Nursing Homes Abuse Blog - By Jonathan Rosenfeld

Ray Mullman at the South Carolina Nursing Home Blog recently wrote about one of the most progressive piece of legislation passed in years-- the mandatory use of pressure relieving mattresses in New Jersey Nursing Homes to help prevent the development of bedsores.

Unlike normal spring-filled mattresses, pressure relieving mattresses steadily inflate and deflate to reduce the amount of pressure and friction put on bony parts of the body prone that are prone skin break-drown and ultimately development of bedsores (also referred to as: pressure sores, pressure ulcers or decubitus ulcers). 

Under the terms of Bill S-1517, nursing home operators must to switch from regular mattresses to pressure-relief mattresses within three years. Nursing home owners would have one year from the bills enactment to begin phasing in the use of pressure relieving mattresses.

“While pressure redistribution mattresses may cost more up front than the standard spring mattresses, we cannot put a price on the continued health and wellness of our state's most vulnerable senior citizens,” said bill co-sponsor Sen. Bob Gordon (D-Bergen). “While these new mattresses alone won't make bed sores an ailment of the past, they will greatly reduce the incidence of bed sores, and make their treatment much easier on the dedicated nursing home staff.”

Bedsores continue to be a devastating problem for many nursing home and hospital residents.  If this law proves effective in New Jersey, it will be interesting to see if other states, or even Medicare, passes similar legislation.

Bed Sores In Nursing Homes

Government Report Confirms Pressure Ulcers Harm All Nursing Home Residents; Regardless Of Race, Sex or Age

Over 500,000 Adults Suffer From Bed Sores In Hospitals

Nursing Home Injury Laws: New Jersey

Pressure Sore Video

Rosenfeld Injury Lawyers has experieced bedsore lawyers who can answer yor questions.  Contact us for a free, confidential consultation.  We can help.

The Illinois Department of Public Health recently revealed the list of nursing homes in Illinois have violations in the fourth quarter of 2008.  A nursing home's name on the list indicates that the Illinois Department of Public Health has initiated action against the following facilities which have been determined to be in violation of the Nursing Home Care Act, or has recommended decertification to the Director of the Illinois Department of Healthcare and Family Services, or the Secretary of the U.S. Department of Health and Human Services for violations in relation to patient care, pursuant to Titles XVIII and XIX of the Social Security Act.

A closer look of the 43 Illinois Nursing Homes on the list reveals many of the facilities are repeat customers and are relatively evenly dispersed around the State of Illinois.  The average Medicare star rating for the facilities is just 1.72 out of a possible 5 stars when looking at each facilities overall rating. Put another way, these facilities poor ratings are well deserved.

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Wrestling legend Verne Gagne, a former professional wrestler, still has some of his moves that made for a successful career in college wrestling, professional wrestling and professional football.  Unfortunately, the wrestling moves have no place in an Alzheimer's unit at Friendship Village Nursing Home.  Recently, Gagne threw down his roommate, Helmut Gutman, resulting in a broken leg and closed-closed head injury.  Several days later, Gutman died from complications related to his injuries.

This incident demonstrates the necessity of nursing home staff to closely monitor Alzheimer's and dementia patients and potentially intervene if the residents pose harm to themselves or others.  It is common for many people suffering from late stage Alzheimer's to act violently and out of character as their disease progresses.  Nursing home employees should quickly intervene when they see a resident begin acting more aggressively and redirect the person even isolate them temporarily.

A case case of horrific nursing home neglect (perhaps more accurately nursing home abuse) has been reported in New Mexico.  The owner of an Albuquerque Nursing Home, has been found guilty of in the death of resident who was left sitting on top of a bedpan for more than 24-hours. 

The incident occurred on Christmas day, 2005, when the owner of the facility placed the bedpan under 76-year-old Richard Gerhardt and disappeared.  Gerhardt was bed-bound at the time because he was recovering from a broken hip.  By the time the incident had been discovered, the bedpan had become embedded in Gerhardt's skin.  An open wound soon developed and became infected that ultimately led to his death five days later.

The nursing home faces a possible $5,000 fine and/or loss of federal funding (Medicare).  “Nursing home[s] and care facilities are paid to provide round the clock care to those who cannot care for themselves… Protecting this population is of paramount importance to the New Mexico attorney general and similar violations will be prosecuted vigorously,” said Elizabeth Staley, director of the New Mexico attorney general Elder Abuse and Medicaid Fraud Division.  Read more about this incident involving the death of nursing home resident here.

Sentencing for the case is set for March 13.

Related Article

Nursing Home Owner Convicted in Bedpan Death
2009-02-22 05:40:37 (GMT) (WiredPRNews.com - Law, News)

New information has come to light regarding the death of the 89-year-old woman who froze to death just a short distance from The Arbor, a Chicago-area nursing home.  Perhaps the most disturbing aspect of this matter was a 'cover-up' of the death by nursing home staff that was quickly detected by local police.  Quite obviously, the staff tried to cover up the woman's elopement and subsequent death from exposure to make it look like she died from natural causes.

Officers arrived at The Arbor to investigation a report of an 'unresponsive resident'.  Staff at the Arbor told the officers the woman died while sleeping in her bed.  Immediately officers became suspicious of the staffs' claim when they noticed the woman was covered in layers of blankets and was in a hospital gown as opposed to pajamas.  Additionally, despite the fact that the woman was in a warm room, her body was cold to the touch.

The nine Arbor employees on duty at the time the woman died gave conflicting accounts of the events leading to her death.  Some employees told the police that the woman was fine and sleeping in her bed during a 3 a.m. well-being check, but detectives later learned that check never occurred.  The investigation also revealed an employee heard an alarm to an outside door, yet only gave a cursory glance because she was so caught up with an episode of "Dog the Bounty Hunter" on television.

After investigating this nursing home death, authorities believe The Arbor staff panicked after finding the resident outside shortly after a 5 a.m. well-being check, and then some of them conspired to try to make it look like she died naturally while asleep in her bed.

At least four employees - all nurses or nursing assistants - may either be charged or asked to cooperate as witnesses, sources said. They range in age from 30 to 57 and live throughout the Chicago area.

It will be up to the DuPage County State's Attorney Joseph Birkett, as to whether criminal charges will be brought.  Possible charges include obstructing justice for lying to police. The employee who failed that morning to investigate the alarm while watching television may face the most serious allegation of criminal neglect. No one is expected to be charged with murder.

The woman's family is has filed a wrongful death lawsuit against The Arbor for this preventable death.  With the new information revealed surrounding this nursing home death, it will be interesting to see if this facility will face punitive damages for the criminal acts of their employees. No word yet as to if the the facility disciplined the employees involved in this matter.

Read more the cover-up of this nursing home death here.

Related Nursing Home Abuse Blog Entries:

Criminal Charges May Be Brought Against Chicago-Area Nursing Home In Connection to Resident's Death

More than 20 years after Congress passed the the 1987 nursing home regulatory law (OBRA) which granted nursing home residents the "right to be free" restraints for discipline or staff convenience--much progress needs to be made to accomplish that goal.

Once widely thought to prevent nursing home residents from falling and wandering off, the use of physical restraints is not nearly as common in most nursing homes. According to a recent USA Today article, the use of physical restraints amongst nursing home residents has been drastically reduced over the past 20 years.  Medicare statistics verify 21.1% of residents were restrained on a daily basis in 1991 compared to just 5.5% in 2007, the most recent full-year set of statistics available. 

'Restraints' are generally known as any device used to prevent a resident from wandering or falling, or residents who may be easily agitated (due to uncontrolled pain).  The most commonly used restraints used in the nursing home setting are bed rails and geri-chairs. However, nursing homes have been be known to use make-shift 'tie downs' thereby securing residents to beds, benches, dining chairs and even toilets.

While the use of restraints may seem like a way of controlling a resident from harm themselves, studies have shown that restraint usage causes muscles to atrophy and result in residents actually becoming reliant upon the restraints for support when sitting or walking.  The psychological consequences of restraints are also a problem encountered in nursing homes.  According to Dianne Snyder, of Thornwald Home--  a restraint-free nursing home in Pennsylvania, "They experience some anguish.  You kind of break their spirit.  They give up."

Situations involving injury or death with the use of restraints are more common than most would like to believe.  If a resident is left unattended with restraints in place, they can become tangled in straps resulting in strangulation or broken limb.

Is it possible to ban the use of restraints in nursing homes?

There will always be residents are some facilities who require the use of physical restraints to protect them from harming themselves.  However, there is ample room for further reduction.  For example, Pennsylvania a voluntary program to ban the use of restraints of which more than 90% of the state's nursing homes participate, has reduced the use of restraints to just 2.8% of residents last year.

Like everything in the nursing home, the quality of care provided to residents is a reflection of the training provided to the staff.  Staff intervention is essential to identify those who may be predisposed to falling or wandering from the facility.  Fall prevention techniques such as: padded floors, non-slip chairs, adjustable beds and socks with traction may quickly reduce the number of residents who require the use of restraints.  Nursing homes must "educate, educate, educate" according to Snyder. "Not only the staff, but also residents, families and physicians."

Related Nursing Home Abuse Blog Posts On Restraints

Warnings Do Little To Prevent Bed Rail Entrapment

How Much Freedom Should Assisted Living Facilities Give The Mentally Disabled?

Web Resources On Restraints

Report: "Freedom from Unnecessary Physical Restraints: Two Decades of National Progress in Nursing Home Care" 

SAFETY WITHOUT RESTRAINTS, A New Practice Standard for Safe Care, Minnesota Department of Health

The Minnesota Department of Health released an investigative report concluding a resident of Presbyterian Homes of Arden Hills Nursing Home sustained a broken neck due to a fall or other trauma at the facility.  The investigation follows the death of 91-year-old Gladys Gall, a resident at the facility.  Despite the fact no federal or state nursing home violations were identified, investigators still determined there was ample circumstantial evidence to conclude the nursing home was at fault in the injury and subsequent death of Gall. 

On April 18, 2008 Gall was admitted to an emergency room after complaining of head and neck pain.  A CT scan confirmed Gall's pain was related to a cervical fracture. On April 28th, Gall died from complications related to the cervical fracture.

Gall was likely as high fall risk due to memory loss and advanced osteoporosis.  Gall required assistance from nursing home staff for most daily living activities.

Investigators interviewed both Gall's family as well as staff at Arden Hills in attempting to determine the cause of Gall's broken neck.  Additionally, a neurosurgeon was consulted for the state's investigation and verified Gall suffered a hangman's fracture.  Further, the neurosurgeon opined the severity of the hangman's fracture could not have occurred without trauma.  Although no specific traumatic event could be identified as the culprit of the injury, three conclusions were reached in the report:

• Gall's death was related to her cervical fracture
• The neck fracture was related to a violent incident or fall
• Someone at the nursing home was aware of what happened to Gall because she would have been unable to pick herself up following her type of injury

Nursing home officials dispute the state's findings, pointing out the findings were not related to any specific event involving nursing home abuse or maltreatment nor can the report rule out an accident. Read more about this cervical fracture of a Minnesota nursing home resident here.

Nursing Home Falls

Falls are one of the most common sources of injuries amongst nursing home residents.  Despite, claims by nursing home officials that some falls are 'unpreventable', steps can be taken to minimize the risk of falls and related injuries;

• Identify residents who may be at risk of falling
• Provide adequate staffing to assist residents with transfers, toileting and general mobility
• Remove clutter from the floors
• Encourage residents to use asistive devices
• Minimize the use of medications that can alter blood pressure

Related Nursing Home Abuse Blog Posts On Falls

$50,000 Penalty Sought Against Nursing Home Where Resident Fell To Her Death

Falls Amongst The Elderly Can't Be Ignored

Hip Fractures And Some Unsettling Statistics

Study Links Medication Use With Falls

Web Resource On Hangman's Fracture

Traumatic Spondylolisthesis of the Axis (Hangman's Fracture), Medscape Today

Days after the Chicago Tribune ran an investigative piece on Berwyn Rehabilitation Center, a new inspection report was released by the Illinois Department of Health demonstrating that the facility has a long way to go to improve conditions at the facility.  In an unannounced visit to the facility, state inspectors found six violations relating to nursing home care.  Among the conditions discovered by inspectors and cited in their report:

• A resident with "a long reddened area" on the right cheek who received no attention from the staff four hours after a nursing home inspector brought the condition to the staff's attention
• The staff failed to inspect and treat open wounds.  Inspectors noted a large sore on the side of a woman's mouth with dried blood, yet there was no intervention by the staff.
• Faulty equipment.  For 10 days a  mechanical lift used to transport residents from their beds was not working.  Consequently, residents sat in their beds without being moved or showers for up to 10 days.
• Improper administration of medication.  There were reports of the staff failing to provide pain medication as ordered by physicians and failing to timely administer medication.

A quick glance at the just the number of citations issued to Berwyn Rehabilitation Center, may appear as though the facility is making significant improvements.  Compared to a similar unannounced visit last year, when the facility had 29 violations-- six violations this time around seems pretty good.  The reality is that the violations against this facility are not minor.  The violations indicate the staff at this facility is still not focused on correcting potentially dangerous conditions. Any of the above conditions cited to in the inspectors' reports could prove life threatening if left unremedied.

Berwyn Rehabilitation Center is a for-profit nursing home located at 3601 South Harlem Avenue. The Centers for Medicare have rated the facility one-star out of a possible five.  The facility is owned by Eric Rothner, a manager of Berwyn Rehabilitation, LLC.

Related News Article On Berwyn Rehabilitation Center

New Violations Alleged At Troubled Berwyn Nursing Home, Chicago Tribune, February 10, 2009

Related Nursing Home Abuse Blog Entries

What Is It Like To Live In a One-Starred Nursing Home?

Nursing Homes Notified Of Their 'Five Star' Ratings Today

Nursing Home Rating System Reveals Inferior Care Provided At For-Profit Facilities

Investigators from the Itasca Police Department and the Illinois Department of Public Health are looking into the recent death of an Alzheimer's resident in a Chicagoland nursing home.  Sara Wentworth, an 89-year-old woman was found death a short distance from door at the The Arbor of Itasca.  Nursing home records indicate that personnel had last checked on the woman at 3 a.m. and area police were notified at 5:40 a.m. when the patient was lying on a gurney not breathing. 

DuPage County Coroner Peter Siekmann said Wentworth had been outside for at least 90 minutes before a nursing home worker found her and brought her back inside. Nursing home workers told police they heard an alarm sounding from a door leading to the courtyard.  However, when staff attempted to look into the situation, they did not see did not take any further action.

Wentworth's daughter, Catherine Shain, said police had told her that her mother had gotten through two sets of doors and walked about 100 yards to the area where her body was found.  Despite the fact Wentworth required a walker to get around, no walker was found by her body.

The DuPage County, Illinois State's Attorney's office will evaluate the evidence surrounding this matter and determine if criminal charges are warranted against the nursing home or individual employees. Read more about the death of this Chicago-area nursing home resident here.

How can a nursing home worker can ignore door alarm?  This really is no different that a worker ignoring a call light or an alarm on a ventilator.  This act goes beyond negligence and certainly reaches the level of a willful disregard for the safety of residents.  No word yet on any disciplinary action taken against the lazy nursing home employee(s)....

Read more about the death of this Chicago-area nursing home resident here.

Related Nursing Home Abuse Blog Posts

Man Wanders 20 Ft. From Chicago Nursing Home To His Death

Nursing Home Negligence Lawsuit Brought After Man Wanders From Facility

Elopement

Well, according to the investigative article by Sam Roe in yesterday's Chicago Tribune-- pretty miserable.  Roe's article details Berwyn Rehabilitation Center, a nursing home in the Chicago-area, that received one-star in every major category according to the Medicare rating system.  The article demonstrates that although nursing homes must meet certain criteria set by the federal government, some nursing homes are doing little more than absolutely necessary to remain eligible for federal funds.

Since December, the federal government has begun posting on-line ratings on all nursing homes.  Nursing homes receive a star rating in four categories on a scale of one to five, including overall quality according to information obtained via inspections and from the operators of the nursing homes. 

The Medicare rating system of rating nursing homes has been criticized by the nursing home as being superficial and arbitrary because Medicare does not disclose its formula used to calculate the ratings.  Nonetheless, information obtained via a Freedom of Information Act verifies the dismal living conditions at Berwyn Rehabilitation Center.

A recent state inspection of the Berwyn nursing home resulted in 29 violations relating to resident safety and care.  The nursing home inspectors documented clear instances of nursing home abuse and neglect.  Among the more disturbing findings:

• Bedsores on the buttocks of incontinent residents
• Unexplained bruising on the arms and legs of residents
• Staff allowing residents to sit in their own feces for hours on end
• Staff failing to administer medication to control residents' pain
• Staff failing to clean catheter tubing
• Staff failing to change dressings on wounds resulting in rapid development of pressure sores
• The inappropriate use of bed rails--using bed rails that did not fit on the bed and with residents that had no orders for their use

"This nursing home was really bad," according to Anjanette Miller, the new director of nursing at the Berwyn facility.  Miller cites staffing problems as a contributing factor in the poor care.  Workers "were punching in and doing nothing," she added.  In an effort to turn things around the facility has fired the bad workers and has been under new management.

Nonetheless, problems at Berwyn Rehabilitation Center persist.  In May, a resident became trapped between his inflatable mattress and the side rails of his bed.  A Cook County medical examiner concluded he suffocated due to entrapment.  An investigation into his death revealed the facility was using improperly fitted rails that were arbitrarily replaced by a nursing home employee shortly before his death. 

Clearly, this nursing home needs a lot more change.

Related Chicago Tribune Resources For Nursing Homes:

Five tips on how to check a nursing home

Chicagolands nursing homes

After ignoring two bench warrants and months on the run, Pennsylvania authorities have captured Henrietta Sprual, an self-admitted elder abuser.  Sprual pleaded guilty to multiple charges of elder abuse including: simple assault, recklessly endangering another person, possession of and instrument of crime and making false statements to authorities in connection to an incident where she beat an Alzheimer's patient she was responsible for caring for at the Arden Court assisted living facility.

An investigation into the incident revealed Sprual struck the elderly man six to eight times with a belt. Prosecutors have photographs of the man's bruises on his arms, elbow, shoulder, knee and thigh.  The bruises were so severe, an imprint of the buckle could be seen.

Sprual's confession comes after she told authorities the man found the belt in the nurses station and was 'out of control' swinging the belt around and striking himself.  A forensic pathologist advised authorities that the man's injuries were not self-inflicted and it was obvious force was used to inflict them.

"I'll know where you are now," Montgomery County President Judge Richard J. Hodgson told Sprual as he revoked her bail and ordered her held in jail until the sentencing hearing.  Sprual faces a possible sentence of three to seven years in prison.  

Photographing Nursing Home Injuries

This case highlights the importance of taking photographs as soon as feasible of both the injured person as well as any injury causing instrumentality.  Many times nursing home residents are physically unable to describe a situation involving nursing home abuse or nursing home neglect. Photographing the injury provides valuable evidence for both criminal and civil cases.

Related Articles

Convicted Elder Abuser Captured By Authorities, The Times Herald, February 4, 2009

Woman Accused Of Beating Elderly Man Skips Court ... Again, The Reporter, February 1, 2009

Residents in assisted living facilities are very much on their own with respect to receiving help from CMS as to the quality of their facility.  As we've discussed, nursing homes are subjected to a centralized rating system that provides consumers with information on both an overall rating of the facility as well as ratings in critical areas such as: staffing levels, inspection ratings and quality measures (such as the incidence of pressure sores amongst residents, amongst other factors) on a five star rating scale.

As the Charleston Post and Courrier reports, no federal rating system exists for assisted living facilities, home to many elderly people.  Some states have instituted their own rating systems for the facilities, but in most areas of the country people are on their own to do their own evaluation of the facility.

What is an assisted living facility?  Assisted living facilities, licensed as community residential care facilities, are different from nursing homes. Assisted living residents need help with a few activities, such as taking their medicine, dressing or cleaning, but do not require the higher level of medical care nursing homes offer.

Despite the differences between assisted living facilities and nursing homes, many of the problems remain the same.  Problems facing assisted living residents can range from serious allegations of abuse and neglect  to dinner being served late. 

The Post Courrier article chronicles the issues faced by Sandra Belaja, a resident of Palmetto Residential Care Facility-- a South Carolina assisted living facility.  Belaja entered Palmetto for assistance with her daily living needs as well as for help with administration of medication after a hospitalization.  

According to Belaja, the care she received at Palmetto was so poor that she was forced to move out of the assisted living facility and into a nearby hotel where hospice workers monitored her well being.  Belaja says she moved into the hotel because residents at Palmetto often went without toilet paper and soap in the common bathroom, which had two toilets for 12 people, she said. And she said that when the heating broke, the oven was used to keep residents warm

The poor living conditions were verified by the South Carolina Department of Health and Environmental Control (DHEC) during an inspection of the facility.  In October 2006, the authority issued a letter to suspend Palmetto's license. In July 2007, however, DHEC lifted the suspension because the facility complied with standards.

Jerry Paul, former DHEC director of regulations, said closure of assisted living facilities is hard. "With the administrative law system, you're looking at long periods of time with a facility out of compliance that can operate. You really have to have horrendous goings on at a facility before you can close one down," he said.

In most states the only way to access information on assisted living facilities is to file a Freedom of Information Act request with state health officials.  Obviously, for a family faced with the stress of placing loved one in a care facility due to immediate care needs this is not practical.  Although a wealth of information may be obtained on nursing homes via the internet, no centralized database exists to access valuable information on assisted living facilities.

Why is this acceptable?  Why does our society treat millions of assisted living residents like second hand citizens?

Related Nursing Home Abuse Blog Entries:

Assisted Living Facility Lets Resident Walk Out Door and Into Semi

How Much Freedom Should An Assisted Living Facility Give the Mentally Disabled?

Attorney General Lays Out Guidelines For Selection of Nursing Homes & Assisted Living Facilities

Hip fractures are one of the most common problems affecting nursing home residents.  As we age our bones thin and become more brittle increasing the likelihood of a sustaining a hip fracture due to a fall or being dropped by nursing home staff. Most hip fractures require surgical repair when the hip joint is actually replaced with hardware. Here is a useful step-by-step explanation of how a hip replacement surgery is done.

Prevention of falls should be a priority in all nursing homes.  To minimize the risk of falls the following fall prevention measures should be taken.

• Remove clutter from floor
• Remove improperly fitting slippers and other clothing
• Keep bed rails up when patients are sleeping
• Provide adequate staff and equipment when transferring into and out of bed
• Install handrails in areas where patients need stability
• Keep call lights within reach of residents in bed at all times.  Residents can request assistance easily.
• Lock wheels on wheelchairs and beds when transferring patients
• Monitor patients with low blood pressure

If a loved one sustained a fractured hip or femur during a stay at a nursing home, it may be due to the negligence of the facility.  Our office can work with you and determine if you have a viable cause of action.  Speak to an experienced nursing home attorney anytime. (888) 424-5757

Past Nursing Home Abuse Blog Articles on falls:

Never Event #1: Hospital falls & Trauma

Improper Transfer Leads To Fall & Untimely Death of Rehab Patient

Study Links Medication Use With Falls

Most people probably haven't heard of ombudsmen, but mention it to a group of nursing home residents and you will likely see smiles come to their faces.  Ombudsmen are advocates for nursing home residents who are too old or too frail to speak for themselves.  Ombudsmen ensure nursing homes are providing adequate care to residents and attempt to resolve any violations.

The Dallas Morning News had an article on the role ombudsmen have in protecting Texas nursing home residents.  The Senior Source, a non-profit agency that runs the Texas long-term ombudsman program in Dallas, sends ombudsmen to 63 nursing homes on a monthly basis and to 160 assisted-living communities at least twice a year.

In 2008, Senior Source's ombudsmen received 8,600 complaints about nursing homes and 600 complaints about assisted living communities in Dallas County.  Many of the complaints are made by residents in the facilities, but the agency will not send an ombudsman to investigate without the permission of the resident.  When complaints are investigated, the names of the complainants are not revealed to the facilities to assure there is no retaliation against the individual.  

The ombudsman's presence in the nursing home actually is welcomed by many nursing home administrators who are appreciative of the opportunity to correct problems identified by ombudsman before they make their way into state investigators reports.  

'I know the ombudsman her here as an advocate for the residents, but she's also a resource for us because she brings another set of eyes and ears to our place and helps us  catch problems early," said Jeff Moffitt, executive director of Traymore Nursing Canter in Dallas, Texas.

While serious deficiencies or neglect  in nursing homes get turned over to the Texas Department of Aging and Disability Services, Ombudsman's actions still have an important impact on improving the quality of life for many nursing home residents.

Leander Boone, has been in Dallas nursing homes since 2005 when he suffered a stroke, had made multiple complaints to the staff at his nursing home about a broken bed without any resolution. Things changed when he got an ombudsman involved, 'The next day, the staff brought a new bed, and I could finally sit up," Boone said.  "Nursing homes probably mean well, but you have to keep them on their toes.  Otherwise, they're forgetful. Without an ombudsman, I'd be lost," he added.

If you have questions or would like to volunteer as a Dallas Nursing Home Ombudsman, call 1-800-252-2412.

Most common nursing home complaints to ombudsmen:

• The staff doesn't respond to call lights
• The staff is rude
• Food is cold or bland
• The building is in disrepair
• The staff doesn't give medication properly

Related articles on ombudsmen

Where To Report Elder Abuse

Ombudsmen In Nursing Homes