves to a drink, is staff offering assistance at regular intervals? If you find several residents who seem confused and disoriented, you may be witnessing signs of neglect
• Ask the management for the latest state survey of the facility readily available for review, read it carefully, and ask questions. Be on the lookout for signs of any problems with basic care. Federal regulations require that all nursing homes have this survey
• Ask about the staff at the facility. What is the size of the staff during the different hours of the day and night? How many staff members are nurses? How many are nursing assistants? Are there social workers and clergy on the staff? Consider how the staffing of that facility compares to other nursing homes with a similar number of patients
• Speak with the relatives of other residents at the facility. Have they observed any problems? Do they have any issues with the management or staff at the facility? You may wish to find out whether any of the residents’ families use web cameras (sometimes called "granny cams"). Although this "cyber visitation" is a new practice, some families who cannot visit their loved ones every day are placing special internet cameras in relatives’ rooms to allow them to see what is happening at any time. If you see a "granny cam" at a facility, ask to speak with family of that resident, to ask what they observed. If possible, inquire if the facility would mind if you used this kind of device
• Use your senses! One of the most effective methods of inspecting a facility may be your sense of smell. A nursing home should not smell of urine or feces. If it does smell, residents may not be receiving adequate toileting care. Often, this basic care is essential to preventing life-threatening illnesses, like urinary tract infections or bedsores
• Watch as residents are being fed. Do many residents look underweight? How much of the food are they eating? Is staff helping residents who have problems feeding themselves? Do the aides who assist with the food seem overwhelmed? Are the aides spending enough time working with each resident during mealtime?
• Visit the potential nursing home more than once and plan your visits at different times of the day and week. If you can only visit the nursing home once, go at night or on a weekend afternoon. Staff levels may be lowest during these "off" times
• Go around the facility. When you attempt to look at the facility, are you deliberately steered to certain rooms or residents? If you feel that you are being denied full access to the facility, you should find out if there is a good reason
• Ask to meet all of the key executive personnel at the facility. Speak with the administrative head, the medical staff administrator, and the nursing staff administrator. Ask how often physicians actually examine residents. Find out about the facility’s staff turnover rate, including the average length of employment for nursing assistants and other primary caregivers

 

If you or a loved one believe that you have experienced neglect or abuse at a nursing home, please contact Michigan's most experienced personal injury law firm as soon as possible.

SOURCES:

https://www.ncoa.org/public-policy-action/elder-justice/elder-abuse-facts/

http://www.mayoclinic.org/diseases-conditions/bedsores/basics/definition/con-20030848

http://www.cdc.gov/nchs/data/databriefs/db14.htm