Nursing Home Violations Explained 

Nursing home facilities care for one of the most vulnerable populations. This responsibility is why state and federal agencies must investigate, report, and prevent nursing home abuse and neglect. Violations of nursing home standards are well-defined, and they help these agencies and family members track the quality of care in these facilities.

Common Violations Nursing Home Residents Experience

Nursing home residents experience various kinds of violations, including abuse, poor care, medication errors, financial exploitation, rights violations, and unsanitary nursing home conditions.

According to the Centers for Medicare and Medicaid Services (CMS), four levels of harm can come out of these violations:

• No actual harm, with the potential for minimal harm
• No actual harm, with a potential for more than minimal harm
• Actual harm that is not immediate jeopardy
• Immediate jeopardy to resident health or safety

The regulatory body always considers the scope of harm to determine the gravity of the violation. It can involve an isolated incident affecting a few residents, a pattern violation affecting some residents, or a widespread violation affecting many residents.

Neglect

Nursing homes and skilled nursing facilities are often understaffed, which can result in inadequate care and neglect. Nursing home neglect includes:

• Failure to provide adequate food and water
• Failure to provide adequate nursing care and medical treatment
• Inadequate personal hygiene care
• Poor quality of life and care
• Failure to ensure safety from hazards and accidents
• Infection control violations
• Poor mobility care
• Inadequate pain management
• Not training nursing staff appropriately

Abuse

Nursing home abuse can be perpetrated by staff members or other residents. It can involve physical, emotional, and sexual abuse and may be challenging to discover, especially when the victim is scared or in cognitive decline.

Nursing homes have strict procedures for preventing and responding to abuse. These include screening residents and staff, providing adequate supervision, and reporting allegations immediately. If they fail to follow these procedures, they put residents in danger of bodily injury, emotional trauma, and even death.

Medication Errors

Medication errors in nursing home facilities are a significant concern, as elderly residents often rely on multiple medications to manage chronic conditions. The consequences of prescribing or administering the wrong medication can be severe, and they include:

• Health complications
• Increased hospitalization
• Emotional and psychological harm
• Wrongful death

Nursing facilities must also store medications according to best practices, such as labeling and dating medications, not keeping expired medications with unexpired ones, and storing controlled substances safely.

Financial Exploitation

Financial exploitation of vulnerable residents can include caregivers, other residents, or even family members. Common forms of economic exploitation include theft of belongings or money, unauthorized access to bank accounts, manipulation of legal documents such as wills, and overcharging for services.

Unsanitary Conditions

When it comes to hygiene, regulatory compliance is key to protecting resident health and safety. The elderly population is often more vulnerable to infections, and the consequences can be more difficult to treat. Nursing homes must prevent the spread of diseases, control antibiotic-resistant bacteria, and keep their residents’ environments comfortable and clean. 

The Centers for Medicare & Medicaid Services (CMS) sets standards for cleanliness and sanitation in nursing homes. Facilities that fail to meet these standards risk fines, penalties, and legal action if their lack of hygiene leads to harm.

Legal Implications of Nursing Home Violations

Nursing home violations are not only unethical but also unlawful. Families have the right to legal assistance if their loved ones suffer any mistreatment in a facility. 

Regulatory Violations

Nursing home violations often violate state and federal regulations designed to protect patients’ safety, health, and rights. 

Federal regulations are set by the CMS, and they cover various aspects, such as patient care standards, facility conditions, and staff qualifications. In addition, each state has its regulations governing nursing homes. In most cases, the state Department of Health manages nursing home compliance. 

If violations are discovered during a regular inspection or after a complaint, enforcement actions can include a monetary fine, sanctions, and license suspension or revocation.

Liability

Nursing home liability refers to the facility’s legal responsibility to provide adequate care for its residents. If a facility failed to provide adequate care and it resulted in injury or death, the facility, management, or negligent staff can be liable for negligence.

Resident Rights

Each resident has the right to adequate, dignified, and professional care. These rights include:

• Right to quality care
• Right to safety and protection
• Right to privacy and dignity
• Right to make decisions
• Right to redress (complain without retaliation)
• Right to family and community involvement

Reporting Violations in Nursing Homes

If you want to file a complaint against the facility, you have several pathways, including state agencies, federal agencies, and the facility itself. We will explain how to report violations in all three cases.

State Survey Agencies

State agencies are generally part of a larger state government body, such as the Department of Health or the Department of Aging. Their responsibilities include enforcing regulations, conducting inspections, and ensuring nursing homes comply with state and federal standards to protect resident rights and well-being.

A state survey agency investigates nursing home complaints by conducting unannounced inspections, visiting the facility, and reviewing its records. If the agency discovers violations, it may issue citations, impose fines, and create a correction plan for each violation in the report. 

The agency may also publish the report for public transparency. Most Department of Health websites list a phone number that you can call to report an issue.

Federal Agencies

Federal agencies, like the Centers for Medicare & Medicaid Services (CMS), oversee nursing homes by setting national standards for care and safety. CMS monitors compliance with these standards, conducts audits, and provides funding through Medicare and Medicaid.

The CMS publishes detailed reports and ratings for each nursing home. For additional information, contact your state survey agency, which collaborates with CMS to oversee nursing homes.

Directly to the Nursing Home

Residents and their families can report violations directly to the facility by speaking to its management, documenting all issues, and following its official reporting procedure (usually detailed in the resident handbook). The facility may resolve the problem immediately. 

When filing a complaint, always ask for written responses and acknowledgment. However, if you suspect you or a loved one is in immediate harm, call 911.

The Role of a Nursing Home Violation Lawyer

Nursing homes are responsible for protecting resident rights and maintaining the quality of the care provided. When they fail to do so, a nursing home violation lawyer can help families address the violations and protect their loved ones.

Legal Representation

In severe violations or injuries, lawyers can file complaints or lawsuits seeking compensation for harm, including medical expenses and pain and suffering. If the negotiations with the facility’s insurance company are unsatisfactory, a lawyer can represent you in court. 

A specialized lawyer will have plenty of experience with nursing home violations, ensuring your case is handled professionally and skillfully, increasing your chances of success. 

Advocacy

A lawyer can advocate for residents’ rights by providing legal expertise and ensuring that their needs are met. They can also hold the nursing home responsible for substandard care and empower residents and their loved ones to speak up and uphold resident rights.

Investigating Allegations

Lawyers investigate claims of mistreatment by gathering evidence, reviewing medical records, and interviewing witnesses to build a strong case and determine the best course of action. They may also collect subpoena documents, coordinate with state agencies, and use forensic accounting to support the allegations and advocate for residents’ rights.

Contact a Nursing Home Violation Lawyer Today! 

If you or a loved one have concerns about nursing home violations, don’t hesitate to seek legal help. Also, if you suspect actual harm, you must act immediately to protect the vulnerable resident. 

Nursing Home Law Center can help you file complaints, gather evidence, and even pursue compensation. Call (800) 926-7565 for a free consultation about your case, or complete our contact form.