Kahn Gauthier Swick is investigating possible legal actions against nursing homes to recover for injuries suffered by nursing home residents. There are more than one and one-half million elderly and disabled persons in 17,000 nursing homes across the United States. It is estimated that as many as 35,000 of these residents die prematurely every year due to the home's negligence, abuse or neglect. At any particular time there are hundreds of legal actions pending against nursing home operators to recover for injury to, or even the death of, a nursing home resident due to the home's abuse or neglect of the resident. These actions are brought by the injured resident, or by his or her family members if the resident has died. Under some circumstances, the family members may assert their own claims against the nursing home operator for financial loss or emotional injury.

Federal and state laws require that nursing homes develop a plan of care for each resident, and that the homes employ sufficient staffing to provide all the care listed on the care plan. Because many corporate-owned nursing homes are not sufficiently staffed, they cannot provide all the care listed on the care plan. Consequently, residents are not taken to the toilet when necessary, develop painful and life-threatening bed sores, are not fed properly, are not given sufficient fluids, are over-medicated or under-medicated, are not cleaned or groomed, or are ignored and not included in activities, among many other possible deprivations. According to a report called 'The Nurse Staffing Crisis in Nursing Homes--A Consensus Statement of the Campaign for Quality Care,' released on March 14, 2001, by the National Citizens' Coalition for Nursing Home Reform, nursing homes across the country are experience a staffing crisis that can jeopardize quality of care, and even the life, of residents.

Nursing homes that receive federal funds must comply with federal laws requiring that residents receive a high quality of care. Since most nursing homes participate in the federal Medicare and Medicaid programs, these homes must obey the laws. A federal statute known as the Nursing Home Reform Act provides that a nursing home 'must provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care. In addition, the federal Older Americans Act requires each state to have an Ombudsman Program that addresses complaints and advocates for improvements in the long term care system.

In addition to federal laws regulating the quality of care in nursing homes, states have enacted laws as well. The state laws must be at least as powerful as the federal laws. Some states have adopted laws that are tougher than the federal laws.

Judgments in nursing home abuse cases can be substantial. In September, 2000, a jury awarded $3 million in compensatory damages and $17 million in punitive damages to the estate of a Georgia man who went hungry, dehydrated and unkempt in a Kenneth City, FL nursing home then run by the Extendicare Inc. national chain.

Types of Abuse

Financial Abuse: Material and financial abuse consists of the misuse, misappropriation, or exploitation of a nursing home resident's material (possessions and property) or monetary assets.

Passive and Active Neglect: With passive and active neglect the nursing home fails to meet the physical, social, or emotional needs of the resident. With active neglect, the caregiver intentionally fails to meet his/her obligations towards the resident. With passive neglect, the failure is unintentional, and is often the result of caregiver overload or lack of information concerning appropriate caregiving strategies.

Physical Abuse: Physical abuse consists of an intentional infliction of physical harm on a nursing home resident. The abuse can range from slapping to beatings to excessive forms of physical restraint, such as chaining.

Psychological Abuse: Psychological or emotional abuse consists of the intentional infliction of mental harm or psychological distress upon the nursing home resident. The abuse can range from insults and verbal assaults to threats of physical harm or isolation.

Sexual Abuse: Sexual abuse consists of any sexual activity for which the nursing home resident does not consent or is incapable of giving consent. The sexual activity can range from exhibitionism to fondling to intercourse.

Violations of Basic Rights: A violation of basic rights often accompanies psychological abuse and consists of depriving a nursing home resident of the basic rights that are protected under state and federal law, ranging from the right of privacy to freedom of religion.

Potential Indicators of Abuse

Material or Financial Abuse:

1. Bank and credit card statements no longer come to the nursing home resident
2. Documents are being drawn up for the nursing home resident to sign, but the resident can not explain or understand the purpose of the documents
3. Personal belongings such as jewelry, art, or furs are missing
4. Signatures on checks and other documents do not match the nursing home resident's signature
5. The caregiver only expresses concern regarding the nursing home resident's financial status and does not ask questions or express concern regarding the resident's physical or mental health status
6. Unusual banking activity (large withdrawals during a brief period of time, switching of accounts from one bank to another, ATM activity by a resident who doesn't leave the nursing home.

Passive and active neglect:

1. Chronic health problems, either physical or phychological
2. Dehydration
3. Pressure sores (bed sores)
4. Signs of malnourishment (sunken eyes, loss of weight)

Physical Abuse:

1. Delay in providing medical treatment
2. Doctor or emergency room 'shopping'
3. Inconsistent explanations for the injuries, or a complete failure to disclose the injuries
4. Injury, particularly if repeated (sprains, fractures, detached retina)
5. Overt signs of physical trauma (scratches, bruises, cuts, burns, punctures, choke marks)
6. Signs of restraint trauma (rope burns, gag marks, welts)

Psychological Abuse:

1. Agitation
2. Ambivalence, deference, evasiveness, passivity, shame
3. Anxiety
4. Confusion, disorientation
5. Depression, hopelessness, helplessness, thoughts of suicide
6. Trembling, clinging, cowering, lack of eye contact