-Edward, Highland Park, IL

Illinois does not require a specific staff to patient ratio for Illinois nursing home facilities.  The responsibility lies on each facility to determine the staffing needs to meet the needs of its residents.  (Section 300.1230 – Staffing)  The Administrative Code requires that a sufficient number of staff remain on duty for all hours of the day to provide services that meet the total needs of the residents.  (Administrative Code Part 300 – Skilled Nursing and Intermediate Care Facilities Code) 

Staffing is based on the needs of the residents and is determined by determining the number of hours of nursing time each resident needs on each shift of the day.  This determination must be made separately for both licensed and unlicensed nursing personnel.  The number and categories of personnel that should be provided is based on:

• Number of residents
• Amount and kind of care required to meet the needs of all residents at all times
• Size, physical condition, and layout of building including proximity to resident rooms
•  Medical orders (Section 300.1230 – Staffing)

The Skilled Nursing and Intermediate Care Facilities Code provides examples for how to compute staffing needs for a 100 bed Skilled Nursing Facility, based on the considerations listed above (see Resources below). 

The facility must provide the necessary care and services to attain or maintain the highest level of physical, mental, and psychological well-being of the residents.  (Section 300.1210 – General Requirements for Nursing and Personal Care) 

Each facility must have a director of nursing services (DON) who is a registered nurse and is a full-time employee on duty a minimum of 36 hours, four days a week, with at least 50% of their hours scheduled between 7 A.M. and 7 P.M.  In facilities with 100 or more occupied beds, there must also be an assistant director of nursing (ADON), on duty a minimum of 36 hours, four days a week.  For all shifts, there must be a licensed nurse designated as being in charge of nursing services when neither the DON nor the ADON are on duty.  The facility must also have a minimum of one staff member awake and ready at all times.

Resources:

Illinois Nursing Home Care Act

Administrative Code – Part 300 – Skilled Nursing and Intermediate Care Facilities Code

Section 300.1210 – General Requirements for Nursing and Personal Care

Section 300.1230 – Staffing – (p) – Example of Staffing Calculations

A)        Total Minimum Hours of Care Needed

Level of Care	# of Residents		Total Hrs. Needed/Day Per Resident		Total Hrs. Needed/Day Per Facility
Skilled	25	[times]	2.5	=	62.5
General ICF	50	[times]	1.7	=	85.0
Light ICF	25	[times]	1.0	=	25.0
	Total hours needed				172.5

B)        Minimum Total Hours Needed Per Shift

C)        Licensed Nurse Coverage

D)        Licensed Nurses Required

E)         Nurse Aide/Orderly Coverage

F)         Nurse Aides/Orderlies Required

Related Nursing Homes Abuse Blog Entries:

Nurses Admit To Problems At Nursing Homes

High Staff Turnover Rates Plague Most Nursing Homes

A Recipe For Danger: Nursing Shortage Could Reach 1M By 2020 

                                                                                           -Sam, Memphis, TN

After a recent post about a nurse tying a resident to a wheelchair with a bed sheet, I received several emails from concerned people regarding the use of restraints in nursing homes with their loved ones.  Restraints among nursing home residents are only permitted when a physician orders them to protect the resident and with the approval of the resident or his representative.  Federal law prohibits nursing homes from using restraints for the convenience of the facility or as a way of punishing the patient. (Code of Federal Regulations, 483.13(a). 

A restraint is considered to be: "any manual method or physical or mechanical device, material or equipment attached or adjacent to the resident's body that the individual cannot remove easily which restricts freedom of movement or normal access to one's body."  According to this definition, almost all medical equipment found in a nursing home could be used in this capacity to restrain a patient.

Rather than rely on restraint devises, staff in the nursing home should re-direct patients who have a tendency to wander.  If staff are unsuccessful in their attempt to re-direct, they should use electronic devices such as bed / chair alarms to alert them when a patient begins to move from the area where he was sitting / sleeping and the help the staff keep track of his whereabouts.

Compared with the nursing homes of the past, the use of restraints in nursing homes today is relatively uncommon.  Much of the reduction in use of restraints can be credited to studies that have demonstrated that the use of restraints in nursing home patients can be not only de-humanizing, but also downright dangerous.

Restrained nursing home patients are at risk for injury in the following situations when restraints are used:

• Falls
• Pressure ulcer / decubitus ulcer / bed sore
• Strangulation
• Loss of mobility
• Reduction of bone and muscle mass
• Incontinence
• Constipation
• Increased stress

Related:

Nursing Homes Curtail Use Of Physical Restraints With Residents

Nursing Home Sued After Resident Fractures Both Hips In Separate Falls

California Nursing Home Issued Most Severe Citation After Patient Fall And Death

Here are some of the most popular FAQ's:

• How do I get a copy of medical records from a nursing home?

One of the most important steps in determining if a cause of action exists against a nursing home or hospital is to review the medical records. The records will help determine what-- if any-- mistakes were made by the facility in the care of the individual.

Getting medical records from a nursing home, physician or hospital can be a daunting task due to privacy regulations (HIPPA) and misunderstanding of the laws that apply to obtaining the records-- both on the part of the person requesting the records and on the part of the medical facility.

• Who is responsible for deciding whether an assisted living facility can properly care for a resident?

Assisted living facilities are generally governed by state law. In Illinois, assisted living facilities (ALF's) are licensed, regulated, and inspected by the Illinois Department of Health (IDPH). The IDPH ensures that all ALF's in Illinois comply with the provisions of the state Illinois Nursing Home Care Act (210 ILCS 45). IDPH is responsible for the initial licensing and continued re-certification and inspection of the facility.

If a patient feels that his or her resident rights are being violated, a complaint may be filed with IDPH, which may prompt a complaint investigation to ensure that the facility is properly caring for all residents.

• What is an advance directive and should I have one?

 An Advance Directive is a written statement about how you want medical decisions to be made in the future if you can no longer make them yourself. Federal law requires that you be told of your right to make an advance directive when you are admitted to a health care facility.

• Are nursing home patients protected under federal law?

Although many nursing home patients frequently feel trapped within the situation they are currently in, nursing home patients actually have many rights granted to them under federal law. Federal law empowers nursing home patients to make decisions with respect to their medical treatment and personal care.

Who Regulates Nursing Homes?

In most states, nursing homes are regulated by a combination of state (Department of Health) and federal authorities (U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services [CMS]). Each agency has its own regulations that control all aspects of the nursing home including: resident care, staffing, policies and procedures and medical equipment.

Because nursing homes are responsible for complying with state and federal regulations, agents from either agency conduct inspections of the facility to assure compliance with the regulations. These inspections are called 'surveys' and are generally done unannounced at least one time per year. Surveys may be conducted more frequently at facilities with a history of prior violations or in response to a complaint regarding resident care.

• What Are Signs Of Nursing Home Abuse?

Physical, mental and sexual abuse are forms of abuse encountered by nursing home residents across the country. Sadly, some of the most commonly abused nursing home residents include those who are physically or mentally disabled and have no way of fighting off a perpetrator.

Remember, you know your loved one better than anyone else. If you suspect mistreatment or abuse immediately report the situation to local police and/or ombudsmen. The reality is that most episodes of elder abuse go unreported.

• What Steps Should I Take Before Meeting With A Nursing Home Lawyer?

When you become aware of mistreatment of a nursing facility it is important to get your loved one the medical treatment they need and then get into ‘fact collection mode’. In fact collection mode, you are beginning to collect information about the incident, acts of the nursing home staff and medical condition of your loved one. Doing some preliminary work before you meet with a lawyer will prove for a more effective meeting.

Don’t assume you will remember all facts regarding the incident. As time goes on, your memory will begin to fade. The following steps will help you organize your thoughts during a stressful time and to give an attorney the information he needs to work best on your behalf.

Have a question regarding nursing home injury or patient rights?  Give me a call or use our contact form to discuss.  (888) 424-5757
 

-Edith Phoenix, AZ

Nursing homes and hospitals use a four stage scale to describe, monitor and treat pressure sores (also called bed sores, pressure ulcers or decubitus ulcers).  By categorizing pressure sores, according to standardized characteristics, a sense of uniformity can be established amongst all medical facilities that treat people with pressure sores.

Bed sores are categorized based on their severity (stage 1, stage 2, stage 3 or stage 4). The National Pressure Ulcer Advisory Panel, a professional organization dedicated to the prevention and treatment of bed sores, has set forth specific characteristics to help medical professionals objectively categorize a wound.

Stage I- Initially, a pressure sore appears as a persistent area of red skin that may itch or hurt and feel warm and spongy or firm to the touch. In blacks, Hispanics and other people with darker skin, the mark may appear to have a blue or purple cast, or look flaky or ashen. Stage I wounds are superficial and go away shortly after the pressure is relieved.

Stage II- At this point, some skin loss has already occurred — either in the epidermis, the outermost layer of skin, in the dermis, the skin’s deeper layer, or in both. The wound is now an open sore that looks like a blister or an abrasion, and the surrounding tissues may show red or purple discoloration. If treated promptly, stage II sores usually heal fairly quickly.

Stage III- By the time a pressure ulcer reaches this stage, it has extended through all the skin layers down to the muscle, damaging or destroying the affected tissue and creating a deep, crater-like wound.

Stage IV- In the most serious and advanced stage, a large-scale loss of skin occurs, along with damage to muscle, bone, and even supporting structures such as tendons and joints. Stage IV wounds are extremely difficult to heal and can lead to lethal infections.

Occasionally, a bed sore may be categorized as ‘unstageable‘. Unstageable bed sores are usually referred to as an extremely advanced wound where there is involvement of skin, muscle and bone.

Bed-bound patients commonly develop pressure sores in the following areas: back or sides of your head, rims of ears, shoulders, hip bones, lower back or tailbone, knees, heels, ankles and toes.

 Resource:

Bed Sore FAQ

National Pressure Ulcer Advisory Panel

Stages Of Bed Sores

Bed Sore Resources

- Rhonda P., Sacramento, CA

One of the most important steps in determining if a cause of action exists against a nursing home or hospital is to review the medical records.  The records will help determine what-- if any-- mistakes were made by the facility in the care of the individual.

Getting medical records from a nursing home, physician or hospital can be a daunting task due to privacy regulations (HIPPA) and misunderstanding of the laws that apply to obtaininging the records-- both on the part of the person requesting the records and on the part of the medical facility.

Nonetheless, federal and state laws ensure patients and their authorized representatives are entitled get copies of medical records when the laws are complied with. This includes the right to inspect and copy the resident’s clinical records and other records regarding the resident’s care and maintenance that are kept by the facility or by the resident’s physician. (Illinois Nursing Home Care Act - 210 ILCS 25/2-104) 

A resident’s contract with a nursing home facility should designate the name of the resident’s representative, if any, which authorizes the representative to inspect and copy the resident’s records. (210 ILCS 45/2-202) Nursing home residents also have the right to privacy regarding the content of resident records. 

When a nursing home survey is performed at a facility, the Illinois Department of Health will respect resident confidentiality and not disclose the contents of a record in a manner which identifies a resident, except upon a resident’s death to a relative or guardian or under judicial proceedings. Also, any confidential medical, social, personal, or financial information identifying a resident will not be made available for public inspection in a manner which identifies a resident. (210 ILCS 45/2-206) 

In some states, such as Illinois, a nursing home resident has the right to sue the facility in court in order to get his or her medical records. Illinois law provides that every private and public health care facility must allow a patient or patient’s legal representative to examine the health care facility records kept in connection with the treatment of the patient (history, bedside notes, charts, pictures and plates) and make copies of such records. 

A request for copies of the records must be in writing and delivered to the administrator or manager of the health care facility or to the health care practitioner. The person requesting copies will reimburse the facility for all reasonable expenses. The health care facility must respond to a written request within 30 days of the receipt of the written request. If the facility needs more time to comply, the facility must provide the requesting party a written statement of the reasons for the delay and the date by which the requested information will be provided. In any case, the facility must provide the requested information no later than 60 days after receiving the request. (735 ILCS 5/8-2001) 

Federal law also provides that the resident or the resident’s legal representative has the right to access all records including clinical records within 24 hours and receive photocopies for a standard charge. (42 CFR §483 – Resident’s rights) The resident also has the right to personal privacy and confidentiality of all personal records. As such, the resident may approve or refuse the release of personal and clinical records to any individual outside the facility unless resident is transferred to another health care institution or release is required by law. 

Tips:

• Do not tell the facility why you are requesting the records
• Keep copies of all record requests
• Send the request via a method to confirm the facility has received the request
• Request the records as soon as you believe you may be interested in getting them
• If you are an authorized representative, attach a copy of any relevant paperwork granting such authority to do so
• Always request a complete copy of the chart

Sources:

Illinois Nursing Home Care Act

Your Medical Record Rights in Illinois

Federal Law – 42 CFR §483 – Resident’s rights.

210 ILCS 45/1-104 – “Access” means the right to: (4) Inspect the clinic and other records of a resident with the express written consent of the resident.

210 ILCS 25/2-104 - (d) Every resident, resident’s guardian, or parent if the resident is a minor shall be permitted to inspect and copy all his clinical and other records concerning his care and maintenance kept by the facility or by his physician. The facility may charge a reasonable fee for duplication of a record. 

210 ILCS 45/2-201. To protect the resident’s funds, the facility: – (3) Shall maintain and allow, in order of priority, each resident or the resident’s guardian, if any, or the resident’s representative, if any, or the resident’s immediate family member, if any, access to a written record of all financial arrangements and transactions involving the individual resident’s funds. 

210 ILCS 45/2-202. – (h) – The contract shall designate the name of the resident’s representative, if any. The resident shall provide the facility with a copy of the written agreement between the resident and the resident’s representative which authorizes the resident’s representative to inspect and copy the resident’s records and authorizes the resident’s representative to execute the contract on behalf of the resident required by this Section. 

210 ILCS 45/2-206. – (a) The Department shall respect the confidentiality of a resident’s record and shall not divulge or disclose the contents of a record in a manner which identifies a resident, except upon a resident’s death to a relative or guardian, or under judicial proceedings. This Section shall not be construed to limit the right of a resident to inspect or copy the resident’s records. (b) Confidential medical, social, personal, or financial information identifying a resident shall not be available for public inspection in a manner which identifies a resident.

210 ILCS 45/2-217. Order for transportation of resident by ambulance. If a facility orders transportation of a resident of the facility by ambulance, the facility must maintain a written record that shows (i) the name of the person who placed the order for that transportation and (ii) the medical reason for that transportation. The facility must maintain the record for a period of at least 3 years after the date of the order for transportation by ambulance.

210 ILCS 45/3-801.1. Notwithstanding the other provisions of this Act to the contrary, the agency designated by the Governor under Section 1 of “An Act in relation to the protection and advocacy of the rights of persons with developmental disabilities, and amending Acts therein named”, enacted by the 84^th General Assembly, shall have access to the records of a person with developmental disabilities who resides in a facility, subject to the limitations of this Act. The agency shall also have access for the purpose of inspection and copying, to the records of a person with developmental disabilities who resides in any such facility if (1) a complaint is received by such agency from or on behalf of the person with a developmental disability, and (2) such person does not have a guardian or the State or the designee of the State is the guardian of such person. The designated agency shall provide written notice to the person with developmental disabilities and the State guardian of the nature of the complaint based upon which the designated agency has gained access to the records. No record or the contents of any record shall be redisclosed by the designated agency unless the person with developmental disabilities and the State guardian are provided 7 days advance written notice, except in emergency situations, of the designated agency's intent to redisclose such record, during which time the person with developmental disabilities or the State guardian may seek to judicially enjoin the designated agency's redisclosure of such record on the grounds that such redisclosure is contrary to the interests of the person with developmental disabilities. If a person with developmental disabilities resides in such a facility and has a guardian other than the State or the designee of the State, the facility director shall disclose the guardian's name, address, and telephone number to the designated agency at the agency's request. Upon request, the designated agency shall be entitled to inspect and copy any records or other materials which may further the agency's investigation of problems affecting numbers of persons with developmental disabilities. When required by law any personally identifiable information of persons with a developmental disability shall be removed from the records. However, the designated agency may not inspect or copy any records or other materials when the removal of personally identifiable information imposes an unreasonable burden on the facility. For the purposes of this Section, "developmental disability" means a severe, chronic disability of a person which ‑     (A) is attributable to a mental or physical impairment or combination of mental and physical impairments; (B) is manifested before the person attains age 22; (C) is likely to continue indefinitely; (D) results in substantial functional limitations in 3 or more of the following areas of major life activity: (i) self-care, (ii) receptive and expressive language, (iii) learning, (iv) mobility, (v) self-direction, (vi) capacity for independent living, and (vii) economic self-sufficiency; and (E) reflects the person's need for combination and sequence of special, interdisciplinary or generic care, treatment or other services which are of lifelong or extended duration and are individually planned and coordinated. 

-Mrytle, Chicago Heights, IL

Assisted living facilities are generally governed by state law.  In Illinois, assisted living facilities (ALF's) are licensed, regulated, and inspected by the Illinois Department of Health (IDPH). The IDPH ensures that all ALF's in Illinois comply with the provisions of the state Illinois Nursing Home Care Act (210 ILCS 45). IDPH is responsible for the initial licensing and continued recertification and inspection of the facility. 

If a patient feels that his or her resident rights are being violated, a complaint may be filed with IDPH, which may prompt a complaint investigation to ensure that the facility is properly caring for all residents. 

Before admission, the assisted living facility must screen all persons seeking admission in order to determine the services needs. (Administrative Code – Section 300.615) The Illinois Department on Aging is responsible for the screening requirement for persons aged 60 and older who are not developmentally disabled or do not have a severe mental illness. The Illinois Department of Human Services is responsible for the screening requirement for persons aged 18-59 and persons aged 60 or older who are developmentally disabled or have a severe mental illness. 

If the facility cannot readily provide an individual necessary services at the facility or through arrangement with a qualified outside resource, the resident should not be admitted or kept in the facility. (Administrative Code – Section 300.620 – Admission, Retention, and Discharge Policies) Each facility must have an advisory physician or medical advisory committee that is responsible for advising the administrator on the medical management of the residents. Each resident admitted must have a physical examination within five days prior to admission or within 72 hours following admission. Any changes to the resident’s health or condition must be reported to the resident’s physician. (Administrative Code – Section 300.1010 – Medical Care Policies)

There are special requirements for residents with a serious mental illness (including but not limited to: schizophrenia, delusional disorder, bipolar disorder, major recurrent depression). (Administrative Code - Subpart S – Providing Services To Persons With Serious Mental Illness) The facility must consider the resident’s aggressive behavior, supervision needs, noise levels, and interests in determining the location of the resident’s room. The ALF facility must establish and Interdisciplinary Team (IDT) for each resident with a serious mental illness in order to design a program to meet the resident’s needs. The IDT must perform a comprehensive assessment in order to determine the individual’s needs prior to admission to the facility in order to determine an appropriate treatment plan. (Administrative Code - Section 300.4010 – Comprehensive Assessments for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S) (Administrative Code – Section 300.4030 – Individualized Treatment Plan for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S)

About Assisted Living Facilities

Assisted living facilities are not nursing homes--- nor are they intended to provide the same services.  Rather, assisted living provide a transitional living environment for people who are unable to live independently, yet do not need the skilled nursing care of a nursing home. 

Assisted living facilities provide residents with help with daily living needs such as: eating, bathing, dressing, laundry, housekeeping, and assistance with medications.  Some ALF's have medical centers on their facilities to provide quick access to medical care.

Sources:

Illinois Nursing Home Care Act

Illinois Administrative Code – Section 300.615 – Determination of Need Screening and Request for Resident Criminal History Record Information

Illinois Administrative Code – Section 300.620 – Admission, Retention, and Discharge Policies

Illinois Administrative Code – Section 300.1010 – Medical Care Policies 

Illinois Administrative Code - Section 300.4010 – Comprehensive Assessments for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S

Illinois Administrative Code – Section 300.4030 – Individualized Treatment Plan for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S 

-Shirley C.- Aurora, Illinois

An Advance Directive is a written statement about how you want medical decisions to be made in the future if you can no longer make them yourself. Federal law requires that you be told of your right to make an advance directive when you are admitted to a health care facility.

Many states, such as Illinois have three advance directives:

• Health care power of attorney
• Living will
• Mental health treatment preference declaration

The health care power of attorney allows you to choose someone to make your future health care decisions if you are no longer able to make them yourself. This power only takes effect if you are no longer able to make health care decisions and lasts until your death unless you cancel it or include time limits. 

The agent you choose cannot be your health care professional or health care provider. You can use the Illinois Statutory Short Form: Power of Attorney for Health Care or write your own. Your agent is required to follow any specific instructions you give regarding care you want provided or with held. 

A living will is a declaration telling your health care provider whether you want life extending measures taken and are you are unable to state your wishes. Unlike a health care power of attorney, it only applies if you have a terminal condition (incurable and irreversible condition such that death is imminent and the application of any death-delaying procedure serves only to prolong the dying process). 

You can use a standard living will form or write your own, with any specific directions about what type of life-extending medical procedures you do or do not want. You can cancel your living will at any time. 

A mental health treatment declaration allows you to specify whether you want electroconvulsive treatment (ETC) or psychotropic medicine when you have a mental illness and are unable to make these decisions for yourself. You can choose someone to make your mental health decisions for you, use a declaration for mental health treatment form, or write out your wishes. Your mental treatment preference declaration expires three years from the date you sign it, and you can cancel your declaration in writing prior to its expiration so long as you are not receiving mental health treatment at time of cancellation.

A Do-Not-Resuscitate Order (DNR order) is a medical treatment order saying that you do not want cardiopulmonary resuscitation (CPR) if your heart and or breathing stops. You or your legal representative must consent to the DNR order before it may be entered into your medical record. 

If you do not have an advance directive and you cannot make health care decisions for yourself, a health care “surrogate” may be assigned under Illinois law. This surrogate will be one of the following (in order of priority): guardian of the person, spouse, any adult children, either parent, any brother or sister, any adult grandchildren, a close friend, or a guardian of the estate. The surrogate can make all health care decisions with certain exceptions (withdraw or withhold life-sustaining treatment unless you have a terminal condition, permanent unconsciousness, or an incurable or reversible condition). A surrogate, other than a court-appointed guardian, cannot consent to certain mental health treatments including electroconvulsive therapy, psychotropic medication, or admission to a mental health facility. 

Under the Illinois Nursing Home Care Act, all nursing home facilities must establish a policy for the implementation of physician orders limiting resuscitation, such as those commonly referred to as “Do-Not-Resuscitate” or DNR orders. Any orders under this policy must b e honored by the facility. Also, the Department of Public Health Uniform DNR Advance Directive or a copy of that Advance Directive shall be honored by the facility. (210 ILCS 45/2-104.2) 

Resources:

IDPH: Illinois advance directives

Statement of Illinois Law on Advance Directives

Living Will Declaration Form

Declaration for Mental Health Treatment Form

Power of Attorney for Health Care, Illinois Statutory Short Form 

IDPH Uniform Do Not Resuscitate (DNR) Advance Directive 

IDPH Uniform Advance Directive – Guidance for Individuals

IDPH Uniform DNR Advance Directive – Guidance for Health-Care Providers and Professionals

"Are nursing home patients protected under federal law?"

                                                                -Tom, Edina, Minnesota

Although many nursing home patients frequently feel trapped within the situation they are currently in, nursing home patients actually have many rights granted to them under federal law.  Federal law empowers nursing home patients to make decisions with respect to their medical treatment and personal care.

Federal law guarantees the following:

1. The right to participate in your care planning along with the right to refuse particular treatments.

A customized care plan must be developed for every nursing home patient.  Nursing home patients (or their representatives) may participate in developing this important part of patient care.

2. The right to privacy and to be treated with dignity and respect.

Nursing home patients are free to communicate any person they wish.  This includes: friends, family, attorneys and patient advocates.  Nursing home patients are entitled to privacy when speaking with visitors.

Unless requested otherwise, nursing home patients are entitled to open their own mail.

Nursing home staff should take steps to ensure privacy during bathing, toileting, and providing medical treatments by using curtains or private areas when necessary.

3. The right to have your own physician and/or pharmacy.

Despite the fact that many nursing homes are set up for a 'one size fits all' approach to care, YOU ARE entitled to select your own physician and pharmacy.

4. The right to be free from restraints.

Physical and pharmacutial restraints may only be used if ordered by a physician and agreed to by the patient or their caretaker.  Moreover, restraints should be used only when they are necessary to protect the individual or other patients from harm or injury.

5. The right to be informed of nursing home policies and procedures.

Policies and procedures regarding patient care and patient expectations must be written out by each nursing home.  When requested, a facility should present you with a copy of such policies.

6. The right to know about all medical care and conditions.

Nursing homes must tell each patient or their caregiver as to their medical condition and the treatment to be provided.  When and if there is a change in care, nursing homes must alert all the decision makers.

7. The right to know of the services the facility provides and the exact charges for such services.  

Nursing home must inform all patients as to the specific services provided and what the accompanying charge is for such service.

8. The right to privacy when it comes to your medical records.

Federal law prohibits disclosure of personal medical records to any person or entity without the written permission of the patient or their authorized representative. 

9. The right to use your own clothing and possessions.

Despite the fact that many nursing homes freely distribute generic clothing and effects, patients are entitled to use their own clothing and possessions if they desire.

10. The right to manage personal finances.

Many nursing homes mange their patients' finances for them.  This is legal.  In some circumstances this is done as a convenience for patients and to help expedite payment of bills.  If you do choose to allow a nursing home to manage your finances, you are entitled to: a) see an itemization as to where you money is; 2) received a written accounting for each account and expenditure; 3) get a receipt for all money  spent on your behalf; and 4) have access to your funds if you desire.

11. The right to be free from abuse in any form including: physical, sexual, neglect or isolation.

Nursing homes must provide the highest feasible level of care.  Obviously, this entitles patients to live comfortably and free from physical and emotional abuse in any form.

12. The right to stay at a nursing home as long as the facility is capable of attending to medical needs, payment is timely made and the facility continues to operate.

In other words, nursing homes CAN NOT simply discharge patients without cause.  In order for nursing homes to properly discharge patients, they must provide a reason for discharge or transfer. If you disagree with the nursing homes reasoning, patients have a right to appeal the facilities decision.

13. The right to speak freely about poor care.

Nursing home can not take any retaliatory action against a patient for making a complaint regarding care or treatment.

14. The right to have visitors.

Nursing homes are 'homes' for the patients who live there either on a temporary or permanent basis. Consequently, nursing homes must:

a) Allow patients to receive any visitor of their choosing.

b) All patients to refuse any visitor of their choosing.

c) Provide at least 8 hours per day of scheduled visiting hours.

d) Allow patient advocates and / or patient attorneys access to the facility during visiting hours.

e) Provide an area for confidential communications between patient and visitors if and when requested.

f) Patients may speak freely to visitors regarding rights and benefits.

The above rights are undeniable.  Additionally, many states have enacted laws to further protect nursing home residents.  If a nursing home is not meeting its obligations, you should contact your state or local nursing home ombudsman.

-Carol, Beachwood, Ohio

Every state is required to have a long-term care ombudsmen program as set forth by the Federal Older Americans Act.  In the long-term care setting, ombudsmen act as patient advocates to help families find facilities that meet resident needs, address problems encountered in long-term settings and inform patients of their legal rights.

Most people utilizes ombudsmen services when they encounter a problem at a facility such as a resident injury resulting from abuse or neglect.  In this context, an ombudsman can help in the investigation of the incident and resolve problems with the facility.  

In many cases, the information provided by a nursing home ombudsman may substantiate an episode of poor care.  This information may be helpful in determining how an incident occurred and if the matter should be pursued as a nursing home negligence lawsuit.  Even in cases where there are findings of improper care, most jurisdictions prohibit ombudsmen reports from being introduced into civil lawsuit.  

If you have a question regarding nursing home care or seek more information regarding a nursing home injury, the ombudsmen program is a great resource to help provide you with more information. Unless you give ombudsmen specific permission to share your information with the facility, all personal information will be kept confidential.

Resource:

National Long Term Care Ombudsman Resource Center- provides contact information for ombudsman in every state.

• Death of a person
• The death was caused by the defendant’s wrongful act, neglect or default
• If not for the death of the person, the deceased would have been entitled to bring an action against the defendant and recover damages
• There exists a surviving next of kin
• The surviving next of kin suffered injury
• Actual damages exist. 

Wrongful death damages include both pecuniary (monetary) damages for loss of support and damages for loss of consortium, loss of society, loss of companionship, and loss of guidance.  Damages can also be awarded for grief, sorrow, and mental suffering.  The damages awarded can then be reduced because of the deceased’s contributory negligence (fault) and any contributory fault by a beneficiary.
 
The amount recovered is for the sole benefit of the surviving spouse and next of kin and is divided based on how much each was dependent upon the deceased.  If there exists no surviving next of kin, the damages are divided to cover hospitalization costs, medical services, and the estate.  In most cases, wrongful death actions must be brought within two years after the death of the person.
 
Hopefully, any abuse or neglect that occurs at a nursing home can be addressed earlier in time, to actually prevent the loss of a loved one.  But, in those unfortunate situations where the death of a spouse does occur, a wrongful death action can help a family deal with the repercussions of their loss. 
 
Sources:
IL General Assembly – Wrongful Death Act (740 ILCS 180)

(740 ILCS 180/1) (from Ch. 70, par. 1)
(Text of Section WITH the changes made by P.A. 89‑7, which has been held unconstitutional)
Sec. 1. Whenever the death of a person shall be caused by wrongful act, neglect or default, and the act, neglect or default is such as would, if death had not ensued, have entitled the party injured to maintain an action and recover damages in respect thereof, then and in every such case the person who or company or corporation which would have been liable if death had not ensued, shall be liable to an action for damages, notwithstanding the death of the person injured, and although the death shall have been caused under such circumstances as amount in law to felony. No action may be brought under this Act if the decedent had brought a cause of action with respect to the same underlying incident or occurrence which was settled or on which judgment was rendered.
This amendatory Act of 1995 applies to causes of action accruing on or after its effective date.
(Source: P.A. 89‑7, eff. 3‑9‑95.)

(Text of Section WITHOUT the changes made by P.A. 89‑7, which has been held unconstitutional)
Sec. 1. Whenever the death of a person shall be caused by wrongful act, neglect or default, and the act, neglect or default is such as would, if death had not ensued, have entitled the party injured to maintain an action and recover damages in respect thereof, then and in every such case the person who or company or corporation which would have been liable if death had not ensued, shall be liable to an action for damages, notwithstanding the death of the person injured, and although the death shall have been caused under such circumstances as amount in law to felony.
(Source: Laws 1853, p. 97.)

(740 ILCS 180/2) (from Ch. 70, par. 2)
Sec. 2. Every such action shall be brought by and in the names of the personal representatives of such deceased person, and, except as otherwise hereinafter provided, the amount recovered in every such action shall be for the exclusive benefit of the surviving spouse and next of kin of such deceased person. In every such action the jury may give such damages as they shall deem a fair and just compensation with reference to the pecuniary injuries resulting from such death, including damages for grief, sorrow, and mental suffering, to the surviving spouse and next of kin of such deceased person.
The amount recovered in any such action shall be distributed by the court in which the cause is heard or, in the case of an agreed settlement, by the circuit court, to each of the surviving spouse and next of kin of such deceased person in the proportion, as determined by the court, that the percentage of dependency of each such person upon the deceased person bears to the sum of the percentages of dependency of all such persons upon the deceased person.
Where the deceased person left no surviving spouse or next of kin entitled to recovery, the damages shall, subject to the following limitations inure, to the exclusive benefit of the following persons, or any one or more of them:
(a) to the person or persons furnishing hospitalization or hospital services in connection with the last illness or injury of the deceased person, not exceeding $450;
(b) to the person or persons furnishing medical or surgical services in connection with such last illness or injury, not exceeding $450;
(c) to the personal representatives, as such, for the costs and expenses of administering the estate and prosecuting or compromising the action, including a reasonable attorney's fee. In any such case the measure of damages to be recovered shall be the total of the reasonable value of such hospitalization or hospital service, medical and surgical services, funeral expenses, and such costs and expenses of administration, including attorney fees, not exceeding the foregoing limitations for each class of such expenses and not exceeding $900 plus a reasonable attorney's fee.
Every such action shall be commenced within 2 years after the death of such person but an action against a defendant arising from a crime committed by the defendant in whose name an escrow account was established under the "Criminal Victims' Escrow Account Act" shall be commenced within 2 years after the establishment of such account. For the purposes of this Section 2, next of kin includes an adopting parent and an adopted child, and they shall be treated as a natural parent and a natural child, respectively. However, if a person entitled to recover benefits under this Act, is, at the time the cause of action accrued, within the age of 18 years, he or she may cause such action to be brought within 2 years after attainment of the age of 18.
In any such action to recover damages, it shall not be a defense that the death was caused in whole or in part by the contributory negligence of one or more of the beneficiaries on behalf of whom the action is brought, but the amount of damages given shall be reduced in the following manner.
The trier of fact shall first determine the decedent's contributory fault in accordance with Sections 2‑1116 and 2‑1107.1 of the Code of Civil Procedure. Recovery of damages shall be barred or diminished accordingly. The trier of fact shall then determine the contributory fault, if any, of each beneficiary on behalf of whom the action was brought:
(1) Where the trier of fact finds that the

contributory fault of a beneficiary on whose behalf the action is brought is not more than 50% of the proximate cause of the wrongful death of the decedent, then the damages allowed to that beneficiary shall be diminished in proportion to the contributory fault attributed to that beneficiary. The amount of the reduction shall not be payable by any defendant.
(2) Where the trier of fact finds that the

contributory fault of a beneficiary on whose behalf the action is brought is more than 50% of the proximate cause of the wrongful death of the decedent, then the beneficiary shall be barred from recovering damages and the amount of damages which would have been payable to that beneficiary, but for the beneficiary's contributory fault, shall not inure to the benefit of the remaining beneficiaries and shall not be payable by any defendant.
The trial judge shall conduct a hearing to determine the degree of dependency of each beneficiary upon the decedent. The trial judge shall calculate the amount of damages to be awarded each beneficiary, taking into account any reduction arising from either the decedent's or the beneficiary's contributory fault.
This amendatory Act of the 91st General Assembly applies to all actions pending on or filed after the effective date of this amendatory Act.
This amendatory Act of the 95th General Assembly applies to causes of actions accruing on or after its effective date.
(Source: P.A. 95‑3, eff. 5‑31‑07.)

(740 ILCS 180/2.1) (from Ch. 70, par. 2.1)
Sec. 2.1. In the event that the only asset of the deceased estate is a cause of action arising under this Act, and no petition for letters of office for his or her estate has been filed, the court, upon motion of any person who would be entitled to a recovery under this Act, and after such notice to the party's heirs or legatees as the court directs, and without opening of an estate, may appoint a special administrator for the deceased party for the purpose of prosecuting or defending the action. If there is more than one special administrator appointed and one of the administrators is a corporation qualified to act as a representative of the estate of a decedent and if the compensation of the attorney or attorneys representing the special administrators is solely determined under a contingent fee arrangement, then upon petition and approval by the court, the special administrator which is a corporation shall not participate in or have any duty to review the prosecution of the action, to participate in or review the appropriateness of any settlement of the action, or to participate in or review any determination of the appropriateness of any fees awarded to the attorney or attorneys employed in the prosecution of the action.
If a judgment is entered or the action is settled in favor of the special administrator, he or she shall distribute the proceeds as provided by law, except that if proceeds in excess of $5,000 are distributable to a minor or person under legal disability, the court shall allow disbursements and fees to the special administrator and his or her attorney and the balance shall be administered and distributed under the supervision of the probate division of the court if the circuit court has a probate division.
(Source: P.A. 92‑288, eff. 8‑9‑01.)

(740 ILCS 180/2.2) (from Ch. 70, par. 2.2)
Sec. 2.2. The state of gestation or development of a human being when an injury is caused, when an injury takes effect, or at death, shall not foreclose maintenance of any cause of action under the law of this State arising from the death of a human being caused by wrongful act, neglect or default.
There shall be no cause of action against a physician or a medical institution for the wrongful death of a fetus caused by an abortion where the abortion was permitted by law and the requisite consent was lawfully given. Provided, however, that a cause of action is not prohibited where the fetus is live‑born but subsequently dies.
There shall be no cause of action against a physician or a medical institution for the wrongful death of a fetus based on the alleged misconduct of the physician or medical institution where the defendant did not know and, under the applicable standard of good medical care, had no medical reason to know of the pregnancy of the mother of the fetus.
(Source: P.A. 81‑946.)

Too we look to environmental causes of falls....cluttered hallways...improperly footwear...yet in many fall-related situations the real 'cause' of the fall lies within the person herself...

Hypotension (low blood pressure) is a problem for many nursing home residents, causing dizziness and fainting. Blood pressure readings measure the pressure in arteries - systolic pressure (the top number in a reading) measures the pressure the heart generates when pumping blood out to the rest of the body and diastolic pressure (the bottom number in a reading) measures the amount of pressure between heartbeats. A systolic blood pressure of 90 millimeters of mercury or less or a diastolic blood pressure of 60 millimeters of mercury or less is considered low.

Orthostatic hypotension, also known as postural hypotension, occurs when a person’s blood pressure drops after changing position from lying down or sitting to standing as blood pools in the legs leaving less blood to circulate back to the heart. In the elderly, orthostatic hypotension can be caused by changes in blood pressure regulation due to aging, dehydration, and certain medications.

Common causes of orthostatic hypotension include dehydration, medications, heart problems, diabetes, and nervous system disorders; all of which are common in the elderly. Dehydration can occur easily in nursing homes because of sickness or inadequate care. Also, many drugs commonly prescribed to the elderly including diuretics, high blood pressure medication, heart medication, and drugs to treat Parkinson’s disease can all cause orthostatic hypotension.

Orthostatic hypotension is more common in older adults, with over 15% of persons 65 and older suffering from it. In addition, about 50% of elderly nursing home residents suffer from orthostatic hypotension. Elderly patients, especially those who are heavily medicated or have prolonged bed rest, are especially at risk. Nursing home patients are also at risk for dehydration if they do not receive adequate care.

Orthostatic hypotension can cause dizziness, light-headedness, blurry vision, nausea, and fainting, which can cause dangerous falls. Elderly persons are particularly vulnerable to falls because of weak bones and complications from other health problems. Orthostatic hypotension can also cause strokes due to the changes in blood pressure and mental impairment because of brain damage.

Elderly nursing home patients should be properly diagnosed by a physician because not all dizziness is caused by orthostatic hypotension. If properly diagnosed, extra care can be taken with patients to prevent dangerous falls. Nursing home staff should take added precautions in the morning, when residents are first getting out of bed because that is when they are most at risk for a drop in blood pressure. The staff should also ensure that elderly residents are adequately hydrated, avoid hot weather, stand slowly, increase salt intake, and even apply compression stockings to help reduce symptoms. These simple steps can make the difference between a healthy and safe nursing home resident and one injured by a severe fall.

If your loved one suffered a nursing-home-related-fall and are looking for an explanation, one of the fist areas that should be analyzed is to see what medications the individual was taking.  Nursing home staff has a duty to do an assessment of all residents-- including a medication review--- to determine their 'risk' of falling.  A failure to do such an assessment-- or if it was improperly conducted opens the facility to potential fall-related liability.

Sources:
MayoClinic.com – Hypotension
MayoClinic.com – Orthostatic hypotension
Merck – Orthostatic Hypotension

Thanks to Heather Keil, J.D. for her assistance with this article.

In most states, nursing homes are regulated by a combination of state (Department of Health) and federal authorities (U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services [CMS]).  Each agency has its own regulations that control all aspects of the nursing home including: resident care, staffing, policies and procedures and medical equipment.

Because nursing homes are responsible for complying with state and federal regulations, agents from either agency conduct inspections of the facility to assure compliance with the regulations.  These inspections are called 'surveys' and are generally done unannounced at least one time per year. Surveys may be conducted more frequently at facilities with a history of prior violations or in response to a complaint regarding resident care.

After each survey a report is completed regarding the facilities compliance with applicable regulations.  If the findings do not immediately threat patient safety, nursing home administrators will have an opportunity to review the survey findings and propose a 'plan of correction'.  If however, surveyors find conditions that pose a threat to patient safety, they have the ability to impose a variety of penalties including: fines, appointed facility supervisors, suspension of new resident admissions or license suspension. 

Physical, mental and sexual abuse are forms of abuse encountered by nursing home residents across the country.  Sadly, some of the most commonly abused nursing home residents include those who are physically or mentally disabled and have no way of fighting off a perpetrator.

Remember, you know your loved one better than anyone else.  If you suspect mistreatment or abuse immediately report the situation to local police and/or ombudsmen.  The reality is that most episodes of elder abuse go unreported.

The following situations warrant further investigation:

• Unexplained bruises, cuts, burns, sprains, or fractures
• Bed sores
• Frozen joints
• Unexplained venereal disease or genital infections, vaginal or anal bleeding
• Bloody clothing
• Sudden changes in behavior
• Staff refusing to allow visitors to see resident or delays in allowing visitors to see resident
• Staff not allowing resident to be alone with visitor
• Resident being kept in an over-medicated state
• Loss of resident's possessions
• Sudden large withdrawals from bank accounts or changes in banking practices
• Sudden loss of appetite

Depending on the severity of the findings, you may wish to report the situation to the local department of health, police or pursue the matter against the facility civilly.  In our nursing home litigation practice, many civil lawsuits come about after an investigation by the state authorities.  Many times, the evidence secured by state authorities proves especially valuable because it was secured immediately after the incident was noted.

Nursing Home Injury Laws: Georgia

Because many nursing home residents are recipients of Medicare and/or Medicaid, it is important to understand that these agencies have an automatic right to get reimbursed from a recovery from a third-party (any party that may have caused the injury).  Lawyers who handle nursing home negligence cases should be able to help determine what benefits Medicare / Medicaid paid on your behalf.  Moreover, lawyers handling nursing home negligence cases should give you an exact figure as to how much money Medicare and/or Medicaid is receiving from a recovery.

Resource

Third Party Liability in the Medicaid Program

Elder abuse encompasses:

• Physical abuse is inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving them of a basic need.
• Sexual abuse is the infliction of non-consensual sexual contact of any kind.
• Emotional or psychological abuse is the infliction of mental or emotional anguish or distress on an elder person through verbal or nonverbal acts.
• Financial or material exploitation is the illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder.
• Neglect is the refusal or failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder.
• Self-neglect is characterized as the behavior of an elderly person that threatens his/her own health or safety.
• Abandonment - The desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.

Source:

Department of Health & Human Services, Administration on Aging

Don’t assume you will remember all facts regarding the incident. As time goes on, your memory will begin to fade. The following steps will help you organize your thoughts during a stressful time and to give an attorney the information he needs to work best on your behalf.

Despite the urge to block out the unpleasant facts and circumstances leading to an injury, much of the information listed below should be obtained as soon after an incident as feasible. The following information will prove to be valuable in both assessing the facilities responsibility and potentially as evidence to be used at trial.

Photographs- Take pictures of the physical injuries themselves, the area where the incident took place and if possible, the people involved. In cases involving particularly gruesome medical conditions (pressure sores, amputations, surgical wounds) no medical record can do justice to what your loved one experienced. Use a real camera as opposed to a camera-phone as the photos will be better quality.

Start Writing- Write down as much information about the incident or events as you can remember. Write some more. Details can be particularly helpful in the course of litigation as many nursing homes have high rates of employee turnover that can make obtaining information difficult. Concentrate on: names, dates, room numbers, names of facilities and medication dosages (if relevant).

Medical Chart- The medical chart from a nursing home and / or hospital is crucial to determining what a facility may have done or failed to do that resulted in injury or death. If your loved one sustained an injury that resulted in subsequent medical care at a hospital, these records will be important as well.

Chronology- This does not need to be one’s life story. However, if a condition developed over time or there are multiple facilities that may responsible for the injury or condition, it is important get the correct names and general dates of admission at health care facilities. The names of doctors who provided medical can be helpful as well.

Other Relevant documents: Healthcare Power of Attorney, wills, death certificates, pre-injury photographs, autopsy reports and nursing home inspection reports all can be helpful when meeting with an attorney. Bring them with.

There really is no such thing as providing a lawyer with too much information. An experienced nursing home lawyer will be able to sort through the materials and determine what information is relevant to your case. Further, a law office that regularly handles nursing home matters should be able to access much of the above information with the use of properly executed medical authorizations.

The bottom line is that you should not let your inability to access certain information delay from meeting your meeting with an attorney as soon as you are comfortable. Meeting with an attorney soon after an incident will provide the best opportunity to secure information relevant to your case.

No.  There are no monetary limits on the damages available for victims of nursing home abuse and neglect.  You are entitled to whatever a judge or jury determines to be fair and reasonable compensation.  A jury may award damages for both past and future: medical expenses, pain and suffering, disability and loss of a normal life.  In the case of wrongful death, a jury may award damages for loss of society to the family of the deceased.

However, there are important issues that impact the amount of compensation an injured person or the estate of deceased person may receive.  The first hurdle involves nursing homes with no liability insurance.  With a weak economy and some large verdicts rendered against them, some nursing homes have decided to go 'naked' with respect to liability coverage for claims and lawsuits brought against them.

The result of having no liability insurance (or in some cases limited insurance coverage) ultimately means that the injured party is limited in his recovery.  Unless a nursing home or assisted living facility is part of large corporation, it is difficult-- if not impossible, to collect on a judgment involving an entity with no insurance coverage.  Put another way, a large judgment may be worthless if the nursing home is unable to satisfy it.  Many individual nursing home owners have established complex systems of ownership that limit the owners personal liability.

In cases of uninsured or under-insured nursing homes, settlements may still be arranged.  Most settlements with nursing homes having limited or liability insurance represent a compromised result--generally less than the full value of the claim. 

Most people never inquire about a nursing home's insurance coverage until it is too late.  In addition to researching facilities track record with respect to complaints and lawsuits, it is also advisable that an inquiry be made with respect to the insurance coverage for a particular facility.  Why not learn as much as possible about the facility responsible for the care and safety of your loved one?

-Asks, Marie a 58-year-old Cicero, Illinois resident who fell on broken stairs when entered a Chicago nursing home during visit to see her mother-in-law and broke her leg

Visitors to a nursing home may pursue a 'premises liability' claim against the nursing home for injuries sustained due to improperly or negligently maintained premises.  Claim for negligence may be pursued against the nursing home and other parties who maintain or control the area where the injury occurred.  In Marie's case she may pursue a claim directly against the nursing home for damages relating to her: medical bills, pain and suffering, lost wages and disability.

Other common injuries to nursing home visitors include:

• Food poisoning
• Infection
• Sex abuse
• Assault by nursing home residents and staff

If you sustained an injury during a nursing home visit, contact the lawyers at Rosenfeld Injury Lawyers, for a free consultation.  Call anytime.  (888) 424-5757

The majority of nursing home neglect cases are far more subtle and many people are hesitant to seek out an attorney.  The best rule of thumb is to trust your instinct.  If something doesn't seem right--it's probably not.  Because most cases of nursing home neglect involve ongoing mistreatment, it is important to contact an attorney when you begin to suspect the nursing home may be treating your loved one improperly. 

Pay attention to the physical signs.  Most elderly are hesitant to report situations involving nursing home abuse or neglect and may be scared to confront the people responsible for providing their care.  Patterns of injury should not be tolerated.  Repeated falls, bruising, cuts or infection deserve to to investigated as they are easily preventable situations that are indicative of staffing problems at a facility.

Statute of limitations, or specific time allotments, govern how much time one has to bring a lawsuit against the nursing home or long-term care facility.  Statute of limitations may provide years for pursuing a cause of action.  However, the sooner an attorney is contacted, the sooner an investigation can be started to determine what may have caused the injury or abuse.  Many cases involving nursing home abuse, neglect or injury require the review of extensive medical records and expert witness consultation--time consuming practices to say the least. 

Even in situations where there may seem to be a lack of evidence to prove neglect on the part of the nursing home, an experienced nursing home attorney will be able to sort through the evidence and determine if there is a case and how to proceed.  Most nursing home attorneys work on a contingency fee, meaning they only receive a fee if they are successful in obtaining compensation for the injured party.  No out of pocket expenses are required on behalf of the client. 

There has been a recent trend, in some situations involving severe injury, where the nursing home or hospital may seem to take responsibility for an injury.  Representations may be made by the staff at these facilities that they will 'do whats right' to remedy the situation.  Don't be lulled into believing this song.  Rarely --if ever -- do these individuals really have the interests of the injured party in mind.  Moreover, without the consult of an attorney well versed in what damages an injured person is entitled to receive, the nursing home or hospital will use its uneven bargaining position in its favor.

If you or a loved one suspect the nursing home, long-term care facility, home nurse or hospital may have caused or contributed to an injury or situation involving abuse, why not speak to an attorney who has your interests in mind without any charge to you?

Resource:

Nursing Home Injury Laws

No!  The nursing home is lying to your face is is probably trying to cover their own.  Bedsores, also called pressure sores or decubitus ulcers, are preventable--with proper screening, early detection, and staff involvement.   Bedsores are a widespread problem in nursing homes and hospitals. The development of of bedsores in nursing home patients is really a reflection of poor nursing care than an inevitable part of of the aging process.