Nursing Home Negligence

Residents of nursing homes and other long-term care facilities often suffer severe injuries as the result of neglect, negligence, or even abuse. Martin, Harding & Mazzotti, LLP is dedicated to upholding the quality of care in our long-term care institutions by seeking compensation for residents who are injured by neglect or inadequate care. Have you or your family member suffered from bedsores, falls, dehydration, malnutrition, chemical or physical restraints, sexual abuse, medication errors or unsanitary or unhygienic conditions? Has a family member wandered in or strayed from a nursing home and suffered an injury as a result? If so, you or your family member may have a case.

These preventable indignities and injuries are not the natural result of the aging process. Long-term care facilities such as nursing homes are required to provide adequate care to maintain and attain the highest practicable level of physical and mental well-being for their residents. Anything less is a violation of New York State and Federal regulations and statutes. If you or a loved one has suffered abuse, neglect, or wrongful death in a nursing home or other long-term care facility, please contact Martin, Harding & Mazzotti, LLP. The initial consultation is free of charge, and, if we agree to accept your case, we will work on a contingent fee basis. It’s Our Free Fee Guarantee™.

When families place a loved one in a nursing home or other assisted living facility, they place their trust in the people who run that home. Sadly, sometimes that trust is terribly betrayed. When nursing home staff and owners abuse, neglect or exploit their residents, they violate older people’s dignity and victimize some of the most helpless people in our society. Frequently, the same ailments that led to placement in a nursing home keep residents from speaking out about abuse. It’s not until a resident suffers terrible consequences that families and the public learn the truth.

When most people think of negligence at an assisted living facility, they think of physical and verbal abuse. Perpetrated on a helpless older or disabled person, this is nothing more than bullying. This type of abuse includes:

  • Hitting and slapping
  • Unnecessary yelling
  • Belittling the victim and name-calling
  • Socially isolating the victim
  • Threats
  • Using restraints or locking the victim up unnecessarily
  • Intentional over- or under-medication

Basic decency and New York State law require that facilities provide adequate food, water and medical care to their residents. Nonetheless, neglect is actually the most common form of negligence at nursing homes and other facilities. Forms of neglect include:

  • Inadequate food
  • Not enough water
  • Allowing patients with mobility problems to fall, which can have serious medical consequences.
  • Failure to treat medical problems in a timely manner
  • Failure to turn bed-bound patients to prevent bedsores (also known as pressure sores)
  • Allowing patients to go without washing
  • Allowing an irrational patient to wander into danger
  • Medical malpractice

Because older people tend to have a lifetime of savings, they can also be vulnerable to financial exploitation by caregivers. Some greedy people will take advantage of an elder’s failing memory or irrationality to help themselves to cash, jewelry or other valuables. Others go further, gaining legal access to the victim’s bank account or property, or stealing his or her identity. By the time relatives’ notice missing heirlooms or unexpected activity in a bank account, the perpetrator may have been able to steal many thousands of dollars.

Nursing home negligence has effects beyond the immediate harm it does. Older people are more physically and emotionally vulnerable than younger adults, especially if they have an underlying medical condition. When abuse or neglect exacerbates these problems, even if the injuries are unrelated to the underlying health problem, it can trigger a serious decline in health. In some cases, this can lead to an unnecessary, early death. And of course, treating the effects of the negligence can put a severe financial strain on families of ordinary means.

One important way for families to avoid these terrible outcomes is to be very careful about which nursing home they choose. After all, the home they choose will be their loved ones’ long-term home — and as the clients, families have every right to investigate their options carefully. This can be hard for families busy with work, school and other activities, but the extra effort is likely to pay off by limiting the amount of worry and trouble families face later. And the State of New York offers a variety of resources for busy families.

The first consideration, of course, is finding a home that meets your loved one’s needs. Different homes cater to people with different health care needs and levels of independence. Insurance coverage is also a factor — some families must work only with a list of homes that take their insurance or Medicare. You should also consider the distance from the home to the places where family members live. Experts say patients get better care when they have visitors often, and being nearby will make it easier for family members to drop by.

To build a list of nursing homes that meet those needs, you can start with an online database listing nursing homes in each region of the state, maintained by the New York State Department of Health. This database also lists quality-of-care indicators for each home, such as the number of patients who lose too much weight or the number who receive flu shots. Unfortunately, that data is self-reported by the homes themselves, so families should consider following up by requesting reports on each home they’re considering. For the public, the state offers reports summarizing the home’s last inspection; complaints and incidents at the home; and enforcement action against the home. The state Department of Health also offers a detailed guide to selecting a nursing home in New York State and a list of nursing home patients’ rights and homes’ responsibilities.

If this seems like an overwhelming amount of information, you can get help through the state’s long-term care ombudsman program. This program connects long-term care patients and their families with a local person who is a professional advocate for patients, particularly in disputes with the patients’ nursing homes. There is a long-term care ombudsman for each county; you can find yours here. An ombudsman cannot recommend a particular home, but he or she can help you understand your rights, answer questions and help resolve any disputes that come up.

Once you have a list of nursing homes that meet your needs, you should visit them to make sure they have created the kind of environment your loved one deserves. In fact, experts recommend that you visit more than once, if possible. Ideally, these visits should take place at different times of day, particularly in the evenings. Though it may seem polite to call ahead, consider not calling ahead every time you visit, so you can see how the home operates when visitors aren’t expected. Take advantage of offers to eat and socialize with residents. Do not be afraid to ask questions or insist on seeing facilities like the kitchen and bathrooms. After all, you are the client. Things to watch for include:

  • The home’s license — it should be up to date.
  • Policies the home follows, which staff should provide to you. Watch out for policies that might cause problems later, such as restrictions on short trips away.
  • Cleanliness.
  • Personal space for the residents — they should have privacy and be able to make their space their own.
  • Safety issues, including working and up-to-date medical equipment.
  • Residents’ level of activity and mental engagement. Feel free to politely ask questions of the residents.
  • Staff interactions with residents — these should be friendly and respectful and never controlling.
  • Mechanisms in place to resolve disputes between residents, or between residents and staff.
  • Staff turnover and training levels. The more consistency and training, the better.
  • Quality and appeal of the food, and attention to special dietary needs.
  • Access to outside medical and religious care.
  • Visiting hours and policies.

If you’ve already put a loved one in a nursing home, however, it’s important to know the signs of negligence. According to experts, the best defense against nursing home abuse, neglect and exploitation is to stay aware of these signs and act on them swiftly if you find them. Experts say patients get better care when their loved ones visit often, so if practical, it’s best to make visits a regular part of your life. And when you do visit, you should keep an eye out for any signs of problems.

Of course, the best way to find out whether your loved one has been hurt by nursing home staff is to ask. Unfortunately, many patients in long-term care have trouble communicating because of their health problems. In patients with dementia or Alzheimer’s, signs of abuse or neglect can also be mistaken for symptoms of the illness. And in some cases, abuse can make a resident afraid to speak out. That means families and friends should watch out for signs of abuse, neglect or exploitation like:

  • Unexplained weight loss
  • Seeming dehydration
  • Bedsores (pressure sores)
  • New health problems without a clear connection to previous ones
  • Injuries with no explanation, or explanations that don’t sound right
  • Confusion (in patients who are mentally competent)
  • Childlike behaviors such as rocking or sucking
  • Changes in medication that don’t match the patient’s illnesses, especially if you do not remember the doctor ordering new medication
  • Too much medication left over
  • Dirty clothes and bedding
  • Missing jewelry and valuables
  • Depression
  • Anxiety about ending the visit
  • Sudden financial changes, such as an unexplained dip in the patient’s bank balance

Your interactions, and the patient’s interactions, with nursing home staff can also be telling. Behaviors by staff that could signal a serious problem include:

  • Controlling behavior
  • Overly affectionate behavior toward the resident
  • Speaking on behalf of patients that can speak for themselves
  • Trying not to leave visitors alone with the patient
  • Any statements that don’t fit with what you know about the patient and his or her health
  • Not enough staff for the amount of work
  • Undertrained and under qualified staff
  • Too much concern about the patient’s finances
  • Consistent billing problems or duplicate bills
  • Buying things that seem beyond their income

If you suspect there’s a serious problem at a loved one’s nursing home, one way you can confirm it is to pay a visit — at a time when staff is not expecting you. If you go in the middle of a weekday, any dishonest employees won’t have the time to hide signs of their misdeeds. When you arrive, look for signs of trouble, such as a lack of cleanliness, residents wandering, or not enough staff. When you visit with your loved one, does he or she look as well cared for as he or she would look when visitors are expected? If necessary, you also have the right to visit the bathrooms, kitchens and other areas where visitors don’t normally go. Ideally, you or other family members should pay several surprise visits to look for problems. You may also want to put a hidden camera in the patient’s room, so you can watch staff members interact with your loved one when they believe they are not being watched.

Don’t hesitate to take action if you find proof or strong evidence that your loved one is in danger. If possible, it’s best to take your loved one out of the home right away. Once the emergency situation is resolved, you should notify the New York State Department of Health, which handles complaints about all facilities in the state, including Medicare-certified facilities. The department maintains a 24-hour, seven-day hotline for nursing home complaints at 1-888-201-4563, or you can send emails to nhintake@health.state.ny.us. Here in the Capital Region, you can also contact the department’s regional office in Troy at (518) 408-5300 during business hours. Other Department of Health complaint hotlines include:

  • Hospital Complaint Hotline: 1-800-804-5447
  • Adult Home/Assisted Living Complaint Hotline: 1-866-893-6772
  • Home Care/Hospice Complaint Hotline: 1-800-628-5972

Families can also call the New York State Office of Children and Family Services at 1-800-342-3009 (choose option 6) to report abuse, or go straight to Adult Protective Services for the county where the home is located. The state maintains a list of social service departments for each county. In Schenectady County, you can reach the Department of Social Services at (518) 386-2258 during business hours or at (518) 382-0383 for after-hours emergencies.

When you make your complaint, it’s best to make it in writing (even if that means following up with a phone call). Keep a copy of your written complaint and include as much detail as possible. If your loved one saw a doctor or you have hired a nursing home negligence attorney, include names and contact numbers for those professionals.

One sign of potentially serious negligence at a home that deserves special attention is bedsores. Also called pressure sores or decubitus ulcers, bedsores are a serious problem for bed-bound and wheelchair-bound patients, both at home and in assisted living facilities. Bedsores develop when the patient’s weight is on one area, especially a bony area, so long that blood to the area is cut off. This leads to damage and death of the affected tissues, causing deep sores that can reach into muscle and bone. Healthy people don’t develop these sores because they can simply change positions when they get uncomfortable, something that disabled people cannot do.

To find bedsores, families should look for any sores or discoloration of the skin in the areas where the patient is most often lying or sitting. In beginning stages, bedsores look like a reddening of the skin that does not disappear when the pressure is taken away. (This is more difficult to see on darker-skinned people, making it important for families of dark-skinned patients with mobility problems to stay aware.) Stage II bedsores look like blisters or scrapes. By Stage III and Stage IV, bedsores are ulcers that extend into the tissues below the skin, sometimes including muscle and bone. In some cases, dead skin cells or fluids from the wound may block the ulcer and make it difficult to tell exactly how deep it goes.

Bedsores are important to New York nursing home negligence lawyers because they are one of the most common results of neglect in residential care facilities. In 2004, a study by the Centers for Disease Control estimated that 11% of all nursing home patients had bedsores. Generally, caregivers should prevent bedsores by turning patients every two hours and being careful about how they position patients. They should also be aware of the medical conditions that make bedsores more likely, including diabetes, smoking and vascular disease. In fact, because pressure sores are easy to prevent, federal law cuts off Medicare funding for any facility that allows avoidable bedsores to form on a patient who did not have them when entering the facility.

Even a little negligence can cause or worsen bedsores:

  • Failure to turn patients often enough
  • Failure to check patients for bedsores often enough
  • Failure to treat known bedsores or notify family and doctors
  • Allowing the patient’s skin to have prolonged contact with moisture, for example, by failing to change soiled sheets
  • Dehydration and malnutrition

Pressure sores are easy to prevent with proper care, but may be fatal if left untreated too long. In fact, according to research by the federal Agency for Healthcare Research and Quality, pressure sores send more than 503,000 people a year to the hospital. The same study found that one of every 25 hospital admissions for pressure sores ends in death. Because bedsores cause tissue to die, they create a breeding ground for bacteria that can lead to an infection, including life-threatening infections. Other serious complications of pressure sores include gangrene, anemia, kidney failure and amyloidosis, a potentially fatal disorder affecting the organs. Doctors can treat early-stage pressure sores without surgery, but for more serious sores, they typically must cut away the dead tissue and use skin grafts or pressure therapy to close the wound.

In addition to damaging patients’ bodies and inviting life-threatening complications, bedsores are very painful. In many cases, the patients cannot call for help because of the same disabilities that leave them dependent on caregivers in the first place. Caregivers who fail in their duty to provide this basic care are guilty of serious medical neglect, and families can and should hold them legally responsible.

After the fact, families can and should report abusive and neglectful homes to the New York State Department of Health, which has the power to punish wrongdoers and shut them down. However, in many cases, it’s too late to stop the harm. Nor can regulatory agencies compensate families for the emergency medical costs, time away from work and the cost of finding a more suitable home for the victims. To recover these costs and expose abusive and neglectful homes to the public, families may file a New York State nursing home negligence lawsuit. That’s true regardless of whether regulators choose to pursue criminal prosecution or professional sanctions against the home and its staff.

Martin, Harding & Mazzotti, LLP® is proud to represent victims of nursing home negligence and their families in these lawsuits. In addition to recovering all of the costs of the abuse, victims and their families can claim compensation for their physical injuries, emotional trauma and any wrongful death resulting from the abuse. To learn more about filing a legal claim against a negligent nursing home or assisted living facility, call the law firm of Martin, Harding & Mazzotti, LLP®, The Heavy Hitters® at 1800LAW1010® (1-800-529-1010).