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Nursing Home Abuse

Officials reported that nursing homes with too low a ratio of employees to patients are significantly more likely to experience quality-of-care problems, thus endangering the safety or health of residents.  As a result, they are strongly recommending strict new rules to require thousands of understaffed nursing homes to hire more nurses and health aides.  That's good news for all Americans who have elderly loved ones under such care, however, Federal recommendations notwithstanding, nursing homes have a long way to go. 

In response to reports of widespread neglect and abuse in nursing homes in the 1980's, Congress enacted legislation in 1987 to require nursing homes participating in the Medicare and Medicaid programs to comply with certain requirements for quality of care.  This law is known as the Nursing Home Reform Act and provides that nursing homes that receive federal funds must comply with federal legislation that calls for a high quality of care.  To participate in the Medicare and Medicaid programs, nursing homes must be in compliance with the federal requirements for long term care facilities as prescribed in the U.S. Code of Federal Regulations.  

Federal and State statutes normally require a facility to follow a standardized method of care for a patient or resident.  These include a proper assessment of the patient including the resident's risk of injury, and the development of a proper plan of care.  Once the plan is developed, it must be put into place and implemented.  However, once a plan is chosen, the facility must continue to update the plan due to changes in the resident's condition and functional levels.

In addition, the facility should continue to report and monitor "incident' involving the patient.  These may include falls or other injuries as well as alleged violations of mistreatment or neglect.

Under the regulations homes must implement and follow guidelines and regulations to prevent the following:

  1. Falls-In a survey of nursing home residents, an average of 43% of patients fall each year.  The rate is so alarmingly high that Federal and State statutes have been written to deal with the problem.  Falls basically result with the tragic result such as fractures that lead to loss of mobility, decreased qualify of life, as well as death.   Accidents involving falls usually arise out of poor quality of care and neglect.  Hip fractures are the most common fall injury.  25% of these patients die within 6 months of injury, 60% of them have permanently decreased mobility
  2. Pressure Sores and Ulcers- Decreased mobility is a major concern of pressure ulcers, also commonly known as bed sores.  Federal nursing home regulations require the prevention of pressure sores and, if they develop, the proper treatment to care and heal them.  Residents that have one or more of the following may have higher risk factors: incontinence, peripheral vascular disease, diabetes, para or quadriplegia AND sepsis. The home is required to ensure that residents do not develop pressure sores and, if a resident has pressure sores, provide the necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing.
  3. Develop a comprehensive care plan for each resident.
  4. Prevent the deterioration of a resident's ability to bathe, dress, groom, transfer and ambulate, toilet, eat, and to communicate.
  5. Conduct initially a comprehensive and accurate assessment of each resident's functional capacity.
  6. Have sufficient nursing staff.
  7. Maintain acceptable parameters of nutritional status.
  8. Provide each resident with sufficient fluid intake to maintain proper hydration and health.
  9. Ensure that residents are free of any significant medication errors.


The following are some, but not all the signs of neglect:

  • Open cuts, fractures, welts or bruises
  • Rapid decrease in the patient's condition
  • Change in patient's hygiene
  • Change in patient's behavior or unusual or frequent complaints
  • Unwarranted medication (sedatives or anti-depressants) or use of bed rails or restraints

The problem of nursing home neglect is widespread; the National Citizen's Coalition of Nursing Home Reform (NCCNHR) reports that 97% of nursing homes fail to provide enough staffing to prevent residents from risking such serious medical problems as infections, bed sores, weight loss, functional decline and avoidable hospitalization.

If you or a loved one has suffered from Nursing Home Abuse and Neglect, contact us at 1-866-Flanzig or 1-516-741-8222. You can also e-mail us at for more information on this issue.

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