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Nursing Home Abuse / Neglect FAQs

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May 19, 2021

1. What is considered neglect in a care home?

Neglect in a care home is the failure of the care home to provide services and goods to a resident that are necessary to avoid physical harm, pain, mental anguish, or emotional distress. The National Center on Elder Abuse classifies neglect as a type of elder abuse, which is any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to an older adult.

2. What constitutes neglect of an elderly person?

Neglect of an elderly person is the failure to meet that person’s basic needs, such as food, water, shelter, clothing, hygiene, and essential medical care. The CDC defines neglect as a type of elder abuse, and it is a growing problem in America’s aging population, both in residential facilities and in the community.

3. What are the warning signs of abuse or neglect in a nursing home?

Often a person who is abused in care does not, or cannot, alert anyone to the abuse themselves. Some of the warning signs of mistreatment in a nursing home or assisted living facility are:

  • Physical: Bruises, scratches, burns, or other physical injuries, either as an isolated incident or recurring.
  • Neglect: Pressure sores, poor personal hygiene, dirty clothes, unclean living conditions, weight loss and malnutrition.
  • Emotional: Fear of certain care providers or staff members, withdrawal from usual activities, anxiety, depression, or unease.
  • Sexual: Bruises or injury to the genital area which may present as difficulty moving or sitting.
  • Financial: Unusual changes to financial or estate planning arrangements, including wills and powers of attorney, uncharacteristic or large purchases, cash withdrawals or bank transfers, missing financial documents, or credit cards.

4. What are the nursing home abuse reporting requirements?

All employees of Delaware nursing homes are required by law to report any incident in which they have reasonable cause to believe that a resident has been abused, mistreated, neglected, or financially exploited. The Delaware Department of Health and Social Services sets out detailed reporting guidelines for employees of nursing homes and assisted living facilities, which take into account the position of the people involved (staff, residents, or other persons) and the type of mistreatment.

Certain people also have an obligation under Delaware law to report suspected abuse of vulnerable adults. Healthcare professionals and financial institutions who have direct contact with a vulnerable adult, and have reasonable cause to believe that the vulnerable adult may be subject to past, current, or attempted abuse, neglect, or exploitation have a legal duty to report the alleged harm to Delaware Adult Protective Services.

5. How do I report suspected abuse in a nursing home?

If someone is in immediate danger of abuse in a nursing home, call 911 to alert the police and get medical assistance, if necessary. 

You should notify Adult Protective Services in your state. In Delaware, suspected abuse of a person in a long-term care facility, such as a nursing home or assisted living facility, should be reported to the Delaware Division of Health Care Quality on the Complaint & Incident Reporting 24-Hour Toll-Free line at 1-877-453-0012 or via their online complaint form.

Finally, notify the nursing home administrator of the suspected abuse, and contact a Delaware nursing home neglect lawyer for advice on your rights under the law. 

6. Who oversees nursing homes in Delaware?

The Delaware Division of Health Care Quality (DHCQ) within the Department of Health and Social Services oversees nursing homes in Delaware. DHCQ is divided into three sections, one of which deals specifically with long-term care.

7. When do I report an assisted living facility to the state? 

You should report any suspected abuse, mistreatment, or neglect to the Delaware authorities so that it may be properly investigated. In some situations, you may be required by law to report your suspicions if you are an employee of an assisted living facility, a healthcare professional, an employee of a financial institution, or other mandated reporter. Specific reporting guidelines for employees of nursing homes and assisted living facilities are published by the Delaware Department of Health and Social Services.

8. What are some types of elder abuse?

Elder abuse is any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to an older adult. It can be physical, emotional, sexual, or even financial, and includes neglect. Some common examples of neglect or abuse in nursing homes are:

  • Falls and injuries when not properly supervised.
  • Pressure sores or bedsores.
  • Malnutrition and dehydration.
  • Choking or suffocation.
  • Infections and illnesses resulting from lack of hygienic conditions or proper assistance with personal hygiene.
  • Wandering off or elopement.
  • Use of improper methods of restraint.
  • Medication errors, including incorrect medication and incorrect dosing.
  • Financial exploitation.
  • Physical, emotional, or sexual abuse by carers.

9. What are the dangers of home healthcare for seniors?

Home healthcare for seniors presents different challenges and dangers than residential care. In-home care is provided outside the controlled environment of the health system, and so it can be difficult to ensure the safety and cleanliness of the physical space, and the training and competency of the care providers, both of which are tightly regulated in a residential healthcare setting. Home healthcare also lacks the coordinated systems for communication and care that are available in a healthcare setting, and can give a patient/resident better and more efficient access to care and services. 

The Institute for Healthcare Improvement has identified specific challenges in-home health care as fragmentation of care; household hazards; ill-prepared family caregivers; limited training and regulation of home care workers; inadequate communication among patients, caregivers, and providers; and misaligned payment incentives.

10. What are some quality issues in home healthcare?

Home healthcare is becoming increasingly popular in the U.S.A, in part due to rising healthcare costs and an aging population. Due to the rapid growth of this industry, it is still less regulated than other areas of healthcare, sometimes allowing home healthcare providers to operate below the safety and quality levels imposed on more regulated providers. Staffing for home healthcare has also not caught up to its popularity. For patients, this can lead to poor quality carer providers, and a high turnover of different carer providers coming into their home.

Other quality issues that have been identified in-home healthcare are a higher rate of medication errors, increased risk of infection, difficulties with the provision of appropriate medical equipment, and delays in care caused by the lack of immediate access to a coordinated healthcare system.

11. What is the statute of limitations for nursing home abuse?

Nursing home abuse cases are usually actions in medical malpractice or personal injury which in Delaware must be brought within 2 years of the date of the injury or the date the abuse was (or should have been) discovered. The time period will depend on the type of case and the individual facts so you should consult an attorney as early as possible to find out what deadline is applicable to you.

12. What should I do if I suspect that my loved one is being abused or neglected in a Delaware nursing home?

Get medical attention for any injuries or medical issues. A physician can also help determine whether any issues are caused by abuse or neglect. If it is an emergency situation, call 911 to alert the police and ambulance services, if necessary. 

In most cases, you should notify the nursing home administrator about your abuse concerns. In some situations, such as where the administrator may be complicit in the abuse, it may be advisable to notify the police or state authorities first.

In Delaware, suspected abuse of a resident of a long-term care facility should be reported to the Delaware Division of Health Care Quality. Reports can be made on the Complaint & Incident Reporting 24-Hour Toll-Free line at 1-877-453-0012 or via their online complaint form.

You can also report the suspected abuse to the police and to the Delaware Long-Term Care Ombudsman which advocates for residents of long-term care facilities, and investigates and resolves complaints.

Finally, contact a Delaware nursing home neglect lawyer for advice on your loved one’s legal rights and protections.

13. How do you file a lawsuit against a nursing home for abuse or neglect?

To bring a claim against a nursing home for abuse or neglect, you should contact a lawyer with experience representing victims of nursing home abuse or neglect. A lawyer will usually not charge for your first consultation to discuss your case. A lawyer will be able to advise you whether or not you have a viable case against the nursing home abuse or long-term care facility, and your chances of success. If you decide to proceed with a legal claim, a lawyer will handle the legal process for you.

14. What if the nursing home was found in violation of federal requirements?

If a nursing home violates federal requirements, it can be subject to a variety of sanctions depending on the nature of the violation, how often it has occurred, and any harm to the resident.

Nursing home sanctions can include: 

  • Fines
  • Mandatory training for staff
  • Appointment of a temporary manager for the facility
  • Directed plans of correction
  • Termination of Medicare or Medicaid eligibility

Nursing homes that accept Medicare and Medicaid payments are subject to the federal Nursing Home Reform Act of 1987. If a nursing home loses Medicare or Medicaid eligibility, they are no longer allowed to accept patients who pay with Medicare or Medicaid. 

15. What happens when you report possible elder abuse?

When you report possible elder abuse to the state authorities, a trained professional will evaluate the report to determine whether or not it meets the statutory requirements for involvement of the local division of Adult Protective Services (APS.) In Delaware, the Delaware Division of Health Care Quality handles APS. When you make the report, you do not have to provide your name or any personal information. You may be asked detailed questions about the victim’s health conditions, the suspected abuse, and any other family or resources available to the victim.  

If the APS thinks it necessary, an APS worker will make an in-person visit to the abused or neglected adult. The APS worker will assess their safety, need for assistance, and what services they may need. The abused or neglected adult may be unwilling or unable to speak to the APS worker. In that situation, the APS worker may be unable to make a determination about the abuse, and it may be necessary for you to take further action to help the abused adult. It would be advisable to contact an experienced lawyer who can guide you through other options and alternative resources.

16. Do I need a nursing home abuse lawyer?

It is beneficial to get a nursing home lawyer if you suspect abuse of your loved one in a long-term care facility. Nursing home abuse or neglect is an area of the law that involves knowledge of state and federal laws, healthcare law, elder law, and personal injury law. It can be complicated both legally and personally as relatives navigate broken relationships of trust, and try to care for their loved one.  

Incidents of nursing home abuse are also sadly common in Delaware nursing homes. Sometimes people do not seek help when they first have suspicions of abuse, which delays getting help for an abused resident. 

It is therefore highly advisable to get the advice of a nursing home lawyer early in the process to understand your rights, and to get help navigating the complex requirements of reporting abuse and filing a legal claim.

17. What type of abuse occurs with the improper use of restraints?

Improper use of restraints or drugs is a type of physical (and sometimes emotional) abuse that is commonly inflicted upon adults in nursing homes and long-term care facilities. Staff use physical restraints such as belts, straps, ties, lap tables, and bedrails or chemical restraints such as sedatives and other drugs to improperly restrain the residents. They are used to inappropriately pin struggling residents down, for convenience to prevent residents from moving from beds or chairs, or even to punish residents. Seniors have incurred bruising, muscle atrophy from lack of mobility, and psychological abuse from the improper use of physical and chemical restraints in long-term care facilities.

18. What can a nursing home abuse or neglect attorney do to help me and my loved one?

A nursing home abuse or neglect attorney can help you or your loved one who is suffering from abuse in a nursing home in a number of ways: 

  • Explain your legal rights and protections under state and federal law.
  • Advise you on any legal requirements you may be under to report suspected abuse.
  • Communicate with the nursing home administrator or attorneys, and other parties such as insurance companies, on your behalf.
  •  Bring a legal claim against the nursing home and other responsible parties.
  •  Handle any paperwork and administrative work associated with your claim.
  • Help you and your loved one get compensation either via a legal claim or negotiated settlement.

19. Does my loved one in a nursing home have to be involved if I bring an action or complaint against the home?

You can bring an action for nursing home abuse or neglect on behalf of your abused loved one, if they are unable to bring the action on their own behalf. However, the abuse victim will inevitably be involved in some way in the investigation of the abuse because the authorities will need to assess the victim and the alleged abuse. Your lawyer can help advise you on legal and practical strategies to minimize the impact of any investigation or legal action on the abuse victim so that your loved one does not suffer any further trauma from the situation.

20. Do I have to be a relative to take action if I suspect abuse in a nursing home?

No, you do not have to be a relative to report suspected abuse in a nursing home. If you suspect abuse of any resident in a Delaware nursing home or long-term care facility, you should report it to the Delaware Division of Health Care Quality on the Complaint & Incident Reporting 24-Hour Toll-Free line at 1-877-453-0012 or via their online complaint form. Certain people, including nursing home employees and healthcare professionals, are even required by law to report suspected elder abuse in a nursing home. 

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