Families trust nursing homes to provide safe and appropriate care for their loved ones. Unfortunately, problems can occur when facilities fail to meet required standards.
Common nursing home violations may involve inadequate supervision, poor infection control, medication errors, unsafe conditions, or failures in a resident’s care plan. Some violations can lead to serious injuries or a decline in a resident’s health.
Not every violation means that nursing home neglect occurred. However, repeated problems or failures that cause harm should not be ignored.
Medicare and Medicaid-certified nursing homes must follow federal health and safety requirements. State inspectors evaluate facilities to determine whether those requirements are being met.
Understanding some of the common violations can help families recognize when something may be wrong.
Failure to Prevent Falls and Other Accidents
Nursing home residents may have a higher risk of falling because of mobility problems, weakness, medications, vision problems, or medical conditions.
Facilities should identify residents who are at risk and take appropriate precautions. Depending on the resident, this may include assistance with walking, proper footwear, mobility devices, adequate lighting, and closer supervision.
The nursing home itself should also be kept free from avoidable hazards.
Families may have reason for concern if a resident experiences repeated falls or is frequently found on the floor. Questions should also be asked when staff cannot explain what happened or what precautions were in place.
CMS identifies accident prevention as one of the deficiency areas commonly addressed during the nursing home survey process.
Failure to Provide Adequate Supervision
Some residents cannot safely move, eat, bathe, use the bathroom, or perform other daily activities without assistance.
A lack of supervision can put these residents at risk.
For example, a resident who needs help walking may fall if left alone. A resident with swallowing difficulties may need assistance during meals. Someone with dementia may require additional monitoring to prevent wandering or other injuries.
The amount of supervision needed depends on each resident’s condition and care plan.
When staff fail to provide necessary assistance, the consequences can be serious.
Inadequate Nursing Home Staffing
Staffing can have a major effect on the care nursing home residents receive.
Federal law requires nursing homes to have enough staff to safely care for their residents. The number and type of staff needed can depend on the needs of the people living in the facility.
When staffing is inadequate, residents may wait too long for help. Repositioning, bathroom assistance, meals, medications, and other care may also be delayed.
Families may notice residents repeatedly waiting for assistance or call lights going unanswered. They may also see rushed employees or frequent changes in staff.
Medicare’s Nursing Home Care Compare tool provides information about staffing levels and staff turnover at individual facilities.
Failure to Follow a Resident’s Care Plan
Nursing home care should be based on each resident’s individual needs.
A care plan may address mobility, medications, nutrition, fall risks, skin care, behavioral health, and other medical concerns.
Creating a care plan is only part of the process. Staff must also carry out the care that has been identified.
Problems may occur when a resident’s condition changes but the care plan is not updated. Concerns can also arise when staff repeatedly fail to follow established precautions.
Federal nursing home inspection records include deficiencies involving resident assessments and care planning.
Medication Errors and Improper Medication Management
Many nursing home residents take several medications each day. Those medications must be managed carefully.
Errors may include giving the wrong medication, giving an incorrect dose, missing a scheduled medication, or failing to properly monitor a resident for side effects.
Facilities must also follow requirements involving how medications are stored and administered.
Families should ask questions if a resident suddenly becomes unusually sleepy, confused, weak, or experiences another unexplained change after medication changes.
A medication problem does not automatically mean negligence occurred. However, unexplained or repeated errors deserve attention.
Poor Infection Prevention and Control
Infections can spread quickly in nursing homes because residents often live close together. Many residents also have medical conditions that make them more vulnerable to serious illness.
Facilities must have infection prevention and control practices in place.
Problems can involve poor hand hygiene, improper handling of medical equipment, inadequate cleaning, or failures to follow infection control procedures.
CMS identifies infection control as another commonly cited area during federal nursing home surveys.
Families may notice repeated infections, unsanitary conditions, or staff members failing to follow basic infection prevention practices.
Failure to Prevent or Properly Treat Bedsores
Bedsores are also called pressure sores, pressure ulcers, or pressure injuries.
They can develop when prolonged pressure reduces blood flow to the skin and underlying tissue. Residents with limited mobility may be especially vulnerable.
Nursing homes should identify residents who are at risk. Depending on the resident’s needs, preventive care may include repositioning, skin checks, pressure-relieving equipment, proper nutrition, and moisture management.
Not every bedsore proves neglect.
However, a serious or worsening pressure injury can raise questions about whether the resident received appropriate preventive care and treatment.
Inadequate Nutrition or Hydration
Nursing home residents should receive food and fluids that meet their individual needs.
Some residents need help eating or drinking. Others may require special diets because of diabetes, swallowing problems, allergies, or other health conditions.
Unexplained weight loss, dehydration, weakness, or repeated complaints about missing meals may deserve further attention.
Families should ask whether changes in weight or appetite have been documented and whether the resident’s physician or care team has been notified.
Failure to Protect Residents From Abuse or Neglect
Nursing home residents have the right to be free from abuse, neglect, exploitation, and mistreatment.
Potential warning signs can include unexplained bruises or injuries, sudden behavioral changes, fear around certain staff members, poor hygiene, untreated medical problems, or missing personal property.
Abuse can be physical, emotional, sexual, or financial.
Neglect can involve failures to provide necessary medical care, hygiene, food, hydration, supervision, or assistance.
Suspected abuse or neglect should be taken seriously.
Violations of Residents’ Rights
Nursing home residents retain important rights while living in a facility.
These include rights involving dignity, privacy, communication, participation in care decisions, visitors, personal property, and freedom from abuse or unnecessary restraints.
Residents also have protections involving transfers and discharges.
A nursing home generally cannot simply remove a resident because caring for that person has become inconvenient or more difficult.
Families who are told that a loved one must leave a facility should ask for the reason in writing and learn what rights the resident may have.
How Can You Check a Nursing Home’s Inspection History?
Families do not have to rely only on what a nursing home tells them about its record.
Medicare’s Care Compare tool provides information about Medicare and Medicaid-certified nursing homes. Families can review a facility’s ratings, staffing information, health inspections, complaint inspections, deficiencies, and certain penalties.
A nursing home’s overall rating is based on three main areas:
- Health inspections
- Staffing
- Quality measures
Inspection records can be particularly useful because they describe deficiencies found by state inspectors.
One citation does not necessarily mean a facility provides poor care in every situation. However, repeated violations or serious deficiencies can provide important context when evaluating a nursing home’s history.
How Do You Report Nursing Home Concerns in Ohio or Michigan?
Families who believe a nursing home is violating health or safety requirements can report their concerns.
Reporting Nursing Home Concerns in Ohio
In Ohio, complaints involving nursing homes can be submitted to the Ohio Department of Health Bureau of Survey and Certification.
Ohio allows complaints to be filed anonymously. However, remaining anonymous may prevent the department from contacting the person for additional information or providing the results of its investigation.
Families may also seek assistance through Ohio’s Long-Term Care Ombudsman Program.
Reporting Nursing Home Concerns in Michigan
In Michigan, nursing home complaints can be filed with the Michigan Department of Licensing and Regulatory Affairs Bureau of Survey and Certification.
Complaints may be submitted online or through Michigan’s complaint hotline at 1-800-882-6006.
Michigan residents can also contact the state’s Long Term Care Ombudsman Program for help with concerns involving a resident’s care or rights.
If a resident appears to be in immediate danger or needs emergency medical attention, seek emergency assistance.
Does a Nursing Home Violation Mean You Have a Legal Case?
Not necessarily.
A regulatory violation and a nursing home negligence claim are different issues.
State inspectors determine whether a facility complied with applicable nursing home requirements. A legal claim examines whether the nursing home’s actions or failures caused or contributed to an injury.
That may require reviewing medical records, care plans, incident reports, staffing records, inspection findings, and other evidence.
A history of violations can be important, but the circumstances involving the individual resident still matter.
What Should You Do If You Suspect Nursing Home Neglect?
If something does not seem right with your loved one’s care, ask questions.
Document unexplained injuries or changes in condition. Keep notes about conversations with staff and when problems occurred. You can also ask about the resident’s care plan, medical treatment, and any incident reports involving the resident.
You may also want to review the nursing home’s inspection history and report serious concerns to the appropriate state agency.
If your loved one has suffered an injury and you believe nursing home neglect may have played a role, Gallon, Takacs & Boissoneault can help you understand your options.
Our team can review the circumstances surrounding the resident’s care and determine whether further investigation may be appropriate.
For a free consultation, contact Gallon, Takacs & Boissoneault at 419-843-6663.
Serving clients throughout Northwest Ohio and Southeast Michigan.
Michael Bell, is Partner and Personal Injury Attorney at GT&B since 2007. His entire career has been committed to protecting the rights of those injured through no fault of their own. Mike concentrates his practice in the areas of car wrecks, trucking accidents, medical negligence, wrongful death, birth injuries, defective products, nursing home abuse & neglect, dog bites, construction accidents and slip & falls.
