Lawsuits Spotlight Widespread Abuse of Nursing Home Residents

Posted April 2, 2012 in Elder Law by Courtney Sherwood

Two lawsuits against Illinois nursing homes are shining a light on a national problem: abuse of residents unable to care for themselves.

One in three nursing home residents, or more than 1 million Americans, have experienced some level of abuse. Staff are not the only ones to blame. Sometimes other residents can be the abusers.

William Kahle, a 47-year-old mentally impaired man, was allegedly burned with a cigarette by another resident at Hillcrest Nursing and Rehabilitation Center. His nursing home never reported the incident to authorities, but Kahle’s father found burn marks and reported them to the Illinois Department of Public Health. That triggered an investigation that uncovered 23 other incidents of patient-on-patient sexual or mental abuse at Hillcrest.

For Anibal Calderon, an 80-year-old Alzheimer’s patient at Oak Park Healthcare Center, a neighbor’s bad behavior did not come to light until it was too late. That 66-year-old resident, who had a violent criminal record, beat Calderon severely, resulting in the brain injury that killed him two days later. A medical examiner ruled the death a homicide.

Though residents, not nursing home staff, were responsible for injuries in each case, Kahle’s and Calderon’s families are holding their care facilities liable.  Kahle’s family filed suit March 20 against Hillcrest for allegedly maintaining a dangerous environment, failing to properly monitor residents with known violent backgrounds, not reporting abuse when it happened, and failing to implement policies to prevent incidents like this. And in February Calderon’s family  sued Oak Park, claiming the nursing home failed to protect residents from abuse and neglect and that it hired too few staff.

Though resident-on-resident violence is less common than other forms of nursing home abuse, these recent headlines highlight the importance of researching care facilities before choosing one for a loved one, and of remaining alert to warning signs after your family member moves in, said attorney Gabe Miller, general counsel with Sokolove Law and a longtime volunteer at a Massachusetts nursing home.

“It’s up to the nursing home to provide a safe environment for residents,” Miller said. “This is just a different form of neglect.”


Finding good care

Attorney Gabe Miller

Family members may be surprised to learn just how lax federal laws governing nursing home disclosures are. Though states can set stricter rules, federal law does not require care facilities to conduct background checks on residents or to disclose problems related to those residents. Illinois is a among the states that have set stricter rules, requiring homes to identify residents who are registered sex offenders and felons on probation or parole. But even those requirements won’t identify non-sex offender felons who have served their time. Ultimately, responsibility for checking out a nursing home rests with families and residents , who cannot always count on getting full information from a home. 

If a loved one may need nursing care soon, Miller advises researchers to start by searching for a nursing home’s name into Google to see if negative news reports pop up. Next ask the agency that oversees nursing homes in your state if there have been any recent violations, and confirm that the home is licensed.

Once you’ve done your own research, then ask officials at the home the same questions. Checking a nursing home’s answers against your research will do more than prove the honesty of its staff – it will give you a feel for how they think about their work, Miller said. “Are they defensive when you ask them if there have been complaints, or what their process is for dealing with complaints? Do they come across as credible? Trust, but verify.”

If you like what you’ve learned so far, it’s time to spend more time around the residents. Often, you’ll be encouraged to schedule an appointment and head directly to staff offices, but don’t let that be your only experience visiting the place.

“A nursing home that doesn’t provide good care may try to get you in during a slow time,” Miller said. “I recommend that you visit the nursing home more than once, especially if they want you to come at a particular time. Try to make a not-scheduled visit and ask if someone can walk you around a bit. If they are defensive, that’s a problem.” Meal times are often busy and can give you a feel for how well-staffed a residential care facility may be.

There’s no national standard for nursing home staffing, but a Kaiser Family Foundation report found that these facilities should pay for a minimum of two hours and 45 minutes of support staff per resident per day, and ideally staffing should be much higher.

Rather than worry about a staffing formula, you can get a feel for how well-run a nursing home is by getting to know it and trusting your instincts, Miller said. “Does it look clean? Does it look well managed? Do the residents look happy? People need to trust their instincts.”


Addressing problems with a loved one’s care

Once your loved one moves in, you should still be vigilant to make sure he or she receives adequate care.

Watch for signs of physical neglect, like bed sores or unusual bruising, and pay attention to other aspects of your loved one’s physical condition, Miller said. Dry skin and thirst could indicate that a resident is not getting enough water — something nursing home care staff should be trained to watch for. Slower-than-normal mental response times could mean a resident has been over-medicated.

“Look for poor hygiene, too,” Miller said. “Is the person in clean clothes, hair combed, teeth brushed? Is the bed made? Is there sudden weight loss that’s not explainable by a particular illness?”

Sometimes the warning signs are more subtle. If you can’t visit unless you make an appointment first, or if you aren’t allowed into the room until staff have had a few minutes alone with your loved one, that could be a sign that something is being kept from you, Miller said. “If they don’t allow you to visit with a family member alone, or if the staff seems to hover while you’re visiting, that’s a warning sign.”

It’s also a good idea to watch for unexpected changes in personality. If a loved one becomes withdrawn, angry, depressed or anxious – especially if he or she reacts badly when nursing home staff walk into the room – that is a red flag, Miller said.

If something seems wrong, document it. Take pictures of bruises, make notes of odd behavior. If no staff members stop by during a six-hour visit, write that down along with the date of the visit. Records like these can help later if an issue arises, Miller said.

At the same time, it’s important to keep perspective. Major life changes, like moving into a new residence, can be stressful and lead to anxiety and other behavior even at a well-run nursing home. Alzheimer’s and dementia, not mistreatment, may be to blame for out-of-character behavior. And even in the best-run care center people may and a minor bruise from time to time.

If you’re not sure if you have a case, a lawyer can help you weigh the evidence, Miller said.

Financial concerns should not keep you from picking up the phone. Nursing home abuse cases are nearly always taken on a contingency-fee basis, which means your attorney won’t get paid unless he or she successfully sues. 

If something seems off, it’s best to consult a nursing-home abuse expert early on, Miller said. “I’d much rather tell you that you have nothing to worry about than tell you later that it was horrific and you should have called.”

Got more questions? Here are answers to common concerns about nursing home abuse.

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