Most Common Violations of Regulations by Nursing Homes

Nursing homes play an important role in providing care and support for the elderly. To ensure the health and safety of residents, governments have implemented a complex web of regulations governing these facilities. In this blog post, we will explore the most common violations of regulations by nursing homes that lead to nursing home neglect lawsuits.

Understanding the Nursing Home Regulations

Nursing home regulations are designed to safeguard the rights, health, and dignity of residents. These regulations are established at various levels, including federal, state, and local authorities. At the federal level, the Centers for Medicare & Medicaid Services (CMS) sets the foundation with regulations that apply to facilities participating in Medicare and Medicaid programs. States then build upon these standards, tailoring them to their specific needs and priorities.

To learn more about the specifics of nursing home regulations, read our blog post The Laws Nursing Homes Must Follow in Alabama.

In short, the key areas of regulations include:

1. Quality of Care:
   • Federal regulations outline the minimum standards for nursing home care, covering aspects such as resident assessments, care planning, and quality of life. These regulations ensure that residents receive the necessary medical, nursing, and mental health services.
2. Staffing Requirements:
   • Adequate staffing is crucial for providing quality care. Regulations specify staffing ratios, ensuring there are enough skilled professionals to attend to residents’ needs. This includes registered nurses, licensed practical nurses, and certified nursing assistants.
3. Facility Safety and Accessibility:
   • Nursing homes must comply with strict guidelines to maintain a safe and accessible environment. This includes building codes, fire safety measures, and provisions for residents with disabilities.
4. Resident Rights:
   • Residents have rights that must be respected and protected. Regulations cover areas such as privacy, dignity, and the right to make decisions about their care. Facilities are required to have processes in place for handling grievances and ensuring resident participation in care plans.
5. Food and Nutrition:
   • Proper nutrition is vital for residents’ health. Regulations address dietary needs, menu planning, and food safety to ensure that residents receive well-balanced and nutritious meals.

Most Common Violations of Nursing Home Regulations

Alabama nursing homes are inspected and regulated by the Alabama Department of Public Health. The ADPH inspectors conduct annual surveys of nursing homes to ensure they are in compliance with CMS regulations.  In most instances, nursing homes are non-compliant in some fashion.

Based on these surveys and on our experience with handling cases involving nursing home neglect, here are the most common violations of the regulations by Alabama nursing homes:

Failure to Reposition Immobile Patients

One of the most important federal regulations applicable to nursing homes is 42 CFR 483.25(b) related to skin integrity.  Pressure ulcers in nursing homes result when nursing homes fail to comply with this regulation. To learn more about pressure ulcers, read our blog post Can You Sue a Nursing Home for Pressure Ulcers?

42 CFR 438.25(b) essentially states that nursing home patients should not develop pressure ulcers unless they are completely “unavoidable.” Most pressure ulcers are avoidable by taking simply measures such as:

• repositioning the resident every two hours
• ensuring adequate protein intake
• incontinence care

The most common injury or complication involved in nursing home neglect cases is the pressure ulcer because so many of these are preventable.  In addition, if the pressure ulcer is not timely assessed and treated, it can cause life-threatening conditions such as osteomyelitis or sepsis.

Medication Errors

Federal regulation 42 CFR 483.45(f) sets standards for medication error rates in nursing homes.  This may be surprising, but it is permissible under this regulation if a nursing home does not exceed a 5% medication error rate. However, many nursing homes still exceed this error rate, leading to preventable deaths and significant medical complications.

Medication errors can lead to harm or death in a variety of ways.  In some instances, it is the wrong medication that causes problems.  In other cases, it is the absence of the correct medication that leads to a decline in health.  Most commonly, since most nursing home residents are on numerous medications, the wrong medication interacts with another correct medication leading to harm.  In medical terminology, this means the medications were “contraindicated.”

Malnutrition and Dehydration

It is disheartening that a common issue in nursing homes is something as basic as getting enough food and water.  However, the truth is that this is a common issue.  Federal regulation 42 CFR 483.25(g) sets standards on nursing homes to ensure a resident receives adequate nutrition and hydration.

Nursing homes are required to create a “plan of care” to ensure that the resident maintains their current or ideal weight. Intake of foods must be recorded and nutritionary supplements must be ordered if medically appropriate. If a resident loses 5% or greater within a one month period, this is considered a “severe loss” that must trigger a change in the plan of care.

Let Us Hold the Nursing Homes Accountable for Violations of Regulations

At Siniard Law, we have handled many cases against Alabama nursing homes when they violate the regulations. If the nursing home violated a regulation that led to a preventable medical condition or death, then a civil lawsuit can seek compensation for the nursing home’s failures.

In order for us to review the case, please make sure you obtain:

• relevant medical records;
• photos of the injuries; and
• if applicable, death certificate

We must review all available evidence to determine whether the case has merit.  If we believe it does, we pursue the case on a contingency fee basis, which means there is no legal fee unless there is a settlement or verdict in your favor.

Reach out today to let us get to work for you and your family.