What You Should Know About Nursing Home Neglect

Attorneys in conjunction with qualified nursing experts deal with personal injury actions arising from elder abuse or nursing home neglect. Medical practitioners and those who care for older people in residential centers often provide a high standard of excellence, however, there are occasions when critical errors and neglect occur and on those occasions you may need the help of an elder abuse lawyer to protect your loved ones. Whilst an award of damages by a court of law will never fully compensate for any neglect suffered by an elderly person it does go some way to mitigating the financial problems and it can make life easier and more comfortable in the future. Elder abuse law does vary depending on location and you should always take advice from local medical malpractice lawyers.

Medicaid Protocols

Residential care has seen substantial increases in demand, the majority of which is paid for by Medicaid. Nursing homes that rely on Medicaid funds must conform to the Health Care Financing Administration regulations which set guidelines for the evaluation, care and treatment of residents, aimed at maximizing the quality of each resident’s daily life and minimizing abuse and neglect. The level of care required for Medicare billing is outlined in the Minimum Data Set (MDS) and in the Resident Assessment Protocol (RAP). These protocols effectively define how many nursing hours are required per day to match the declared level of care. In the event of a resident suffering personal injury, a nursing home neglect lawyer can refer to the records of nursing care. If the record of actual care fails to match up with the minimum Medicare requirements then there is a strong case for claiming that the care provided was inadequate which may constitute evidence that will support a successful claim for negligence against the nursing home.

Adequate Qualified Staff

In the event of an elderly person suffering neglect or abuse, one of the items high on the list for investigation by a lawyer relates to the numbers of properly qualified staff available to ensure that residents receive adequate care and attention. Every nursing home is subject to inspection by the Health Department which files deficiency reports to provide a public record of citations for health code violations.

Contractual Obligations

If a resident suffers serious injury a lawyer will initially consider the establishments obligations outlined in the contract and will also take into account the duties and obligations that are implied or expressed in any advertising copy that was intended to induce a contractual relationship. The normal contractual obligation of residential care includes: 

  • room and board
  • access to competent medical care
  • adequate assistance with activities of daily living
  • adequate skilled nursing services
  • safe home environment

Assessments & Care Plans

Another useful line of investigation by a negligence lawyer following an incident relates to whether or not the administrator of the residential home had in place a care plan which should take account of the potential for medical diagnoses and contain a stated goal with documentation of any follow up. Failure to comply with their own stated policy may be important in establishing negligence.

At the time of admission, a nursing assessment should be made by a qualified practitioner indicating what conditions existed at the time of admission. A fall risk assessment and a skin integrity assessment should be documented. If any of these queries are in the affirmative the record should detail a proposed action plan and follow up procedures to minimize the risk of falling injuries or to prevent pressure sores. Failure to comply with their stated policy may assist in establishing negligence.

In addition, there should be nursing progress notes in the patient’s record which may identify any lapse in the chronology of events.

Common Errors, Incidents & Injuries

Errors of Commission: 

These are actions that deviate from accepted standards and may include:

  • improper invasive actions
  • negligent traumatic transfers
  • administering harmful medication or treatment
  • withholding medication or treatment
  • over filling stomach whilst using a tube feeding
  • physical, sexual or mental abuse

Errors of Commission:

These are actions that deviate from accepted standards and may include: 

Errors of Omission: 

  • This is the provision of inadequate services that results in an adverse event and includes failure to:
  • take a proper case history and devise an adequate care plan
  • report any changes or potential changes in clinical condition
  • maintain adequate and proper safety protocols
  • maintain and record adequate pressure ulcer prevention
  • wear appropriate clothing and wash hands between patients
  • make full and adequate risk assessments
  • maintain adequate nutrition and keep a record
  • maintain adequate hydration and a keep record

Common Incidents

These are the events most likely to cause serious injury which occur in residential care:

  • falls and/or wandering
  • physical and/or sexual and/or mental abuse
  • depression and/or anxiety
  • skin breakdown, pressure sores and infection
  • malnutrition and/or dehydration
  • stomach over filling and aspiration
  • blood clots particularly in the legs

Common Injuries: 

There are injuries that particularly affect the elderly and include: 

  • head trauma with brain hemorrhage
  • bone fractures
  • pressure ulcers with infection and necrosis
  • pneumonia and pleurisy
  • pulmonary embolism

Pressure Sores & Skin Integrity Documentation

One of the most common reasons for a nursing home neglect lawyer to take legal action relates to pressure sores also known as bedsores or pressure ulcers which are completely treatable if found early, without medical attention however they can become life-threatening. It is important for residential care homes to be alert to the possibility of pressure sores and to that end they should properly record and treat any occurrence. 

Fall Risk Assessment & Bone Fractures

Elderly people often suffer from underlying osteoporosis that weakens bone which combined with decreased mobility and slower reflexes may lead to falls that result in fractures or other serious injuries. A nursing home neglect lawyer faced with a patient suffering from fractures incurred as a result of a fall will initially enquire whether or not the documented risk assessment score is consistent with the documented clinical condition in order to establish whether or not there has been negligence in underestimating risk and will also obtain full information on what the nurses could and should have done to prevent the fall.

Physicians Records & Medication Administration

Doctors are usually involved in the treatment of frail or sick elderly patients and their record may be an invaluable source of information to a nursing home neglect lawyer who will initially makes the following enquiries: 

  • Physician’s Order Sheet
  • What were the relevant orders and were they transmitted?
  • Were verbal orders confirmed in writing and countersigned?
  • Were cultures ordered prior to antibiotic administration?
  • Was there a valid order for each nursing action for which orders were required?
  • Medical Administration Record (MAR)
  • Were medications administered as directed?
  • Were all doses administered properly?
  • Were any doses missing or unaccounted?
  • Were all controlled substances accounted for?

Vulnerable Adults

An elder abuse attorney may take legal action for intentional or negligent acts that cause harm to a vulnerable adult including physical, sexual, financial, emotional or psychological harm. Vulnerable adults include those who need care services by reason of mental or other disability, age or illness and may be unable to properly take care of themselves and who are unable to protect themselves against harm. Examples of behavior that is legally actionable include: –

  • Physical Abuse
  • Mental Suffering
  • Abandonment 
  • Financial Abuse
  • Isolation
  • Abduction 

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