Federal Laws Protecting Nursing Home Patients

Our affiliated personal injury lawyers at Nursing Home Law Center, LLC, are legal advocates for nursing home patients harmed through another's negligence. Call our negligence injury law firm at (800) 926-7565 (toll-free phone number) or use the contact form today to schedule a free consultation.

In 1986, the Institute of Medicine conducted a study at Congress' request and found that nursing home residents were receiving inadequate care and neglected and abused. In the wake of this study, the Institute of Medicine proposed reforms, and many of them ended up being part of the 1987 Nursing Home Reform Act.

The Act's main objective was to ensure that the residents received quality care in nursing home facilities. Moreover, the Act aimed to ensure that nursing homes provide the highest achievable level of psychosocial, mental, and physical well-being to their residents.

If the nursing homes comply with the Act's requirements, they qualify for Medicare and Medicaid payments for long-term care. To date, the Nursing Home Reform Act is the most comprehensive and thorough set of regulations for the care of nursing home residents.

The Act specifies the services that must be provided to nursing home residents by their respective facilities. These services include:

• The patient has access to a comprehensive care plan to remain fully involved in curating and assessing. Moreover, the resident and family groups have the right to know of any change made to this plan. Plus, they can refuse any form of treatment if they are fully aware of the adverse effects of not getting that particular treatment.
• Periodic assessments. These are usually done by physicians who the residents have the right to choose on their own.
• Nursing services
• Social services
• Pharmaceutical services
• Rehabilitation services
• Dietary services
• A full-time social worker on-site if the facility houses over 120 beds

The law establishes a certification process to check if the nursing home facilities are abiding by the regulations of the Act. Per that, every state has to conduct resident interviews and unannounced surveys at regular intervals.

There should be an assessment of this sort at least once in 15 months. The survey focuses on monitoring the quality of care, life, and services provided in the facility.

Moreover, the surveyors are responsible for conducting complaint investigations and targeted surveys if there are any complaints against a particular nursing home.

If the survey assessment reveals that the nursing home is not complying with the rights mentioned in the Act, the state begins the Nursing Home Reform Act enforcement.

The extensiveness of the remedy depends on whether the deficiency of certain services puts the residents at grave risk or if the neglect was an isolated incident. The state can enforce compliance with the Act using one or all the sanctions listed below:

• Civil monetary penalties
• State monitoring
• Direct in-service training for the staff
• Plan of correction
• Temporary management
• Terminating the provider agreement

The state can also deny payment for Medicaid or Medicare patients.

The Act also established some rights for nursing home residents, ensuring autonomy over their bodies and health even when dependent on the staff. The list of rights for every nursing home resident include:

• Right to proper treatment, care plan, and healthcare
• Right for privacy and confidential communication
• Right to making their own decisions if they are of sound mind
• Right to filing complaints in case the nursing home facility is not in compliance with the federal regulations

Here's an overview of some of the most important nursing home laws.

The Act was enacted in 1987 and set a benchmark for care provided in nursing homes. According to this Act, all nursing home facilities have to:

• Keep their residents as healthy as they possibly can
• Asset the individual needs along with the health status of each resident in the facility
• Develop a care plan for each nursing home resident
• Ensure an assortment of activities for nursing home residents to participate in and choose for their leisure and physical wellness
• Provide hydration, hygiene, and nutrition to the nursing home residents
• Provide appropriate devices and staff supervision to prevent falls
• Maintain accessible and accurate records for nursing home residents
• Maintain sufficient staff in the facility to cater to all nursing home residents

The Elder Justice Act was enacted in 2010, although it was drafted eight years before in 2002. The Act specifically tackled the issue of nursing home abuse and neglect.

Many federal laws, including the Elder Justice Act, require staff members to report physical abuse and neglect incidents at the facility. Here are some other highlighting features of this Act:

• Elder Justice Coordinating Council: The council holds two meetings a year to talk about new ways of keeping the elderly safe. They offer recommendations to Congress on improving the conditions for seniors in nursing homes.
• 60-day Window: In case a nursing home is closing, the staff must inform the Secretary of Health and Human Services along with the state. They also have to explain how their nursing home residents will find accommodations.
• Employee Background Check: federal and state laws require caregiving facilities to hire the most competent and qualified people for the facility to keep the elderly safe from nursing home abuse and neglect. Therefore, all nursing homes have to conduct background checks for their employees and maintain a database.

The Older Americans Act comprises specific nursing home federal and state laws from 1965 guaranteeing optimal health and safety of the elderly in nursing homes. The Act assists 685 state and local agencies, 20,000 service providers, and 244 tribal agencies to access service programs.

The following services are supported under state laws and the Older Americans Act:

• Prevention of nursing home abuse
• At-home care services
• Legal resource
• Social services
• Community planning
• Medication for seniors
• Meals for seniors

The Administration on Aging was also established under this Act. Currently, it runs more than 25 programs for seniors, helping them in different ways.

The Office on Women's Health reports that women have a higher risk of being abused at nursing homes than men. So, even though this Act is not particularly for nursing homes, it applies to cases of sexual assault in the elderly living in nursing homes.

Women in nursing home facilities may suffer different forms of abuse from:

• Family members who are their primary caregivers
• Other residents in the nursing home
• Caregivers, such as the staff members or their physicians

The Act defines sexual assault as:

• Any conduct leading to penetrating the vagina or anus using a body part or an object without the woman's consent
• Any unwarranted non-penetrative touching by anyone against another person if it causes other bothersome bodily contact and condition
• Incest is also considered a crime that may be punishable under this Act

Along with these federal laws, some national programs help the elderly, keeping them safe from nursing home abuse.

This health care insurance program paid through federal funds by the federal government aids seniors over 65 in affording treatments. In some cases, Medicare and other Federal programs could cover the cost of comprehensive services at nursing homes for the elderly.

The parts of Medicare are as follows:

• Part A: It is free and covers short-term stays in the hospital or a skilled nursing facility.
• Part B: It comes with a monthly fee and pays for comprehensive medical services.
• Part C: It has partial private insurance and may cover nursing home stays in some cases. Part C is also referred to as Medicare Advantage.
• Part D: It covers prescription medications.

The personal injury attorneys at Nursing Home Law Center are legal advocates for nursing home patients who have been harmed due to the negligent acts of others.

Keep in mind that Medicare does not typically cover long-term stays in nursing home facilities. But you may qualify for a free stay in a nursing home. Contact your nursing home for more details.

Some consumer protection laws also protect residents from financial exploitation in the health care system when paying for medications and other services.

Federal and state agencies provide community-based care and services through Medicare and Medicaid that provide housing, treatment, and rehabilitation for older Americans living in long-term care facilities.

Veterans who might require nursing home facilities qualify for care via the VA. These facilities may be available for beneficiaries who have served in the US military or are related to veterans.

The VA pays for other services, including hospice care, home-based primary care, and outpatient programs. The compensation offered by the federal government has no cost-sharing requirements.

Medicaid provides healthcare to people at no cost. For example, a 2017 Kaiser Family Foundation report showed that Medicaid covers 62% of the nursing home stays, especially for seniors who cannot afford it.

However, the nursing home must be certified by Medicaid to receive federal and state funding.

The Ombudsman Program is quite helpful to nursing home residents since it gives them a voice. Any nursing home resident can report a complaint or voice their concerns through this program.

In 2017, 7,900 officials helped residents in nursing homes all across the country. The Administration for Community Living reports that 73% of the officials resolved the complaints brought forward by the nursing home residents.

Elder abuse is any form of mistreatment that harms older Americans, including inflicting physical, emotional, or sexual harm and neglect and exploitation.

Neglect is the failure to provide necessary care for a person who cannot care for themselves, resulting in suffering or death, including withholding medication, nutrition, personal hygiene items such as a toothbrush, bedding, and clothing from a patient.

Self-neglect is the inability of an older adult to meet their basic survival needs, resulting in serious harm or death, including becoming unable to communicate, clean oneself, handle toilet needs, cook food, and pay bills.

Self-neglect could be due to mental illness like dementia or Alzheimer's disease or the direct result of substance abuse.

There are many types of elder abuse, which can cause different symptoms in an older person. Some general warning signs include:

• Self-neglect or neglect by a caretaker
• Malnutrition, poor hygiene, and not being appropriately dressed
• Wandering away from home
• Being aggressive, rebellious, or disruptive when asking for help
• Signs of physical abuse like bruises, burns, skin tears, pressure marks on wrists or ankles
• Sudden changes in financial situations could show signs of exploitation with missing cash or valuables
• Changes in mental status such as an unexplained decline in thinking or memory or a change in personality
• If you suspect any of these signs to be true, you should immediately contact Adult Protective Services

Our law firm understands many families have unanswered questions about protecting a loved one in a nursing facility and who to call and abuse occurs. A nursing home injury attorney has answered some of those questions below.

For additional information, call (800) 926-7565 and speak with a lawyer who can provide legal options and remedies to pursue justice and recover your financial damages.

Were you severely injured, or was a loved one killed due to nursing home neglect, mistreatment, or abuse? If so, contact a personal injury lawyer to help with your case.

A lawyer can help investigate the signs and symptoms of neglect or abuse and what rights your family member has under federal law.

Call the personal injury attorneys at Nursing Home Law Center at (800) 926-7565 (toll-free phone call) or use the contact form today to schedule a free consultation. All confidential or sensitive information you share remains private through an attorney-client relationship.

Our legal team accepts all personal injury cases and wrongful death lawsuits through contingency fee agreements. This promise ensures you pay nothing until we resolve your case through a negotiated settlement or jury trial award.

• National Center on Elder Abuse – Administration on Aging
• National Council on Aging – Facts on Elder Abuse