Nursing Home Abuse

It is a very difficult decision to place a love one in a long term care facility. Unfortunately, many of these facilities are chronically understaffed and operate with a “profits over people” mentality. As a result, many elderly residents are seriously injured or die as a result of negligence and corporate misconduct.

Ragland Law Firm, LLC prosecutes Nursing Homes and Assisted Living/Personal Care facilities throughout the State of Georgia that have caused serious injuries or a resident’s death. We believe that all long term care residents deserve to live in a safe environment. Families deserve that their loved ones receive appropriate and safe care. Our elderly population deserves better.

Ragland Law Firm, LLC will hold nursing homes and other long term care facilities responsible for their negligence and abuse. Areas of Nursing Home Abuse may include but are not limited to:

  • Falls and fall related injuries;
  • Bed sores, and pressure sores (bad wound care);
  • Dehydration;
  • Malnutrition;
  • Unexplained Fractures;
  • Infection;
  • Medication/drug errors;
  • Understaffing; and
  • Medicare/Medicaid Fraud.
Nursing Home Abuse Cases – Common Causes Of Action

1. Professional Negligence or Negligence in general

This cause of action arises from the duty that professional staff at nursing homes owe to residences in acting in accordance with the standard of care ordinarily exercised by skilled nursing facilities or long-term care facilities under like conditions and similar surrounding circumstances. O.C.G.A. § 51-1-27.

Examples: failing to protect residents from falls, failing to follow residents’ care plans, failing to follow toileting plans for residents, failing to utilize safety measures such as bed alarms, wheelchair alarms, etc., failing to train staff, failing to maintain records, and failing to prevent skin breakdown.

2. Violation of the Georgia Bill of Rights for Residents of Long-Term Care Facilities (Negligence Per Se)

This cause of action arises from the rights that long-term residents are owed under the Georgia act. Thurman v. Pruitt Corp., 212 Ga. App. 766, 422 S.E. 2d 844 (1994). These rights include: reasonable care and skill, respect for dignity and privacy, and compliance with the applicable laws and regulations. This Bill of Rights was created to protect residents from abuse and neglect.

Examples: Failing to plan for falls and failing to follow a resident’s care plan violates a resident’s dignity. Dignity is defined as a resident’s “self-worth.” 42 U.S.C. § 483.15(a). A nursing home has a duty to maintain and enhance an elderly resident’s dignity and self-esteem.

3. Violations of the Omnibus Budget Reconciliation Act (OBRA) (Negligence Per Se)

This Act applies to skilled nursing facilities that accept Medicare and Medicaid. Employees of these facilities are required to follow the regulations set forth by Medicare and Medicaid under this act. These rights include: dignified self-existence, self-determination, quality of life, dignity, a comprehensive and accurate resident assessment, and quality of care. No matter a patient’s respective medical condition, these regulations are required to be followed. A violation of these regulations is a viable cause of action in the State of Georgia. McClain v. Mariner Healthcare, Inc., 279 Ga. App. 410 (2006), cert. denied.

Examples: Failing to provide patients with a safe living environment, failing to adequately supervise residents, and failing to prevent accidents.

Assisted Living Cases – Common Protections under Georgia Law

1. Department of Community Health Rules and Regulations

These rules and regulations were designed to establish the minimum standards for the operation of homes, which provide residential services to citizens of the State of Georgia. These regulations lay out the necessary requirements for staffing, inspections, training, and safety standards for assisted-living facilities. They also include rules regarding residents’ care plans, medications, nutrition, and procedures for documenting changes in condition. Responding to changes in condition play an important role in many nursing home and assisted-living cases as these procedures, if implemented effectively, can help prevent deadly falls and injuries.

DCH Rules and Regulations for Assisted Living Communities, Chapter 111-8-62, Chapter 11-8-63.

2. Official Code of Georgia Statutes

In addition to claims of negligence, professional negligence, and violations of OBRA and DCH rules, the Official Code of Georgia provides several avenues for asserting claims in assisted living suits. Specifically, these statutes are intended to hold assisted living facilities accountable for respecting the dignity and privacy of residents, providing reasonable care, skills, and services, and complying with applicable laws and regulations. Under these statutes, essential services including: social, medical, psychiatric, or legal services necessary to safeguard these elderly residents are required to be provided. The statutes are intended to protect residents from neglect and abuse, while also creating a safe environment. These statutes allow residents and their families to recover for failures, violations, and injuries by the professional staff of these assisted living facilities, while also granting the Department of Community Health with rule-making authority in this area.

O.C.G.A. § 31-8-131; O.C.G.A. § 31-8-133; O.C.G.A. § 30-5-1; O.C.G.A. § 30-5-3; O.C.G.A. § 3-5-8; O.C.G.A. § 30-8-3; and O.C.G.A. § 31-21-1.

Nursing Home Abuse Statistics
  • 90% of nursing homes have staffing too low to provide adequate care for their residents.
  • American Association for Justice, Nursing Home Statistics

  • In 2007, the Administration on Aging received 257, 872 complaints regarding resident rights, quality of care, quality of life, staffing, and facilities or approximately 20 complaints per nursing home.

  • Current statistics indicate that 24% of Americans die each year in a nursing home.
  • “Predicting Death in the Nursing Home” Porock, David and Oliver, Debra.

  • 1 in 5 residents who were not designated as “near end of life” in their initial assessments died within the first 6 months of admission.
  • “Predicting Death in the Nursing Home” Porock, David and Oliver, Debra.

  • In 2003, a total of 13,700 elderly persons died from falls.
  • Centers for Disease Control and Prevention, “Fatalities and injuries from falls among older adults”

  • Overall mortality rates for Medicaid residents in nursing homes was 14.8% points higher than privately-funded residents suggesting that policymakers may need to look more closely at whether Medicaid residents are segregated into lower-quality facilities.
  • Med Care, October 2004, 42(10), 985-91, “Examining Differences in death rates for Medicaid and non-Medicaid nursing home residents.”

  • In 2008, approximately 1.4 million people lived in nursing homes at any given time and over 3.25 million spent time in a skilled nursing facility.
  • A study of 323 residents with advanced dementia followed for 18 months had a mortality rate of 54.8 percent.
  • A 2005 study found that 55 percent of nursing home residents had depression during their first year.
  • Falls are a common problem in nursing homes, with the average incidence of falls being 1.5 per resident, per year.
  • Polypharmacy, or the use of multiple medications, is a common problem in nursing homes. In a study of 22 Boston nursing homes, 37.5% of patients with advanced dementia received at least one medication that was not appropriate for their diagnosis.
  • “Medical care of the nursing home patient in the United States,” Gillick, Muriel.

  • In 2008, approximately 269,000 complaints about elder mistreatment were registered and 78 percent of those related to nursing home care
  • “Elder mistreatment: Abuse, neglect, and financial exploitation.” Halphen, John.

Legislative History on OBRA (Omnibus Budget Reconciliation Act of 1987)

In 1986, an expert panel was formed, Committee on Nursing Home Regulation, to recommend reformations to nursing home quality of care. The Committee found:

  • Need for a stronger federal role in improving quality;
  • Need to reform performance standards, inspection processes, and remedies to improve services
  • Need for better training
  • Need for improved assessment of residents and their needs
  • Need for a revised regulatory process

These recommendations were made to Congress with one major conclusion: that increased federal regulation was necessary in order to improve the quality of patient care and quality of life in nursing homes. For four years, Congress held hearings on the long-term care industry and those hearings consistently revealed that both the quality of care and quality of life in many nursing homes were less than adequate. Many nursing homes repeatedly ignored federal regulations and subjected the elderly to unfavorable conditions, while also staffing homes with aides who were poorly trained and not qualified to perform nursing care duties. Further, it was found that one of more basic individual rights conferred upon all Americans by federal statutes and the Constitution were routinely violated. In sum, these findings led to the passage of the Federal Nursing Home Reform Act or OBRA in 1987.

“Federal Nursing Home Reform Act from the OBRA ’87 Summary,” Turnham, Hollis.

“Improving the Quality of Care in Nursing Homes,” Committee on Nursing Home Regulation. <

“Nursing Home Reform: Its Legislative History and Economic Impact Upon Nursing Homes,” Emerzian, A.D. Joseph and Stampp, Timothy.

Legislative History on Georgia’s Bill of Rights for Residents of Long-term Care Facilities

This Bill of Rights emerged from a growing national trend that there should be a declaration of a patient’s bill of rights by statute in each state. The General Assembly recognized that residents of long-term care facilities are generally isolated from the community and lack the means to fully assert their rights as citizens. Therefore, in 1981 they adopted the GBOR for Residents of Long-Term Care Facilities in order to preserve the dignity and personal integrity of these residents by safeguarding against encroachments on the residents and their needs.

O.C.G.A. § 31-8-101 – Legislative Intent
“Construction and Application of State Patient Bill of Rights Statutes,” ALR5th, 2001.

Things to Consider
  • OBRA and the Bill of Rights are intended to protect residents of Nursing Homes.
  • Violations of OBRA and the Bill of Rights leads to resident abuse.
  • Ragland Law Firm, LLC prosecutes Nursing Homes and holds them accountable for violations of OBRA, the Bill of Rights, and the standard of care.