Rue Ziffra, PA

Yes, nursing homes in the state of Florida are monitored by the Long Term Care unit within the Agency for Health Care Administration. This unit is responsible for the licensure and Medicaid and Medicare certification of nursing homes, while also conducting routine inspections of these facilities. In response to complaints they receive from victims or their families, the agency maintains an interactive list of nursing home facilities showing their rank and any violations found during the most recent agency nursing home update.

Although states have differing definitions on what constitutes abuse or neglect of the elderly, elder abuse is broadly defined within three categories:

• Domestic abuse- This is a type of elder abuse inflicted by someone with a close relationship with the elder, such as a family member, friend or caregiver. This mistreatment generally occurs in the elder’s or caregiver’s home.
• Institutional abuse- This is a type of elder abuse that occurs in outside facilities, such as nursing homes and group homes, who claim to give proper care and attention to their residents.
• Self-abuse- This is a type of elder abuse inflicted by the elder person on themselves. This situation could be a result of many types of causes, including stress, depression and illness.

Nursing home facilities differ in terms of environmental settings, staff, procedures and support given to their residents. However, when nursing home abuse occurs, some typical patterns may start to emerge although each case seems different. Some of the most common types of cases found in nursing home abuse and neglect can include some of the following:

• Improper health care– This can include situations where the nursing home fails to provide adequate supervision over a resident, resulting in dangerous scenarios where the resident does not receive immediate medical attention for past or future conditions. Improper health care can also be seen when a facility fails to follow a doctor’s orders regarding the medical care and treatment of a resident, as well as performing medication errors.
• Malnutrition or dehydration – This includes situations within a nursing home facility where a resident shows signs of rapid or unhealthy weight loss or dehydration. A resident may experience these results from receiving an inadequate diet or having the inability to feed themselves independently while the facility neglects to monitor their eating habits. When it comes to providing adequate care in the form of a resident’s diet, a nursing home is responsible for following the customary standard of care in providing adequate nutrition and hydration to a resident and monitoring any changes that occur.
• Bedsores - This is a type of ulcer caused by the sustained pressure of soft tissue or skin between a bone and a hard surface (such as a bed or wheelchair). They typically form on the legs, heels, buttocks and other bony prominences of the body where pressure is often applied. A nursing home is responsible for periodically assessing whether a resident is at high risk for skin breakdown, and failure to provide reasonable and timely treatment may constitute evidence of neglect.
• Falls – This includes situations where a resident within a nursing home facility falls or continuously falls out of bed or while trying to get from one place to another. Because this can cause severe conditions (such as bone fractures) a nursing home has the responsibility to take preventative measures to help stop a high risk resident from falling. Some measures may include putting up bed rails, placing a soft mattress next to the bed, lowering the bed and providing the appropriate number of staff to assist the resident during transfers.

Signs of physical abuse

• Disfigurement of the body including abrasions, bedsores, bone fractures  
• Rapid weight loss due to malnutrition
• Dry and “weathered-looking” skin caused by dehydration
• Unexplained injuries such as bruising, burns and open wounds
• Acts of mistreatment on behalf of the nursing home staff such as slapping, hitting, pushing or shaking
• Continuous or unexplained sedation of the resident caused by giving too much medication
• Relapses in a resident’s former condition caused by not getting their needed medication
• Unreasonable physical restraints being used on a resident

Signs of emotional abuse

• A resident is extremely upset or angry
• A resident is withdrawn or isolates themselves
• A resident displays unusual behavior such as hitting and biting
• A resident feels threatened around nursing home staff or other residents

Signs of neglect

• Continuous illness or infection caused by a resident being exposed to unsanitary conditions
• Lack of medical care for a resident’s condition, such as failing to follow a doctor’s orders or give necessary medical attention in a timely manner
• Failure to assist a resident in the provision of daily necessities such as food and shelter
• An injury or death reported after a resident was missing without any knowledge of their whereabouts by the staff

If a family member or caretaker begins to see certain signs that nursing home abuse is occurring, there are certain steps they can take in order to discover and put an end to the problem. Keep in mind, however, that if the resident’s condition requires immediate medical attention, do not hesitate to find them the proper care they need first.

Visit frequently

To help prevent the occurrence of continuous abuse, it is important for family members or caretakers to frequently visit the resident (also during different times of the day). This will help them uncover areas of abuse sooner and hopefully stop it before it becomes too late.

Confront the nursing home

If there is suspected nursing home abuse, it may be wise for a family member or caretaker to confront the nursing home facility about it. This could involve talking with the nursing staff, the director or someone within administration about any concerns of abuse or neglect.

• What if the nursing home retaliates? Often, people may feel that if they confront someone within the nursing home facility about potential acts of abuse the facility may actually retaliate against the resident, resulting in unpleasant conditions or more abuse for them. To prevent this from happening, a resident may be moved to another facility first in order to safeguard them incase something were to happen when confronting the facility.

Report the abuse

If confronting the nursing home facility does not produce a successful remedy to the problem of abuse or neglect, an individual can take the next step and report the abuse to someone who can fight for the rights of the resident.

• Nursing home abuse hotlines- Each state has a directory of hotlines to report nursing home abuse. To view some of these hotlines, please visit the National Center on Elder Abuse website.
• State ombudsman- Each state has an appointed ombudsman who serves to settle disputes and investigate complaints that individuals report against local agencies and programs. To find out more information or to contact a state ombudsman, please visit the National Long-Term Care Ombudsman Resource Center.
• State agencies- An individual may also make a complaint for nursing home abuse to their state survey agency, a division of the Department of Health. This division is in charge of overseeing nursing home procedures and enforcing regulations.
• Licensing and certification division- An individual may make a complaint for nursing home abuse to the licensing and certification branch of their state’s health department. This division must investigate the alleged abuse claim, collecting any evidence and witnesses during their visit to the facility in support of the claim. Please visit the Florida Department of Health website for more information.

If the individual making the complaint is dissatisfied with the investigation’s findings, they may request an informal hearing with the state agency and can ultimately appeal it to obtain another review of the case.

Know your rights

In order for an individual to take corrective action against nursing home abuse, it may be important for them to know the rights of the resident within the facility. Based on the specific nursing home facility and residential situation, there may be different privileges based on federal and state regulations as well as standard care for patients.

Seek legal counsel

Although an individual can take the necessary steps to report nursing home abuse on their own, legal counsel is available to provide help at any time during the process. Even if a situation may not seem as critical as others can be, individuals may even choose to seek legal counsel before confronting the nursing home or any other outside entity. In doing this, they can receive answers to sensitive yet challenging questions they may have about the perceived abuse, while gaining more insight to their particular rights and options.

Ultimately, an attorney well versed in the laws regarding nursing home abuse can try to fight for the privileges and compensation owed to the victimized resident and their family.

In the state of Florida, nursing home residents are guaranteed certain rights as stated in the Nursing Home Resident’s Bill of Rights. To see the complete list, please visit the Florida Department of Health website.

The following highlights the six sections within the Nursing Home Resident’s Bill of Rights with a few examples of each:

• Right to individual dignity- This includes privileges such as the right to be respected and treated fairly by a nursing home facility at all times, to be free from mental and physical abuse, seclusion and restraints, the right to privacy and the right to have a prompt response to a request.
• Right to information- This includes providing a nursing home resident with adequate information on the medical care they receive, the facility’s policies and procedures and any patient support services available to them.
• Right to financial information and disclosure- A nursing home resident has the right to be given information and counseling on available financial resources, reimbursements and an explanation of charges for medical treatment given to them.
• Right to access to health care- A nursing home resident has the right to reasonable health care and legal services.
• Right to experimental research- A nursing home resident has the right to know and consent to any medical treatment used for experimental research.
• Right to obtain knowledge of patient’s rights and responsibilities- A nursing home resident has the right to know of their rights and responsibilities upon receiving care from a facility and health care provider.

Certain Florida statues create a special cause of action against any facility that deprives a resident of his or her rights. This cause of action makes it possible for an abused nursing home resident to select a private attorney to file a civil lawsuit against the facility for violating any of the protected rights.

Some conditions that may warrant an eviction from a nursing home facility can include:

• Failure to pay rent
• Posing a threat or danger to the other residents within the facility
• Needing specific medical attention not provided by the nursing home facility
• Having a condition that improves to where they do not need to be within the facility anymore
• Unwilling to follow the rules and procedures adopted by the facility which affect patient care and conduct

If a resident has been notified of a violation which merits an eviction from a nursing home facility, they have the right to appeal any discharge.

Determining past and future costs

To help figure out how to compensate victims of nursing home abuse, courts first use rulings and awards from previous abuse cases to help determine the worth of a recent victim’s case. Secondly, the resident’s specific condition will be evaluated in terms of pain and suffering, sustained injuries, how the abuse occurred as well as present and future medical costs.

Making an offer

After determining an estimate of all combined costs, an offer is made to the nursing home for compensation of this amount. However, a case may only be worth either the maximum amount the nursing home will offer to settle the case or the maximum amount of an award offered by a judge and jury if the case goes to court.

If nursing home abuse is suspected, it is advisable that this mistreatment be reported immediately to the division within the state’s health department in charge of investigating nursing home claims. Also, immediate consultation with an attorney knowledgeable in nursing home negligence law is another option capable of producing quick results.

Like a standard medical malpractice claim, the timeline for asserting legal rights for nursing home abuse claims is generally two years from the date of the incident. However, this may fluctuate in regards to when the mistreatment was actually discovered.

If a family member is acting independently of the abused resident in regards certain legal processes, they may want to consult with an attorney who is knowledgeable within the area of nursing home negligence law. This will give the attorney and their staff the permission to scour medical records, talk to expert physicians, question witnesses and take other steps to lay out a proper claim.

Nursing home abuse claims can often be difficult to prove and lengthy in regards to taking the necessary steps set by state statutes. This can be made into even more of a nuisance if an individual acts one their own to find reprieve for a victimized nursing home resident. Many pieces of evidence need to be summoned in order to prove a nursing home negligence case, such as proof of any physical injuries sustained as a result of the negligence, medical records, witness statements and expert opinions.

The attorneys at the law firm of Rue & Ziffra, P.A. who are knowledgeable within the area of nursing home negligence law, have handled numerous nursing home abuse cases. These cases can be complex, requiring an intimate knowledge of the nursing home industry which an attorney may be able to extend to their clients. We have a team of lawyers able to take on nursing home negligent cases while having an understanding of both the legal and domestic issues related to fighting for a resident’s rights.