Nursing Home Negligence

My name is Ed Smith. And I have over three decades of experience as a Sacramento Nursing Home Negligence Attorney. Abuse or negligence toward an elderly member of your family that is in a nursing home or long-term care facility is a travesty. I have a particular interest in making sure that those who engage in this behavior toward your family member are punished.

If you suspect that an elderly family member has been abused or is being neglected in a Sacramento nursing home, let me help. I will answer your questions and let you know what legal options you have.  Call me at (916) 921-6400 for a free, no-obligation consultation.

In this article:

• California Nursing Home Negligence and Abuse
• We Represent Injuries in Various Health Care Facilities
• Common Errors, Mishaps, and Injuries
• Asking the Right Questions
• Quality Indicators for Long-Stay Residents
• How An Experienced Sacramento Nursing Home Abuse Lawyer Can Help

The incidence of long term care/nursing home abuse in California is growing rapidly. Every day members of our senior population are victimized. If your loved one is a victim of neglect or abuse in a nursing home or residential facility, there are likely other residents at the nursing home who are also being neglected or abused.

In fact, there is probably a continuing pattern of neglect at the facility. In every nursing home negligence case we carefully study the nursing home's history of violations of both federal and state law to determine if there is a pattern of abuse and neglect. We'll also focus on staffing and training deficiencies, which are often the root cause of nursing home injuries.

Nursing home abuse and neglect take a variety of forms: negligent care, physical abuse, sexual abuse, and financial exploitation, just to name a few.

My office specifically represents those suffering serious pressure sores and significant falls, among other injuries. These incidents occur in various health care institutions, including acute and subacute care hospitals.

• Acute care hospitals include facilities conducting surgeries or assisting in crisis management in an effort to stabilize life-threatening conditions.
• Sub-acute care hospitals care for patients with conditions requiring nursing management with high tech equipment or management of chronic illnesses in stable patients. Generally, patients in sub-acute care hospitals are short term stays.
• Intermediate Care Facilities: These facilities conduct goal-oriented rehabilitation with the expectation of discharge within six months. Patients include those with severe disabilities such as brain injury; coma; and neurological disorders.
• Long Term Care Facilities: Patients in long term care facilities (nursing homes) include patients undergoing rehabilitation, those managed for chronic illnesses, permanent disabilities or poor rehabilitation prognosis, patients with cognitive deficits, or those otherwise requiring specific care such as our elderly family members.

Common errors, mishaps, and root causes of injuries in all these facilities include:

Errors of Commission - Overt acts that deviate from accepted standards, such as:

• Invasive blunders
• Traumatic transfers
• Administering harmful medication or treatment
• Withholding medication or treatment
• Over-filling the stomach with tube feedings
• Physical abuse

Errors of Omission - Failure to provide services resulting in an adverse event, which include:

• Failure to take a proper history and devise a care plan
• Failure to report changes in clinical condition
• Failure to maintain safety protocols
• Failure to maintain pressure ulcer prevention
• Failure to wash hands between patients
• Failure to make risk assessments
• Failure to maintain adequate nutrition
• Failure to maintain adequate hydration

Common mishaps in these facilities include:

• Falls
• Physical abuse
• Fear
• Depression
• Sexual abuse
• Wandering
• Skin breakdown
• Infection
• Malnutrition
• Dehydration
• Over-filling of stomach and aspiration
• Blood clots in the legs

Common injuries include:

• Head trauma with subdural hematoma
• Fractures of the hips, spine, limbs, and ribs
• Large multiple pressure ulcers with exposure of muscle and bone with infection and necrosis
• Aspiration pneumonia
• Pulmonary emboli
• and Death

It is important to obtain and analyze nursing home records and ask the right questions. For example:

• What contracts and consents exist?
• These must specify facilities obligations and residents’ responsibilities – What are the contractual obligations?
• Advertising – What duties and obligations are implied or expressed in the advertising copy?

We also consider the care plans.

• What care plans exist?
• Are there appropriate nursing diagnoses?
• Is there a stated goal?
• Is there documentation of follow-up?

Skin Integrity should often be documented.

• Is there a Braden form on the chart properly filled out?
• Is the score consistent with the documented clinical condition?
• Is there any documentation of wounds with descriptions of size, odor, drainage, presence of necrosis, etc.?
• Is there a positioning record that shows the length of time spent in each position?

A fall risk assessment should be performed for every patient.

• Is the score consistent with the documented clinical condition?
• If a fall has occurred, what could the nurses have done to prevent the fall?

Regarding laboratory reports:

• Are there any relevant findings?
• What do the lab values say about the patient’s response to a treatment or adverse occurrence?

Regarding radiology reports:

• What are the positive findings?
• What was the reason for getting the X-ray, MRI, or CAT scan?
• What do the findings say about how the incident occurred?

Concerning physicians’ order sheets:

• What are the relevant orders?
• Were the orders picked up?
• Were verbal orders countersigned?
• With antibiotics, were prior cultures ordered?
• Was there a valid order for each nursing action for which orders were required?

An experienced attorney will know to review the Medication Administration Records (MAR).

• Were medications given as ordered?
• Are any doses missing?
• Were all controlled substances accounted for?

An experienced attorney will review nursing assessments.

• What conditions existed at the time of admission?
• Was there a fall-risk assessment?
• Was there a skin integrity assessment?
• A review of the nursing progress notes may indicate:
• Which notes identify departures from accepted standards?
• Are there any hiatuses in the chronology?

Some quality indicators for long stays in nursing homes include:

• Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season.
• Percent of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination.
• Percent of Long-Stay Residents Whose Need for Help With Daily Activities Has Increased.
• Percent of Long-Stay Residents Who Have Moderate to Severe Pain.
• Percent of High-Risk Long-Stay Residents Who Have Pressure Sores.
• Percent of Low-Risk Long-Stay Residents Who Have Pressure Sores.
• Percent of Long-Stay Residents Who Were Physically Restrained.
• Percent of Long-Stay Residents Who are More Depressed or Anxious.
• Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder.
• Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder.
• Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair.
• Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse.
• Percent of Long-Stay Residents With a Urinary Tract Infection.
• Percent of Long-Stay Residents Who Lose Too Much Weight.

Nursing Home Contractual Obligations must include:

• Room and board
• Access to competent medical care as needed
• Assistance with activities of daily living as needed
• Skilled nursing services as needed
• Maintain a safe home-like environment

The signs of elder abuse are often subtle and a senior who is being abused frequently fails to report the abuse.

If your friend or relative has had unexplained injuries, bedsores, a broken hip, or frequent falls, and you are suspicious of elder abuse or nursing home negligence, you may be able to file a personal injury lawsuit including a wrongful death lawsuit if the elder abuse has led to death.

Elder abuse law is complex and changes frequently. Hiring an experienced Sacramento nursing home negligence lawyer can make a big difference.

My law office is a personal injury firm that handles select Sacramento nursing home abuse and elder abuse cases. I am committed to protecting the rights of the elderly and enforcing elder law.

I not only assist Sacramento families, but I also represent nursing home abuse and elder abuse victims, and their families, throughout California.

If you have experienced elder abuse or if a member of your family has been neglected or abused, then why not contact highly experienced Sacramento Nursing Home Abuse Attorneys. Contact me online or call me at 916.921.6400 or 800.404.5400 for free, friendly advice.

We are members of the Million Dollar Advocates Forum and the National Association of Distinguished Counsel.

See our client reviews on Avvo, Google, and Yelp, and our past cases on our Verdicts and Settlements page.

Editor’s Note: This page has been updated for accuracy and relevancy [cha 9.28.20]