Older people frequently opt to move into nursing homes or long-term care facilities to ensure that they are well cared for, and will be protected from the effects of any deteriorating physical and/or mental conditions. Ordinarily, these facilities provide a positive environment and a beneficial experience for their patients. However, older people are sometimes actually physically and/or psychologically harmed by the negligent or intentional acts of their caregivers. In institutional settings, several factors have been shown to contribute to the abuse or neglect of residents, including: poorly qualified and inadequately trained staff; staff with a history of violence; inadequate numbers of staff; the isolation of residents; and, the reluctance of residents to report abuse out of embarrassment or fear.
Liability for Nursing Home Injuries
There are many ways in which nursing homes can be held responsible for injuring others as a result of their negligence, abuse, false imprisonment, or violations of criminal statutes, as well as violations of regulations pertaining to their licensing, maintenance, and general operation. An act of abuse, neglect or exploitation of an older person might give rise to one or all of the following types of proceeding:
1) an investigation and finding by an adult protective services agency;
2) a civil cause of action for damages (a lawsuit); and/or,
3) a criminal prosecution.
These three types of proceedings have different objectives. The objective of a protective services investigation is to provide immediate help and relief to the victim and prevent further harm. The goal of a civil action (lawsuit) is to remedy damages, and the criminal prosecution is meant to punish the harmful conduct.
Civil Actions Against Nursing Homes
The liability of a nursing home owner or employees can result from:
- Negligent personal supervision and care,
- Negligent hiring and retention of employees,
- Negligent maintenance of the premises, and
- Negligent selection or maintenance of equipment.
A nursing home can be held liable for negligence if the injured party can prove:
- that the nursing home's owner or employees breached a duty of care owed to the injured person;
- that the person's injury was caused by this breach; and,
- that the nursing home owner's or employee's conduct caused the injury.
While these elements apply equally to negligence actions brought by nursing home visitors and residents alike, the following discussion focuses specifically on issues that arise in negligence actions brought by residents.
Proving Duty and Breach of Duty: A plaintiff suing a nursing home may need to offer expert medical testimony about what is or is not a proper practice, treatment or procedure in a given situation, unless the lack of care or skill by the nursing home is so apparent that the average person would comprehend it based on his or her common knowledge and experience. For instance, if a nursing home administrator is alleged to have failed to exercise care with respect to maintaining the nursing home facility, that issue will likely not require expert testimony, whereas a nurse's treatment of a patient's condition might.
Statutory Standard of Care: Many states have enacted statutes or regulations that establish certain minimum standards of care for private nursing homes. Even if a nursing home can show it complied with minimum licensing standards, however, it may still be liable for a resident's injuries. For these reasons, it is important to have an attorney research the applicable standard of care, licensing requirements, and other regulations in your area.
Causation: An issue that comes up frequently in nursing home litigation is whether the resident's injury was inevitable due to his or her preexisting poor health, medical complications, mental condition, or advanced age. Defendants often argue that a resident's preexisting health condition, and not any negligence on the part of the nursing home, was the true cause of an injury alleged in a lawsuit. But this should not deter a resident who believes a nursing home caused his or her injury; there is a well-established rule of law that a defendant (such as a nursing home) takes its victim as it finds him/her, preexisting conditions and all. Thus, the fact that a resident's injury may have been made worse, or harder to treat, because of a preexisting physical or mental condition does not relieve the defendant of liability.
Defense Considerations: In negligence actions, nursing homes are entitled to assert the sorts of defenses that are available inmost negligence cases, such as the contributory negligence of the injured party, and assumption of a known risk. However, in some cases, such as where a person has placed him or herself into a nursing home specifically because he or she needed to be protected from the effects of certain medical conditions, the defense of contributory negligence may not be allowed.
Breach Of Contract
Usually, a nursing home will enter into a contract with a resident, in which it sets out what services it will provide, and the cost of those services. If the perceived abuse or neglect of the nursing home or its employees is contrary to promises made in the contract regarding the care of residents, the nursing home can be sued under a breach of contract theory. Many contracts require only that the home provide such services as are "reasonably necessary" for the resident's well-being, but even under this standard, a nursing home could be found negligent if it failed to meet the basic needs of a resident.
Some states provide criminal penalties for the abuse, neglect, or other mistreatment of nursing home residents. Historically, prosecutions for crimes involving abuse, neglect and exploitation of the elderly were relatively infrequent. Recently, however, there have been more and more prosecutions of such actions. Moreover, some states have enhanced penalties for crimes committed against older people. In some cases, failures to provide residents with sufficient food, keep residents clean enough, or prevent bedsores from occurring, have supported convictions for criminal neglect. In other cases, the unjustified use of physical restraint or force against nursing home residents has resulted in convictions for nursing home abuse. In some states, the definition of abuse may require inappropriate physical contact that harms or threatens to harm the patient, and may not cover verbal threats.
Getting Legal Help for Nursing Home Abuse
If you or a loved one has suffered injury or abuse as a resident of a nursing home, you should speak with an experienced attorney as soon as possible to ensure that your legal rights to compensation are fully assessed and protected, especially in light of time limits for filing a lawsuit for nursing home injuries.