Nursing Home Abuse & Neglect Guidebook

Nursing
Home Neglect
Guidebook
A Roadmap For Helping
Families Navigate Through
the Legal Process
of Getting Justice for
Their Loved Ones
BY ATTORNEY
Jonathan Rosenfeld
Nursing Home Neglect Guidebook
A Roadmap For Helping Families
Table of Contents
Forward: Why Listen to a Lawyer When it Comes to the Care of Your Loved One? . . . . . . . . . . . . . . . . . . . . . . . 2
Introduction: What you can learn from this Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Background on Nursing Homes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Patient Rights. Yes, They Have Them! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
What are the signs of poor care or neglect? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
The Most Common Types of Nursing Home Negligence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Bedsores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Sexual Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Physical Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Medication Errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Malnutrition and Dehydration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Dropped Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Unexpected Deaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
The Sad Truth: Most Accidents in Nursing Homes Are Ignored and Never Reported . . . . . . . . . . . . . . . . . . 51
Reporting Poor Care to Authorities. How and Where to Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Do You Have a Civil Case? What You Need to Win a Nursing Home Lawsuit . . . . . . . . . . . . . . . . . . . . . . . . . . 56
What to Look For When Hiring an Attorney to Represent Your Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Our Recent Nursing Home Negligence Recoveries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
www.rosenfeldinjur ylawyers.com 1
Forward:
Why Listen to a Lawyer When it Comes
to the Care of Your Loved One?
I have spoken to so many people whose frustration with nursing homes over their negligent care was
completely justified. It all begins with the very heavy hearted decision to place a loved one into the care
of others. It is often the only viable choice because they and the rest of their family simply cannot stay
at home to take care of their loved ones needs. Then they receive a phone call from the home that they
doled out thousands of dollars a month to in order to keep their loved one safe and healthy.
You are informed that your loved one has been sent to the hospital, experienced a fall or been injured
due to an accident. You arent satisfied with any of the answers you are asking and you begin to wonder
what it is youve been paying for all this time.
Nursing care is expensive and yet for the expense that so many people incur to have their loved ones
cared for, many are dumbfounded at how inattentive nursing homes can be toward their patients. Those
patients are our loved ones and deserve kindness, dignity and respect. Unfortunately, the only language
the numerous for-profit nursing chains that have popped up all over the country speak is the language of
greed.
How can it be that nursing homes are allowed to prioritize profit over quality care? The majority of
nursing negligence cases arent the product of villains choosing to willfully assault or harass patients,
but rather the inability of staff members to meet the needs of everyone who is depending on them. The
reduction of staff levels at for-profit facilities to barebones levels has had a drastic impact on the quality
of residents living.
One of the reasons that nursing facilities continue to get away with it is because they are not held
accountable. This is because the vast majority of cases go undetected or unreported either due to the
fear of retaliation against victims or because the victims families dont know their rights.
My name is Jonathan Rosenfeld, and my mission isnt just to represent those who have suffered harm
at the hands of negligent nursing centers, but to help prevent abuse by educating the public and giving
victims the voice that they so desperately need. It is a fact that over nine out of ten nursing facilities have
been cited for some form of deficiency each year and that over half a million seniors are victims of abuse
or neglect each year. It is also a fact that for every two reported cases of abuse, there are eight that have
occurred silently without any legal action.
In a time where many people rush to file lawsuits over the most trivial of matters, I am not suggesting
that you join in by looking for every minor concern to take issue with. Doctors and nurses make genuine
mistakes from time to time and they may do without acting negligently. It is my hope that by the time
you are finished reading this book that you will be able to recognize what constitutes negligence and
when you need to act on behalf of those you love.
You need to understand that the law is not going to do you many favors. Lobbyists have worked hard on
behalf of large nursing chains to have nursing home abuse laws amended to their advantage. It has all
been done under the guise of protecting the medical field from frivolous lawsuits, but the changes have
taken a toll on the rights of people who have legitimately been mistreated.
If you believe that your loved one has been abused or neglected, you are going to need the advice of
an attorney who has specialized experience in this form of law. I founded Rosenfeld Injury Lawyers
because I wanted to be the voice for those who have been injured by the irresponsible actions of others.
Our nursing home abuse law team is made up of attorneys who have taken on cases like your own and
successfully secured the compensation our clients rightfully deserved.
Representing your legal interests is not the only way that I can help promote change, however. Many
people worry about their loved ones but just dont know how to tell if they are being treated poorly. This
is where the advice of an attorney with my experience can be invaluable. It can save you a lot of time to
know exactly what to look for and how to defend your interests so that if your loved one is being abused,
you can take the actions needed to protect him or her from any further harm.
In addition to this book, Ive compiled

numerous resources for you on my website at
https://www.rosenfeldinjurylawywers.com.
My law firm also online resources for families in
need of information on nursing home injuries at
https://www.nursinghomelawcenter.org and
https://www.bedsorefaq.com. Nonetheless, in
the event that you have any questions or need
to speak with an attorney about filing a claim,
you can be sure that one of my attorneys will be
happy to assist you in any way possible.
Introduction:
What you can learn from this Book
This book will be a comprehensive guide to the many forms of nursing home abuse, how to identify
them and what you can do about it when you suspect your loved one has become a victim. Ive started
with a background on the reasons nursing care has changed so drastically over the last ten years and the
root of most nursing issues understaffing.
One of the reasons so many people choose not to pursue action against negligent nursing homes is
because they are unaware of their rights. Once you understand the rights you are guaranteed under law,
you will be surprised at how so many nursing facilities get away with violating patient rights on a routine
basis. Knowing your rights will also help you know what to demand from nursing facilities and which
actions caregivers are not allowed to take.
You will then learn how to detect poor care and neglect so that you know whether your suspicions are
founded. Some victims family members are slow to act because the signs can mimic dementia or other
neurological disorders, but now you will be able to make more definitive observations to determine
whether your loved ones changes in behavior are due to aging or abuse.
Understanding the different types of abuse will further allow you to notice and intervene when your
loved one is being mistreated. This is why Ive committed a considerable amount of space in this book to
the common forms of abuse and their signs. Many of these forms of negligence are easily prevented or
treated.
After you have learned about the different forms and signs of abuse, you will learn why the majority
of nursing home abuse goes unreported. It is a sad truth that almost eight out of ten cases are either
ignored entirely or never acted upon. If we could hold nursing homes liable for these unreported cases, it
is possible that we could truly begin to enact change by making nursing homes suffer consequences for
their misdeeds.
I strive to provide the best civil law services you can possibly retain, but many nursing home abuse cases
are also criminal in nature. You will learn which agencies to contact in the event your loved one is being
abused so that you can ensure his or her safety throughout the investigation.
You will then be provided with information on

how to determine whether you have a civil case.
Not every error or misjudgment constitutes
negligence, so you will save yourself and your
attorney a lot of time by reviewing whether your
case has a solid chance in court. You will also
learn what you can do to help establish your
case and what factors can impact it in both
positive and negative ways.
Finally, you will learn what qualities to look for

in the attorney who will ultimately handle your
case. The decision to make will be the attorney
you choose to represent you, as a well prepared
and experienced attorney can make all the
difference while an unqualified one can doom
your case from the beginning.
Background on Nursing Homes
Someone once told me that a society should be judged on how well it takes care of its poor, its veterans
and its elderly. We are currently failing when it comes to the overall regard that we have for the elderly
in our society. After making severe cuts to the Medicare/Medicaid system and other cuts that have
specifically targeted nursing homes and the elderly, lawmakers wish to enact even more cuts while
so many nursing homes remain understaffed. Weve taken so much already from our elderly and need
to ask how much more they should be forced to pay while others receive breaks or avoid responsibility
because of loopholes that allow them to.
Cuts Already Enacted to Reduce Government

Funding to Nursing Facilities
Since 2009, nursing home care has been the target of cuts on both a state and national level. Here are
the cuts we have seen in the last three years so far and their impact on nursing care.
Forty states have cut or frozen all payments related to skilled nursing facility care.
The nursing care sector is currently looking at $48 billion in cuts between 2012 and 2021 with more
coming if current legislators have their way.
The Middle Class Tax Relief and Job Creation Act of 2012 cut $3 billion in Medicare/Medicaid
funding over the period of 2012 through 2021.
Nursing homes faced another $782.3 million in cuts for the fiscal year 2014 due to sequestration
threat.
How the Cuts are felt at Nursing Homes throughout the Nation
It is not surprising to learn that medical care is expensive but the nursing home facility sector has the
lowest margins in the entire healthcare industry. Many people are still unable to afford care without
assistance and 57% of daily care is paid with funds from Medicare or Medicaid a fact that advocates
of more reliable nursing home care wish that lawmakers would consider before making cuts to funding.
While patients struggle to pay for their care, the nursing facilities themselves often struggle with
understaffing issues that cannot be remedied because they are simply unable to hire additional staff if
their facilities are not-for-profit nursing homes that rely on government funding.
The Ryan Budget and Other Suggested Cuts to Medicare Spending
After three years of enduring one cut after another, the nursing home sector is faced with the Ryan
Budget which, if passed, will take another $3.3 billion from Medicare, Pell grants and other publicly
funded programs in order to give tax breaks to the wealthiest Americans. In addition to these cuts,
lawmakers are suggesting making cuts to programs that pay into the skilled nursing facility sector in
order to pay the bill to allow college students to keep their low interest rates on student loans.
When nursing home facilities fail to take care of the elderly, they become liable when the well-being
of their patients suffers. After enduring massive cuts, they must also pay damages if the care that they
provide is inadequate or if their lack of staff contributes to negligence and abuse. Our nursing homes are
in need of much improvement that can only come in the form of more qualified staff in the facilities that
we trust our loved ones care to.
To make matters worse, these budget cuts have made it extremely difficult for not-for-profit homes to
keep up with for-profit homes. The prevalence of for-profit homes has come just as a record number
of abuse cases are being reported. Nearly 70% of nursing facilities are now owned and operated by
corporations or individuals who care more about returning a profit than providing the best possible
service to patients.
We need to decide whether our elderly are worth more to us than the wealthy in this country and take
a stand against the constant barrage of cuts to programs that are already lacking. Rather than forcing
nursing home facilities to cut back even more, we need to provide relief so that workers in nursing
homes can be trained properly and the facilities can hire enough staff members to tend to the needs of
their patients.
I am still of the belief that a society will be judged by how it treats its elderly. When we look back on how
our actions today affected nursing care for decades to come, will we look back with pride because we
fought for our loved ones or try to hide our shame for allowing politicians to wage war on the people
who matter most to us?
Patient Rights. Yes, They Have Them!
Although many nursing home patients frequently feel trapped within the situation they are currently
in, nursing home patients actually have many rights granted to them under federal law. Federal law
empowers nursing home patients to make decisions with respect to their medical treatment and
personal care.
Federal law guarantees the following:
1. The right to participate in your care planning along with the right to refuse particular
treatments.
A customized care plan must be developed for every nursing home patient. Nursing home patients
(or their representatives) may participate in developing this important part of patient care.
2. The right to privacy and to be treated with dignity and respect.
Nursing home patients are free to communicate any person they wish. This includes: friends,
family, attorneys and patient advocates. Nursing home patients are entitled to privacy when
speaking with visitors.
Unless requested otherwise, nursing home patients are entitled to open their own mail.
Nursing home staff should take steps to ensure privacy during bathing, toileting, and providing
medical treatments by using curtains or private areas when necessary.
3. The right to have your own physician and/or pharmacy.
Despite the fact that many nursing homes are set up for a one size fits all approach to care, YOU
ARE entitled to select your own physician and pharmacy.
4. The right to be free from restraints.
Physical and pharmaceutical restraints may only be used if ordered by a physician and agreed to
by the patient or their caretaker. Moreover, restraints should be used only when they are necessary
to protect the individual or other patients from harm or injury.
5. The right to be informed of nursing home policies and procedures.
Policies and procedures regarding patient care and patient expectations must be written out by
each nursing home. When requested, a facility should present you with a copy of such policies.
6. The right to know about all medical care and conditions.
Nursing homes must tell each patient or their caregiver as to their medical condition and the
treatment to be provided. When and if there is a change in care, nursing homes must alert all the
decision makers.
7. The right to know of the services the facility provides and the exact charges for such
services.
Nursing homes must inform all patients as to the specific services provided and what the
accompanying charge is for such service.
8. The right to privacy when it comes to your medical records.
Federal law prohibits disclosure of personal medical records to any person or entity without the
written permission of the patient or their authorized representative.
9. The right to use your own clothing and possessions.
Despite the fact that many nursing homes freely distribute generic clothing and effects, patients
are entitled to use their own clothing and possessions if they desire.
10. The right to manage personal finances.
Many nursing homes manage their patients finances for them. This is legal. In some
circumstances this is done as a convenience for patients and to help expedite payment of bills.
If you do choose to allow a nursing home to manage your finances, you are entitled to: a) see
an itemization as to where you money is; 2) received a written accounting for each account and
expenditure; 3) get a receipt for all money spent on your behalf; and 4) have access to your funds if
you desire.
11. The right to be free from abuse in any form including: physical, sexual, neglect or
isolation.
Nursing homes must provide the highest feasible level of care. Obviously, this entitles patients to
live comfortably and free from physical and emotional abuse in any form.
12. The right to stay at a nursing home as long as the facility is capable of attending to
medical needs, payment is timely made and the facility continues to operate.
In other words, nursing homes CAN NOT simply discharge patients without cause. In order for
nursing homes to properly discharge patients, they must provide a reason for discharge or transfer.
If you disagree with the nursing homes reasoning, patients have a right to appeal the facilities
decision.
13. The right to speak freely about poor care.
Nursing homes cannot take any retaliatory action against a patient for making a complaint
regarding care or treatment.
14. The right to have visitors.
Nursing homes are homes for the patients who live there either on a temporary or permanent
basis. Consequently, nursing homes must:
a) Allow patients to receive any visitor of their choosing.
b) All patients to refuse any visitor of their choosing.
c) Provide at least 8 hours per day of scheduled visiting hours.
d) Allow patient advocates and / or patient attorneys access to the facility during visiting hours.
e)Provide an area for confidential communications between patient and visitors if and when
requested.
f) Patients may speak freely to visitors regarding rights and benefits.
The above rights are undeniable. Additionally, many states have enacted laws to further protect nursing
home residents. If a nursing home is not meeting its obligations, you should contact your state or local
nursing home ombudsman.
What are the signs of poor

care or neglect?
A recent study concluded that nearly one in ten nursing home patients experienced some form of abuse
in the past year. While such a statistic may seem insignificant, the scope of nursing home abuse is
daunting considering more than 1.3 million Americans are currently patients at these facilities. The sad
truth is that every time you drive by a large nursing home, you can assume that a handful of innocent
people are being abused at the facility in one manner or another; whether physically, emotionally,
financially or sexually.
While the media has done a commendable service in exposing the significance of this problem, the
majority of these episodes of poor care take place in behind closed doors in patient rooms, making the
discovery of these atrocities even more difficult. Since many families may have a loved one at a facility
across the state or across the country, the detection of abusive conditions may go delayed or ignored
completely.
Indication of Elder Abuse in Skilled Nursing Facilities
Families need to remember that they know their loved ones personalities and traits far better than a
person who may be temporarily caring from them in a nursing home setting. Even though you may not
have any formal training in detecting poor care, using your instinct can go a long way towards detecting
mistreatment.
The following may also be considered signs of possible abuse:
Change in behavior
Bruising or bleeding
Emotional withdrawal
Bed sores or decubitus ulcers
Unknown fractures
Loss of weight
Neglect or dirty living conditions
Loss of energy
Financial problems
Physical pain
Infections, viruses or sexually transmitted diseases
Taking a Stand Against Nursing Home Abuse
Feelings of anger and betrayal are common reactions experienced by many people who discover their
loved one is being abused at a skilled nursing facility. We have outlined some of the steps you may
wish to take following these discoveries at our page here. Should you have further questions or wish to
discuss your legal options for pursuing a civil lawsuit to recover compensation from the facility, we invite
you contact the Nursing Home Law Center here and an attorney will be in contact with you shortly.
The Most Common Types of

Nursing Home Negligence
Over the last couple of decades, there has been a sharp rise in the prominence of for-profit nursing home
chains that has coincided with increased reports of nursing home abuse and neglect. According to the
CDC, there are around 15,600 nursing homes throughout the United States serving 1.4 million residents
and nearly 9 million patients receive some form of assisted short term or long term care every year. The
number of homes owned by for-profit businesses has nearly reached 70% and it is no coincidence that
the saturation of the nursing field with corporations out for financial gain has resulted in an epidemic of
abuse and neglect.
Nursing Home Data Gives Reason for Alarm
In the period from 2010 until present day, there have been over 324,000 deficiencies reported for over
15,000 nursing facilities throughout the country. These deficiencies are classified by severity, with B class
offenses considered as minor concerns and ranging to L class offenses, which are the most heinous and
irresponsible. Over 90% of all nursing homes have at least one recorded deficiency, meaning that the
odds are extremely likely that your loved one could be subject to some form of substandard care, even if
the offense were minor.
Here is the number of deficiencies recorded over the last six years, by class of offense.
Class B Offenses These offenses do not result in any actual harm to patients, but represent a risk
of potential injury and the development of a pattern worthy of concern. There were 7,135 of these
deficiencies reported during the last six years and 264 were reported in the State of Illinois.
Class C Offenses Similar to Class B offenses, a Class C offense doesnt result in any actual harm,
but poses a significant risk to patients. The upgrade from a Class B to Class C offense occurs when
the issue is considered widespread. There were 7,746 of these deficiencies reported, 1,091 of which
occurred in Illinois.
Class D Offenses The majority of deficiencies reported fall into this category, which represents
offenses that present the potential for more serious harm, even though no actual injury was
reported. Class D offenses are isolated and not widespread, but there were a total of 185,619 of
these offenses recorded, with 9,678 of them occurring in Illinois homes.
Class E Offenses A Class E offense is like a Class D offense aside from that it is more widespread
and part of a pattern. Whenever a pattern of negligence is established, a nursing facility should
be subject to higher levels of scrutiny to ensure that the pattern does not lead to an actual injury.
There were a total of 85,855 Class E offenses reported, 3,146 of which occurred in the State of
Illinois.
Class F Offenses These offenses pose the risk of more serious harm and are considered
widespread or systematic. A Class F offense indicates that there is an elevated risk that the
negligent pattern could result in the injury or neglect of a patient. 21,979 of these violations were
reported, 1,507 of which were inside Illinois nursing facilities.
Class G Offenses A Class G offense indicates that a patient suffered an actual injury, but the event
does not place other residents at risk of similar harm. These deficiencies are isolated events and
normally the result of individual actions rather than systematic negligence. There were a total of
9,999 Class G offenses reported over the last six years and 655 of them were reported in Illinois.
Class H Offenses These violations also result in the moderate injury of a patient, but indicate a
developing pattern of neglect or abuse. While other patients are not considered to be in immediate
risk of harm, the concern is no longer due to an isolated event. Roughly 837 of these violations
were reported.
Class J Offenses A Class J offense represents an immediate and serious threat to a patient that
resulted in an injury. These events are isolated and not part of a systemic pattern. There were a
total of 2,410 Class J offenses recorded and 89 were reported in Illinois.
Class K Offenses These offenses are due to a consistent pattern of negligent or abusive behavior.
Class K offenses are part of a pattern of systemic abuse and pose a hazard to all of the residents at
the offending facility. There were 2,012 of these offenses recorded and 49 occurred inside of Illinois.
Class L Offenses Considered the most severe and heinous class of offenses, these offenses
represent widespread deficiencies that exhibit a complete disregard for the safety of residents and
staff members. Of the 719 Class K offenses recorded, 59 occurred in the State of Illinois.
In order to discourage negligent and abusive nursing facilities from ever committing the same offense
again, we always aggressively pursue the maximum amount of compensation allowed by state law on
behalf of those who have suffered due to abuse, neglect or negligence.
Common Types of Nursing Home Injuries
If you have experienced any of the following or feel that your loved ones injuries were due to abuse or
malpractice, we would like the opportunity to investigate your claim.
Medication errors, which may include prescribing or administering the wrong medication, the
wrong dose or prescribing medications without consideration for potential drug interactions.
Nursing home falls due to lack of supervision, environmental hazards or dropping a patient during
transport.
Physical or sexual abuse. This heinous offense can lead to both criminal and civil litigation.
Assisted living accidents occurring during hospice care, home nursing or at day care centers.
Choking accidents due to lack of supervision or failure to assist patients with a choking risk.
Wheelchair accidents occurring while helping a patient into or out of a wheelchair or during transit.
Evidence of physical restraint or the use of drugs or chemicals to subdue a patient.
Broken bones or fractures suffered due to an accident.
Untimely or wrongful death.
Bedsores
A study done by the North Texas Health Care System has revealed that patients have had a bleak outlook
whenever they have developed stage four pressure sores. The data suggests that preventing bedsores
from developing into stage three or four sores may be more practical than treating the sores after they
have developed. Nursing homes that neglect patients until they show the presence of advanced stage
sores may be giving their patients a death sentence. While the actual pressure ulcers were not the cause
of death in any of the patients studied, they contributed by introducing deadly infections to the patients
bodies.
The High Mortality Rate among Those with Stage Four Sores
Of those who developed stage four bedsores, almost 69% died inside of a period of 180 days. The
average length of time between the development of stage four sores and death was merely 47 days.
None of those who died with the sores recovered from them and while the sores were never the cause of
death, infections and sepsis that occurred as a result of the sores often was.
To be fair, many of the patients who were studied were already suffering from potentially life ending
conditions, but the study showed that none of the patients who developed pressure ulcers reached
their life expectancy if they were already diagnosed with a terminal illness. The data suggested that the
bedsores exacerbated the existing conditions and brought on death earlier than anticipated. Patients
who were not already diagnosed with terminal illnesses died as well from complications such as
infections and sepsis.
A Painful Death
Bedsores are extremely painful, even in the early stages when cells are just beginning to die and the sore
has not yet reached deep muscle tissue. As the wound progresses, it becomes an open sore which can
easily become infected. The infection itself causes extreme amounts of pain and it is not comfortable
to have the pressure of ones body coming down on a gaping wound. Dying of complications that arise
from pressure ulcers is not a dignified way to leave the world and our loved ones deserve much better.
Prevention of Stage Four Sores
The prevention of all bedsores begins with educating families and staff members on the causes and risk
factors that may contribute to their development. Caregivers must recognize whether a patient is at risk
and treat him or her accordingly if so. Bedsores can be prevented by turning a patient every two hours
in order to restore circulation to areas that have pressure applied to them when the patient stays in one
position.
Pressure sores really should not be a problem in nursing homes across the country because of how
preventable they are. When they are allowed to develop and fester, patients must suffer during their final
days as they fight infections, gangrene and sepsis. The prognosis for those with severe sores is extremely
bleak, yet more is not being done in order to solve the problem through prevention. Until the issue is
addressed properly by requiring nursing facilities to employ larger staffs and provide more extensive
training, the problem will continue to exist.
For further discussion, visit our Pressure Sore FAQ section.
Falls
While many nursing home falls are accidents and truly due to mistakes or misjudgments on the part of
nursing home staff members, others are the result of senseless and reckless disregard for patient safety.
Regardless of why a person falls, the nursing home is liable for compensating the injured patient if the
accident could have been prevented.
The Primary Causes of Nursing Home Falls
Elderly patients are at a fall risk due to the ongoing deterioration of their bodies, which may be
exacerbated by certain medical conditions that affect bone density, motor function or balance. Nursing
care facilities need to take every reasonable step toward ensuring that the existing risk of falls is not
compounded due to negligence and a disregard for safety. Following is a list of preventable causes of
nursing home falls.
Lack of supervision every patient that is admitted to a nursing facility requires a personalized
plan of care that addresses any medical conditions and needs that are specific to that individual.
There is no reason why any patient that presents a fall risk should be unsupervised and allowed to
attempt to move on his or her own. When this occurs and the patient falls, it is the responsibility of
the nursing home to provide compensation for the cost of medical treatment and other expenses.
Environmental hazards there are numerous environmental hazards that can prove catastrophic
in the atmosphere elderly patients are required to live in. These include wet floors, clutter and
furniture with a low profile. These hazards pose a risk to any individual, let alone the elderly and it
is the duty of nursing care staff to ensure that wet floors are marked, clutter is organized and out of
the way and that there is no furniture that can present a tripping risk to residents.
Falling while entering or exiting chairs or vehicles elderly patients who suffer from conditions
that limit their mobility may require assistance getting in and out of bed, into or out of a wheelchair
or into or out of a vehicle. The staff members that assist these patients need to take steps to ensure
that the patient is safe such as applying the brakes to wheelchairs and hospital beds and using
proper technique when assisting a patient to his or her feet.
Injuries Sustained in Nursing Home Falls
The injuries elderly patients may suffer when falling can be debilitating and painful, especially if they are
already suffering from conditions which limit their independence and mobility. Our attorneys have often
found that these injuries permanently impact the victims quality of living in their final years. The most
common injuries suffered due to falls follow below.
Fractures and shattered bones the combination of old age and the brunt trauma caused by
hitting the ground can cause severe fractures. The most common bones that are broken in falls are
the wrists, arms, hips, legs and knees. Fractures are much more difficult to treat when the patient is
elderly and suffering from other medical conditions and surgery is often required to help the bone
heal properly or to replace a damaged joint.
Internal injuries it is possible for a fall to cause trauma to internal organs or to result in the
perforation of blood vessels underneath the skin. These conditions can turn deadly quickly if
doctors are unaware of the bleeding, the patient is on blood thinning medications or the damage
to internal organs is unnoticed.
Traumatic brain injuries blows to the head are also possible during falls, either due to a collision
with an object on the way to the ground or with the ground itself. Whenever the brain suffers
trauma, fluid can build up within tiny micro tears that are undetectable without the use of imaging
technology such as MRI or PET scanning. Victims who suffer from these injuries may lose the ability
to recall important events, diminished motor function, the inability to speak or communicate, the
loss of hearing or vision or cognitive impairment. A TBI can be a tragic and life altering injury.
Falls can also result in premature death. When this is the case, the family of the deceased has the right to
file a lawsuit on the grounds of wrongful death. These are the most unfortunate and appalling cases we
have taken on and we are very serious about finding justice for the victims family whenever this is the
case.
Sexual Abuse
Physical and sexual abuse have no place in society, let alone in the nursing care industry and these
heinous acts must be met with a swift and aggressive pursuit of justice. The attorneys here at Rosenfeld
Injury Lawyers do everything in our power to best represent the interests and needs of the victims of
these horrible crimes and understand that the true damage lasts long after the abuse has occurred.
Many victims remain silent out of embarrassment or fear, so it is also important that you recognize the
signs of abuse and know when to act in order to protect those who you hold dear.
Common Perpetrators of Sexual Violence in Nursing Homes
Those who commit sexual crimes in nursing facilities are often very close to their victims. They may be
friends, caregivers or regular visitors. Understanding the different types of perpetrators can help you
recognize when something is not right and take the needed steps to protect your loved one. We have
noticed that those who commit these acts fall into the following categories.
Nursing home staff members while most people are under the impression that nursing care
facilities place potential employees through a rigorous screening process, it is possible that some
offenders fall through the cracks, have no prior record or the facility wasnt thorough enough
during the screening process. If your loved one is sexually assaulted by an employee with a history
of abusive treatment toward patients, the facility can be held liable for the employees actions due
to its failure to act.
Residents staying in the same facility there are instances where another resident will physically
or sexually assault another and the nursing home staff may or may not be aware of the abuse.
If nursing home staff members have reason to suspect a resident of misconduct, appropriate
measures must be taken which include investigating the incident and taking the needed legal
actions against the offender.
Guests who abuse residents during visits it is the responsibility of nursing facilities to have
adequate security measures in place which would prevent guests from entering the home
and assaulting residents. All visitors should be required to check in and those who are acting
suspiciously should be monitored. Many of the guests who abuse residents have no reason to be
there other than to target the elderly.
Victims own family members some victims are abused by their own family members. These
cases happen primarily when a family member is taking care of the victim and often includes
physical and financial abuse as well.
Signs of Sexual Abuse and When to Act
When potential clients ask us when they should act on their suspicions, our knee jerk response is that it
is better to investigate and be proven wrong than to be right and have done nothing. Most of the victims
of physical and sexual abuse refuse to come forward for a number of reasons their assaulters may be
threatening them, they may be ashamed or their caregivers may be downplaying their accusations by
claiming they are suffering from senility or dementia. You should never simply take the word of nursing
home staff and it is best to trust your instincts when you notice sudden changes in your loved one.
If you notice the following symptoms of abuse, consult with an attorney to review your options or launch
an investigation.
Your loved one suffers from intense mood swings which include deep depression and anger. This is
often downplayed by the abusers as symptoms of dementia, but should never be ignored.
You notice physical signs of abuse such as marks and bruises. Common locations include the
wrists and ankles as well as the genitals. Any marks located in sexual areas are a red flag for
launching an investigation.
Your loved one becomes silent in the presence of caregivers. This is a sign that he or she is afraid
of whoever is in the room and especially afraid of what might happen if he or she says the wrong
thing. It could mean that the caregiver has threatened your loved one and warrants investigation.
Your loved one makes an accusation. Regardless of how outrageous the claim may sound, it needs
to be followed up with an investigation. Some sexual predators hide their perversions very well and
their friends and colleagues are often quoted as never having suspected they could be capable of
such heinous deeds.
Illinois Governor Bruce Rauner recently signed legislation into law in Illinois that allows families to install
cameras in their loved ones rooms given that they shoulder the cost of installation and monitoring and
that any residents sharing the room consent. This is one way many families are choosing to help deter
sexual predators from preying on the people that they care about and the cameras can also uncover
evidence of any other forms of abuse such as neglect or failure to provide supervision when the patient
requires it.
If you believe that your loved one is the victim of abuse, it is imperative that you launch an investigation
right away. Oftentimes, the only way to deter this kind of behavior is to exact stiff penalties upon
offenders as an example toward other facilities.
Fractures
Senior citizens are more prone to fractures because their bones have become much more fragile and
certain medical conditions may make increase the risk they may be involved in accidents that result in
these injuries. Nursing care facilities must create treatment plans for each patient that takes into account
his or her risk factors and take the needed steps to ensure that the risk of injury is minimized through
supervision and special accommodations when necessary.
The Causes of Fractures in Nursing Homes
Inadequate staffing can be linked to many accidents and individual caregivers may be unable to
provide quality care due to a lack of resources and excessive burden. For profit nursing companies
have prioritized profits over patient wellbeing, which is an atrocity when considering just how much we
pay these organizations to care for the people who we love. In addition to poor staffing, many facilities
do not offer the training needed to ensure that staff members are able to prevent and respond to
emergencies.
Here are the primary causes of fractures and how they can be prevented.
Slip and trip accidents many nursing home injuries result from environmental hazards or poor
supervision. Slip and trip incidents can be prevented by ensuring patients are properly supervised
and that hazards such as low profile furniture, clutter and other objects are not placed in the path
that patients are likely to travel. Wet floors should be marked and patients assisted whenever they
must walk over them.
Falls when moving into or out of bed or a chair patients with poor mobility should be assisted
whenever they are entering or exiting bed or getting into or out of their wheelchairs. There are
many ways a caregiver can place a resident at risk, including failing to ensure that the brakes on a
chair or mobile bed are locked, failing to supervise the patient or dropping the patient during the
transition. Prevention of these injuries requires adequate supervision and training.
Accidents when entering or exiting a vehicle the nursing facility and medical transport staff
can be held responsible if a patient is injured when entering or exiting a vehicle on the way to an
appointment or to the hospital. The most common accident occurs when the patient is dropped
or the staff member forgets to apply the wheelchair brakes before helping the patient into or out of
the vehicle.
Fractures suffered due to physical assault occasionally a staff member, fellow resident or visitor
may assault a patient, inflicting physical and emotional damage that cannot be easily mended. If
the assault results in broken bones, the victim is entitled to the cost of medical treatment as well as
the cost of any other therapy and rehabilitation needed to cope with the incident.
Most Common Types of Fractures
While it is possible for patients to experience fractures anywhere on their bodies, the elderly are more
prone to experience fractures in certain areas of the body than others. Following are the most common
types of fractures.
Hip fractures elderly patients who fracture their hips are far more likely to permanently lose
their mobility or to require artificial hip replacement surgery. The loss of mobility often results in a
diminished quality of life and patients who suffer hip fractures have an increased risk of premature
death.
Wrist fractures when falling, it is an instinctual reflex for us to throw our hands forward in order to
brace ourselves for impact. The unfortunate result of this reflex is that it can exacerbate the injuries
by placing the wrist in a positon where it can break. As we age, our bones become much weaker
and our wrists are not able to protect us in the event of a fall as they may have when we were
younger.
Broken ankles and feet when encountering environmental hazards or obstacles, it is possible for
patients to twist their ankles severely in an effort to avoid the fall. Instead of experiencing a sprain
or muscle tear, the ankle or foot may fracture when it is weakened through old age.
Broken skull when a patient falls to the ground, his or her head may impact with considerable
force, resulting in a cracked or broken skull. Even when the skull remains unbroken, there is the
potential for a traumatic brain injury.
Many nursing facilities will try to provide a cover story that exonerates them of blame, but you should be
wary when the explanation of events does not add up. If you have any reason at all to suspect that your
loved ones fracture was the result of negligence or abuse, contact an attorney right away.
Physical Abuse
Some caregivers may choose to physically restrain a difficult patient. Unless the patient poses a risk to
him or herself or to other people, however, it is not ethical or lawful for physical restraints to be used.
It is common for abusers to pair the use of physical restraints with physical or sexual assault and for
caregivers to threaten or verbally harass the patients that they restrain.
Use of Chemical and Physical Restraints for Convenience
Many nursing facilities will use restraints as a means of controlling patients or as disciplinary measures.
Patients who are restrained may also be subject to verbal or emotional abuse and afraid to come
forward due to the issuance of threats by the caregivers placing them under restraint. The use of
restraints may make it easier for nursing homes to control their more difficult and volatile patients, but
it is illegal to use restraints in this manner. Only when a patient has been proven to be a threat to him or
herself or others can restraints be used.
When visiting your loved one, take note if you notice any marks on his or her wrists or ankles, as these
are the most clear physical signs that he or she is being physically restrained. It may be more difficult for
you to detect when he or she is under chemical restraint, but you will be able to tell primarily by changes
in his or her mood or behavior. You may notice that your loved one appears groggy, goes through mood
swings or appears emotionless. If you have any concerns about whether medications are being used in
an illegal manner to subdue him or her, seek the advice of a legal representative immediately.
Physical Assault
The symptoms of physical assault are pretty clear. You receive a report that your loved one has been
admitted to the hospital for a sudden unexplained fracture, you notice bruises all over his or her body, or
your loved one chooses to confide in you that he or she has been attacked. The attacker is not always a
caregiver and may be a fellow resident or a visitor. Regardless of who assaulted your loved one, there is
one thing that is clear the attack(s) happened under the watch of the people who you trusted to care
for and protect your relative.
Medication Errors
Medication errors result in some of the most easily preventable injuries in nursing homes and most of
these errors are the result of systematic negligence or a lack of attention paid to detail. There is little
excuse for the administration of the wrong medications or doses to patients when there is a multi-
layered system in place to prevent these incidents from occurring. While most of the injuries that result
are minor, some patients can suffer catastrophic harm simply because those responsible for their care
failed to do their due diligence.
Multiple Layers of Protection Meant to Prevent Errors
Most people are unaware of just how many people are involved in the process by which a medication
is prescribed, filled and then administered to a patient. Lawyers always examine this chain when
investigating a case involving medication errors to determine at what point things went wrong and
which people along the way failed to prevent the wrong medication or dose from being administered
to the patient. Following are all of the people typically involved in the prescription and administration
process and their individual roles and responsibilities.
The prescribing doctor or nurse practitioner in too many instances, the doctor or practitioner
who prescribes medication to patients is overburdened and in a hurry. This could be due to low
staff levels forcing existing staff members to rush from patient to patient in order to take care of
everyone under their care. It is the responsibility of the person prescribing the medication to weigh
the potential risks associated with the medication with any potential side effects or adverse events
that could result from its administration. This includes making sure that the medication prescribed
will not interact with other medications or the patients diet.
The pharmacist filling the prescription pharmacists are the perfect intermediary between the
doctor and patient because they are trained to detect potential problems and to question doctors
about drug interactions and possible alternatives. They may fill the prescription incorrectly,
however, by providing the wrong medication or dose. Where they become a strong link in the
chain of protection, they can also become a weakness if their errors go unnoticed by the person
responsible for administering the medication.
The nurse or caregiver administering the medication it is the responsibility of the caregiver to
check the work of both the doctor and pharmacist by making sure that the prescription was filled
according to the doctors wishes and that the dose and medication is correct. Many caregivers
working in understaffed facilities simply lack the time to check every single medication and may
simply administer meds without making sure the prescriptions have been filled correctly. They may
also provide patients medications in the wrong form, at the wrong times or in incorrect dosages.
The patient receiving the medication unless the patient is unable to participate in his or her
care due to neurological disorders or other disabilities, he or she should be understand why
certain medications have been prescribed and how they are to be dispensed. Many patients are
wrongfully embarrassed at the thought of questioning their caregivers when they are administering
medications and it is entirely within their rights to verify that the medications being administered
are correct.
Multiple Medications Increase Risk of Errors
Patients are often placed on more medications as they age and required to stay on these medications
for a longer period of time. Polypharmacy is a term used to refer to the prescription of multiple different
medications for the same patient. Greater exposure to polypharmacy increases the chances that a
patient will experience an adverse drug interaction or be injured due to a medication error. His or her
caregiver is more prone to administer the medications at the wrong time or frequency and the doctor
may prescribe medications without verifying they are safe.
In one study conducted abroad with patients taking an average of nine medications per day, it was
revealed that 93.5% of those patients had been prescribed at least one non-evidence-based medication.
This means that the medication was not prescribed based on effective research, interaction with the
patient and clinical expertise. The study also revealed that a staggering 56.2% of patients were given the
wrong dose of medication at some point during their treatment.
Medication errors most often result in minor side effects or discomfort, but some of the medications
prescribed to the elderly have the potential to cause serious injury if not administered properly. For
example, an excessive amount of anti-clotting medication can cause life threatening internal bleeding
and the incorrect dose of blood pressure medication can cause the heart to stop beating. When these
errors cause the injury or death of a patient, the people responsible should be held liable to both the
patient and family for damages.
Malnutrition and Dehydration
Malnutrition refers to not receiving the proper amount of nutrients because of an unbalanced diet. This
may occur due to lack of food or because of a lack of variation. In many cases, nursing home residents
receive the wrong serving size or are not fed on a normal schedule. If this happens consistently, it will
result in medical complications.
It is important to remember that elderly patients may have lingering dental problems that prevent them
from eating, even if the nursing home does provide correct portions. It is normal for elderly patients to
experience a loss of appetite as well, which makes it even more important for qualified staff members to
monitor the patients to ensure that these patients are somehow receiving enough calories.
Finally, it is important to realize that these patients often receive a multitude of prescription-based
drugs. These may have unwanted side effects, leading to a decreased appetite or nausea. This again
makes it less likely for patients to eat enough throughout the day.
Signs of Malnutrition
Malnutrition can be a life-threatening condition. Without the proper nutrition, it becomes even harder
for elderly patients to ward off infection, which may lead to additional complications that could prove
fatal. If you notice any of these signs, it is important to speak up and act fast.
Confusion
Tooth decay
Dry skin
Bloated abdomen
Decreased organ function
Mental decline and memory loss
Fragile bones, muscle loss, weakness
Swollen and/or bleeding gums
Dizziness
Fatigue
Weight loss
There are a number of different tasks people take for granted until they lose the ability to perform
those particular tasks. One of them is the ability to get up and get a drink of water when they are feeling
thirsty. Many nursing home patients may be bedridden or have reduced mobility. For these patients, it is
important that nursing home staff provide them with enough fluid throughout the day. A failure to do so
could lead to dehydration.
What is Dehydration?
The broad definition of dehydration is an excessive loss of body fluid. According to the definition of the
American Medical Association (AMA), it means that the patient loses more than 3% of his or her total
body weight very quickly. This may occur because of a drastic decrease of fluids intake, medication
side effects, or illnesses. For many of the elderly patients in a nursing home, their physiological changes
play a major role in dehydration as well. For example, it may be more difficult for elderly patients to
concentrate urine from the kidneys.
The primary factor for dehydration is neglect. This can occur if staff members refuse to or forget to
provide enough fluids to patients. Shocking statistics from a 1999 study showed that amongst 40
different residents who were surveyed, only a single resident had proper hydration levels at that time.
Many patients are unable to maintain their own hydration level because they are physically unable
to do so. This makes it even more important that staff members remain diligent, especially because
dehydration is a problem that can occur very quickly.
Once dehydration does set in, it can lead to many different medical problems, including a higher rate of
developing infections, pneumonia, electrolyte imbalances, ulcers, bedsores, worsened dementia, and a
weakened immune system.
Signs of Dehydration
Signs to be aware of include the following.
Dizziness, faintness, or lightheadedness
Chills
Fatigue or weakness
Dry mouth
Dark colored urine
Skin flushing (red in the face)
Dry skin
Loss of appetite
Thirst
Other serious symptoms include seizures, difficulty breathing, and vomiting. It is important to get
someone exhibiting these symptoms to emergency care as quickly as possible, because these symptoms
need to be treated as life threatening.
Why Staff Shortage is a Problem
One of the largest issues in nursing homes across the nation is staffing shortages or a lack of qualified
personnel. Not only does this put the residents at greater risk of malnutrition and dehydration because
of neglect, but may also lead to a host of other issues. If patients need help when eating, a staff shortage
or a lack of qualified staff is going to cause staff members to feel overwhelmed. Oftentimes this means
that the quality of patient care decreases.
When people talk about nursing home abuse, the primary concern is physical harm abuse. However,
both dehydration and malnutrition are dangerous factors in nursing homes across the country,
especially now that countless nursing homes are drastically reducing staff costs in order to remain
profitable. The estimate is that more than 10,000 elderly residents died because of malnutrition and
dehydration between 1999 and 2002.
Dropped Patients
Many nursing home residents are unable to move to a different area of the home by themselves.
Oftentimes this means that they are reliant on nursing home staff members to help them get from place
to place. While many people may suggest that a wheelchair might improve mobility, getting out of bed
and into a wheelchair is an important step that requires assistance.
Even though there are protocols in place on how to transfer a patient from one location to another
safely, these procedures are often ignored because the staff member is in a rush, inexperienced or
negligent. This may lead to drops that result in serious injuries.
Drops during Routine Transfers
Most problems with dropped nursing home patients occur during routine transfers. These transfers are
performed several times per day, which is why complacency can become an issue. Some of the most
common types of patient transfers include the following.
Transferring from one chair to another
Transferring from or onto the toilet
Transferring from the wheelchair into a bath or shower
Transferring from the bed to the wheelchair or vice versa
When improperly using the Hoyer Lift
Injuries Suffered Due to Drops
Dropped patients require assistance for a reason they may be frail or bedridden. When considering
the added elevation at the time of the fall and their weakened condition, you can understand why
the resulting injuries are often debilitating and serious. Some of the common injuries that are directly
attributed to these falls include the following
Fractured bones or shattered bones
Internal organ damage
Traumatic brain injury
Death due to complications
The data concerning falls is staggering. One out of three elderly people fall every year and falls are the
leading cause of deaths amongst patients over the age of 65. Perhaps more surprising is that patients in
nursing homes are more susceptible to falls than those living on their own. When you are paying such a
high cost for your loved ones care, it is reasonable to be able to expect that they will be much safer in
the care of their nursing facility rather than on their own.
The reason a patient drop may necessarily be due to abuse, but rather because staff members fail to
follow protocol or use bad judgment. Remember that many nursing homes are trying to cut corners by
providing less than adequate staff training, keeping minimal staff levels, and not having the right type of
equipment to help patients.
If your loved one was dropped at in a nursing facility, it is important to remember that poor judgment
or brief moments of inattention are not excuses for potentially serious injury. It was an unavoidable
mistake is not a good enough explanation.
The decision to take legal action is not always about being right or receiving compensation. Sometimes,
it is about ensuring that a change is made in the future so that other patients do not need to suffer the
same fate that your loved one has.
Remember that everyone who has placed their loved one in a nursing facility did so with a heavy heart
and is paying a fortune with the expectation that their loved ones will be treated with dignity and
respect. Caregivers and nursing home administrators alike need to show that respect by following the
very protocols meant to protect their residents.
Unexpected Deaths
Everyone deserves to be treated with dignity and respect; especially those loved ones in our lives who
have spent the majority of their own lives working hard to provide us with our base needs and the
opportunity to excel. When negligent nursing care results in the untimely death of someone you care
deeply for, it is your right to demand answers, accountability and justice. The attorneys of Rosenfeld
Injury Lawyers pursue justice against those facilities and staff members whose disregard for others
results in needless and premature deaths and will work tirelessly to ensure you receive the answers and
justice that you deserve following your loved ones passing.
Common Causes of Wrongful Death in Nursing Homes
There are many things that can go wrong in medical settings, but the simple truth is that most of those
things can be prevented with proper preparation, supervision and training. Nursing staff should be
aware of each patients potential risk factors, complications and needs so that they can provide effective
treatment. Some of the most common causes for untimely nursing home deaths include the following.
Medication errors prescription and dosing errors are extremely common, unfortunately.
While most of them result in minor discomfort or complications, others can have disastrous
consequences. If a patient is prescribed a medication that reacts adversely with another he or she
is already on, has an allergic reaction to a drug or is given the wrong dose of a medication such as a
blood thinner or blood pressure medication, it can easily lead to death.
Infections there are many causes for infections in nursing homes and they are often the result
of a different concern. Poor hygiene, ineffective disease prevention methods and poor food
preparation methods can spread disease throughout a nursing home, including serious infections.
Other injuries may also lead to infection, such as when pressure sores become infected or when
the infection results from an operative procedure. Once an infection begins to spread to other
areas of the body, it can become uncontrollable and lead to major organ failure and death.
Dehydration or malnourishment the complications that can arise from poor nutrition and
hydration may lead to death. There have been instances in which severely understaffed nursing
facilities have been unable to provide three meals a day to residents and it is completely
inexcusable that a patient die prematurely because he or she was not provided the fluids and food
needed to remain healthy.
Choking some patients are at a higher risk of choking than others and it is up to the nursing staff
to assess each patients choking risk upon admittance. The majority of choking accidents can be
prevented and occur because the victim was eating unsupervised or unassisted.
Injuries resulting in loss of mobility falls or accidents that result in fractures to the legs, hips
or knees can greatly reduce the life expectancy of the victim. Studies have shown a strong link
between hip fractures and loss of life and it is suspected that this is due to complications that often
accompany loss of mobility. The inability for a patient to move under his or her own power can
have an impact on hygiene, pain management, bedsore and infection risk and more.
Traumatic brain injuries if the victim has suffered a fall, it is possible that he or she may have
struck his or her head on an object or the ground, resulting in a debilitating injury to the head.
These traumatic injuries can result in permanent brain damage or the death of the patient if the
accident resulted in uncontrolled hemorrhaging inside of the brain.
The Rights of the Bereaved
If you have lost a loved one and believe that his or her caregivers irresponsible or negligent actions
were what caused the accident or injuries leading to your loved ones death, you may be entitled to
compensation for wrongful death. While a wrongful death lawsuit will not bring your loved one back
and no value can be placed on his or her life, it will help promote change by deterring nursing homes
from continuing to treat other patients in a similar manner. Many questions arise when clients approach
our lawyers about pursing wrongful death litigation and these questions include the following.
Who may file the lawsuit? If the deceased left behind a spouse, his or her spouse would be able to
file the lawsuit on behalf of the victim, but if the victim has no spouse, the claim may be filed by
the remaining survivors of the deceaseds estate. Every state has different laws regarding who may
file, so if you would like to know which members of your family may pursue the lawsuit, you should
speak with an attorney.
What compensation is my family entitled to? In addition to damages for the loss of consortium,
or companionship, wrongful death claim damages include the cost of medical treatment prior to
death, compensation for the cost of a funeral and burial, the determined value of the victims pain
and suffering and the loss of valuable wisdom and guidance the deceased may have provided his
or her family.
You shouldnt hesitate to ask a qualified attorney about your rights and how your family should proceed
with a claim. Your case could fail if it is brought by the wrong person or filed against the wrong party.
Before you decide to proceed with litigation, you need to know how to do so the right way. This is where
we can provide an invaluable service.
We can let you know whether your case is worth investigating and assist you in gathering the evidence
that you need to build your case. For more information, do not hesitate to contact us. Delaying an
investigation can lower your chances of success due to the statute of limitations, so it is best to inquire
about your rights early on so that whichever attorney you do retain has the time to do his or her job.
For more information on the legal options regarding wrongful death cases, please visit our Wrongful
Death FAQ section here.
The Sad Truth: Most Accidents

in Nursing Homes Are Ignored
and Never Reported
Whenever people hear about the rising number of nursing home abuse cases, they feel a strong need for
alarm. The data leaves out a very important group, however, which is the people who are abused and
never file a report, initiate an investigation or take legal action. When you consider just how many cases
go unreported, it becomes immediately clear just how serious this problem has become.
Studies have been conducted since the mid-1990s tracking the number of nursing home incidents and
the frequency of patient reports. The National Elder Abuse Incidence Study in 1996 revealed that there
were over 550,000 cases of abuse throughout the United States, but only 21% of the victims reported the
abuse to the authorities. This means that for every two reported incidents, there are almost eight that go
unnoticed and uninvestigated.
The Reasons for Unreported Abuse
Education is critical to changing the state of our nursing care system and it can also empower victims
and their families. The lack of information fuels the ability of abusers to continue neglecting or
mistreating patients. Following are the primary reasons why abuse may go unreported.
The victim doesnt even know he or she is being abused neglected patients may believe that the
way they are being treated is normal and certain neurological conditions may prevent patients
from being fully aware of what is happening to them. These patients are often the unfortunate
target of many criminals who would take advantage of their confusion.
The victim is being threatened with physical harm or restraint whether the abuse is of a physical,
verbal or sexual nature, the abuser may threaten the victim in order to coerce him or her into
silence.
The victim is too ashamed to speak up about the abuse many victims of nursing home abuse
are afraid that they will not be taken seriously if they tell someone what is happening to them.
They may believe that their family and friends will write it off as senility or dementia, or may be
embarrassed by the abuse and wish to keep it hidden.
The nursing facility covers up the incident even when a nursing facility is aware of an incident or
series of occurrences, an effort will be made to cover the abuse up rather than open the door for a
potential lawsuit. Not only can a facility be subject to a lawsuit, but if the home has been reported
for similar violations in the past, it could lose access to Medicare and Medicaid funding.
There are no witnesses to corroborate the claims if the only witnesses happen to be the victim
and the abuser, it becomes a case of one persons word against another. Nursing home staff
members are trained not to admit wrongdoing, so the victim may remain quiet because he or she
feels that there is no way to prove the abuse occurred.
The nursing home alters or forges records if the facility is anticipating a lawsuit, it may
preemptively alter medical records without the victims knowledge to make it appear that the legal
action is frivolous. Although this is highly unethical and illegal, it is one of the ways that nursing
facilities dodge lawsuits. (For information on obtaining copies of nursing home records, look here.
The family is not present to detect the abuse or poor conditions lets face it. Sometimes life gets
in the way and it is difficult for us to check in on our loved ones. If we are not around, we are unable
to notice changes in our loved ones behavior or to observe symptoms of abuse or neglect. You
are ultimately the greatest asset your loved one has to prevent or detect abuse, however, as your
observations provide the evidence needed to press nursing home staff on issues and catch abusers
in the act.
The nursing home was negligent, but there was not justifiable cause for action attorneys cannot
dedicate resources to pressing nursing facilities on every minor injustice caused to residents. If the
victim only suffered minor injuries, there may simply not be a case worth pursuing.
There is a fear of repercussions in the case that the victim is being threatened, he or she and
his or her family may fear that the abuser will only do more harm if they take action. This is why
it is important to have a plan in place to remove your loved one from the environment while
investigating the claim of abuse.
The victims wait too long to file their claims the statute of limitations prevents people from filing
lawsuits long after an injury has occurred. Some victims wait for too long before deciding to act
and their attorneys are unable to prepare their case before the statute of limitations has expired.
The statute of limitations for most personal injury cases is two years from the date of abuse. There
are some exceptions, especially in the event of wrongful death. What is important to know is that the
only way we as a society can improve the quality of nursing care in this country is to report cases of
abuse. You may be able to file criminal charges in cases of assault or severe abuse and could collect
compensation as a means to discourage other nursing centers from mistreating patients.
If you suspect your loved one is being abused, speak up and seek legal guidance. You should also be
prepared to report the abuse to the authorities so that real action can be taken to protect your loved one
and any other potential victims.
For additional discussion on this an other topics, visit our Nursing Home Abuse FAQ section.
Reporting Poor Care to Authorities.

How and Where to Report
Every state is required to have a long-term care ombudsmen program as set forth by the Federal Older
Americans Act. In the long-term care setting, ombudsmen act as patient advocates to help families find
facilities that meet resident needs, address problems encountered in long-term settings and inform
patients of their legal rights.
Most people utilize ombudsmen services when they encounter a problem at a facility such as a resident
injury resulting from abuse or neglect. In this context, an ombudsman can help in the investigation of
the incident and resolve problems with the facility.
In many cases, the information provided by a nursing home ombudsman may substantiate an episode
of poor care. This information may be helpful in determining how an incident occurred and if the matter
should be pursued as a nursing home negligence lawsuit. However, even in cases where there are
findings of improper care, most jurisdictions prohibit ombudsmen reports from being introduced into
civil lawsuits.
If you have a question regarding nursing home care or seek more information regarding a nursing
home injury, the ombudsmen program is a great resource to help provide you with more information.
Unless you give ombudsmen specific permission to share your information with the facility, all personal
information will be kept confidential.
You may also contact any of the following agencies to report an incident or launch an investigation if
you feel that your loved one is being mistreated.
The Illinois Department on Aging Senior HelpLine, which is 1-800-252-8966. Be sure to have the
address of the facility and daytime phone number on hand.
The Illinois Department of Public Health, which operates a Nursing Home Hotline. You can call the
hotline by dialing 1-800-252-4343 or file the complaint online at http://www.idph.state.il.us/pdf/
CCR_ComplaintForm_Fields.pdf.
Healthcare and Family Services for Supportive Living Facility Complaints. This agency may be
reached by dialing 1-800-226-0768 between 8 AM and 5 PM on Monday through Friday.
The Illinois State Police Medicaid Fraud Unit. This unit investigates claims where services were not
rendered although billed or in cases where your loved one was the victim of theft or fraud. You can
reach this unit by dialing 1-888-557-9503.
Do You Have a Civil Case?

What You Need to Win a Nursing
Home Lawsuit
I wish that I could tell you that taking your nursing home to court is a simple process and that you have a
great chance of success. The reality is that since nursing home abuse or neglect cases fall under medical
malpractice, the odds are stacked in the favor of the nursing home. Many laws have been passed over
the years with the intent of protecting doctors and medical facilities from frivolous lawsuits, but those
same laws make it extremely difficult for those who have legitimate claims to receive the justice that they
deserve.
The Duty of Care and What it means to Your Case
In order to win a medical malpractice case, you need to prove that a doctor, nurse or other staff
member failed to act in the same manner that his or her peers would have and that the failure to meet
that duty of care was the direct cause of your injuries. The breach of the duty of care is what constitutes
negligence and is the basis of your entire case. In order to prove that your loved ones injuries were the
nursing facilitys fault, you need the testimony of an expert who is able to show the court how nursing
staff members should have acted and where they failed to meet their standards.
You can be assured that the nursing facility will bring its own experts forward as well. It can be possible
for a doctor or nurse to make a mistake without making it negligently. There needs to be indisputable
proof that the error was reckless or could have been prevented had nursing staff members followed
reasonable protocols and procedures. The injury also needs to be serious enough to substantiate legal
action.
Nearly seven in ten medical malpractice cases fail. There are a multitude of reasons why this is, and the
attorneys bringing the cases have quite a lot to do with it. Many attorneys who take on these cases are
not prepared for them. They may not have enough experience or lack the knowledge needed to prepare
and bring your case to trial.
How We Determine Whether You Have a Case
Whether or not you may have a case can rest on how well you saved your loved ones medical records
and kept track of dates and events. These records form the starting point for an investigation and help
our attorneys when speaking with relevant experts who can definitively state whether the duty of care
was breached. If the medical experts that we work with believe that the nursing home did act negligently
and the injuries were serious enough to warrant legal action, we will advise moving forward with a
Notice of Intent to File Suit.
In some rare cases, the nursing home will offer a settlement, but most of the time, the issue will proceed
to court. The reason it is important to consider statute of limitations when considering legal action is
that the nursing facility has six months to respond to the notice. Once the nursing facility responds, we
would be able to file the lawsuit.
The damages sought could include the value of medical expenses, pain and suffering, a resulting
disability or other expenses that the law allows us to include in your claim. While most nursing homes
refuse to offer an initial settlement, the majority will ultimately settle before the case reaches court if
there is a solid case being presented.
What to Look For When Hiring

an Attorney to Represent
Your Family
You dont need to look far to find an attorney willing to run with your personal injury case. Their
advertisements are on every billboard, television and radio in sight and many will give you lofty promises
that deliver false hopes. With so many lawyers out there that are inappropriate for your case, how can
you find an attorney that has your needs at heart and has the experience and knowledge needed to win?
The first step is to find an attorney that specializes in nursing home abuse law. Just as you wouldnt trust
an ear, nose and throat doctor to perform heart surgery, you shouldnt trust that an excellent attorney
will excel with your case if he or she has no previous experience handling similar cases. Always ask the
lawyers you are considering whether theyve had experience working with nursing abuse cases and how
many claims theyve handled successfully.
It is also easy to be sucked in by lawyers full of hype and who promise you lofty settlements or
judgments. While it has happened for some people, not everyone is awarded multi-million dollar
settlements and it is important that you work with an attorney that provides you with expectations that
are realistic. If what he or she is telling you seems like it is too good to be true, there is a solid chance that
it isnt.
What you do want is an attorney who has knowledge about the law regarding your matter, who can
show you a proven track record of success and who places the needs of his or her clients first. I wouldnt
blame you for meeting with multiple attorneys before deciding who should represent your interests and
actually encourage it.
You also need to understand how the attorney you are working with is to be paid for his or her services
and whether you can afford his or her legal fees. Rosenfeld Injury Lawyers is a firm that works on
contingency agreements, allowing our clients to retain our services without any upfront or recurring fees.
The reason we choose to do this is so that we can offer our legal services to people who might otherwise
be unable to afford them. No person should be unable to have access to quality legal representation
simply because he or she is not wealthy.
If you believe that your loved one is the victim of abuse, I would like the opportunity to meet with you
and determine whether you have a case. Rosenfeld Injury Lawyers has a legal team composed solely of
attorneys who specialize in nursing home abuse cases and access to the medical and social resources
you may need to build your case and to help your loved one move forward. It is my hope that with every
case my firm is able to handle successfully that we can advance one step closer toward changing the
nursing care industry for the better.
Our Recent Nursing Home

Negligence Recoveries
Our nursing home abuse attorneys work hard to recover every bit of compensation our clients are
entitled to receive. It is important to understand that we cannot guarantee you millions of dollars, but we
can promise to seek the full value of your claim. Following are some of the settlements and judgements
we have been able to secure on behalf of clients who found themselves neglected or abused in manners
similar to how your loved one has been treated.
$875,000 an 88-year-old man developed multiple pressure sores to his buttocks, ankles and
head during an admission to a hospital. The wounds became infected and necessitated an
extended stay at a series of long-term care facilities. The man passed due to complications from an
underlying illness as opposed to the pressure sores.
$1,095,000 a 62-year old woman was admitted to a reputable nursing home for rehabilitation
following a hip replacement surgery. The staff at the nursing home failed to get her out of bed at
the intervals prescribed by her doctor. As a result of the inattentive care, the woman developed
significant pressure sores on her buttocks necessitating multiple debridements and a flap-
reconstruction surgery.
$815,000 nursing home staff ignored soft diet orders and gave a hot dog to a man who was
recovering from a stroke and incapable of chewing or swallowing. The man struggled for more than
30 minutes to clear the food from his throat before staff responded. It was not until three hours
after the incident the paramedics were called. The man was pronounced dead at the hospital. Two
nursing home staff members were fired after the incident.
$750,000 a 76-year-old man who was wheelchair bound fell down the front stairs of a nursing
home when staff forgot to engage the wheel-locks. The fall resulted in facial fractures and a
subdural hematoma.
$710,200 a staff member with a criminal history allegedly molested an elderly nursing home
patient. Our attorneys alleged that the facility was negligent in hiring this person who was then
allowed to care for patients with Alzheimers.
$600,000 a wheelchair-bound patient was transferred from her bed to a nearby wheelchair by a
staff member using a Hoyer Lift. Instead of utilizing a two-person assist as required by the patients
care plan; the staff member elected to move the patient without assistance. The patient fell and
fractured her hip and femur. Orthopedic surgery was performed via open reduction / internal
fixation. After a four-week recovery at a different skilled nursing facility, the woman died.
$570,000 a resident living in an assisted living facility fell while being escorted by a staff member
to the dining area with a walker. The CNA instructed the resident to use the stairs as opposed
to waiting for an adjacent handicapped lift. The patient fell down the stairs and sustained facial
fractures and a torn rotator cuff, which necessitated two surgeries.
$395,000 staff at a national nursing home chain failed to prevent the development of bedsores
and notify the family of a patient of their development. The elderly gentleman died from sepsis
within 30 days of the formation of the wound.
$299,000 a patient fell and fractured her hip within two days of initial admission. Staff at the
facility failed to supervise when patient was using the toilet despite orders, which indicated she
was a full assist.
To learn more about how we can help you, contact us today to arrange a free consultation with an
attorney or visit https://www.rosenfeldinjurylawyers.com to learn more about your rights. It is my hope
that this book has given you the information you need to determine whether your loved one is being
mistreated and how to proceed when seeking answers. Only by holding nursing homes accountable for
their misdeeds can we prevent others from enduring the same forms of abuse in the future.

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Nursing

In addition to this book, Ive compiled

You will then be provided with information on

Finally, you will learn what qualities to look for

Background on Nursing Homes

Cuts Already Enacted to Reduce Government

The Ryan Budget and Other Suggested Cuts to Medicare Spending

Patient Rights. Yes, They Have Them!

Federal law guarantees the following:

2. The right to privacy and to be treated with dignity and respect.

3. The right to have your own physician and/or pharmacy.

4. The right to be free from restraints.

5. The right to be informed of nursing home policies and procedures.

6. The right to know about all medical care and conditions.

8. The right to privacy when it comes to your medical records.

9. The right to use your own clothing and possessions.

10. The right to manage personal finances.

13. The right to speak freely about poor care.

14. The right to have visitors.

a) Allow patients to receive any visitor of their choosing.

b) All patients to refuse any visitor of their choosing.

c) Provide at least 8 hours per day of scheduled visiting hours.

f) Patients may speak freely to visitors regarding rights and benefits.

What are the signs of poor

Indication of Elder Abuse in Skilled Nursing Facilities

The following may also be considered signs of possible abuse:

Bed sores or decubitus ulcers

Neglect or dirty living conditions

Infections, viruses or sexually transmitted diseases

Taking a Stand Against Nursing Home Abuse

The Most Common Types of

Nursing Home Data Gives Reason for Alarm

Common Types of Nursing Home Injuries

Evidence of physical restraint or the use of drugs or chemicals to subdue a patient.

Broken bones or fractures suffered due to an accident.

Untimely or wrongful death.

Prevention of Stage Four Sores

For further discussion, visit our Pressure Sore FAQ section.

The Primary Causes of Nursing Home Falls

Injuries Sustained in Nursing Home Falls

Common Perpetrators of Sexual Violence in Nursing Homes

Signs of Sexual Abuse and When to Act

The Causes of Fractures in Nursing Homes

Most Common Types of Fractures

Use of Chemical and Physical Restraints for Convenience

Multiple Layers of Protection Meant to Prevent Errors

Multiple Medications Increase Risk of Errors

Malnutrition and Dehydration

Decreased organ function

Mental decline and memory loss

Fragile bones, muscle loss, weakness

Swollen and/or bleeding gums

Signs to be aware of include the following.

Dizziness, faintness, or lightheadedness

Dark colored urine

Skin flushing (red in the face)

Why Staff Shortage is a Problem

Drops during Routine Transfers

Transferring from one chair to another

Transferring from or onto the toilet

Transferring from the wheelchair into a bath or shower

Transferring from the bed to the wheelchair or vice versa

When improperly using the Hoyer Lift

Injuries Suffered Due to Drops

Nursing Home Abuse & Neglect Guidebook

Nursing Home Abuse & Neglect Guidebook