More than 1.5 million elderly and disabled Americans reside in more than 16,000 nursing homes across this country. Despite the fact that by law, these nursing homes must take steps to attain or maintain the "highest practicable physical, mental, and psychosocial well-being of each resident," too many of these residents are the victims of neglect or abuse by these facilities and/or their employees. In fact, in 1998 in Texas alone, more than 200 nursing home facilities were sanctioned for jeopardizing the health and safety of their residents, according to the Texas Department of Human Services. Despite increased regulatory oversight of the nation's nursing homes, it is safe to assume that many violations posing threats to the health and safety of the residents go unreported. According to Jim Lehrman, Associate Commissioner for Long Term Care for the TDH, "we cannot be in every facility 24 hours a day so we are only one part of the safety net." Therefore, family members with loved ones who are residents of nursing homes must never take the resident's care for granted and assume adequate protections are in place. The nursing home resident's only protection may be the family member's diligence in reporting any perceived problems.

Perhaps due to an attempt to squeeze more profit out of the bottom line, too many nursing homes simply do not hire sufficient numbers of qualified staff to appropriately care for their residents. Poorly qualified, untrained, and/or overworked staff are not capable of addressing the demanding daily needs of nursing home residents. Exposing neglect and abuse in a nursing home facility is much more difficult than in some other health care contexts because the nursing home abuse/neglect victims are often incapable of communicating the nature and occurrence of their abuse or neglect because of their physical and/or mental infirmities.

Nursing home abuse and/or neglect can involve not only the physical well-being of the resident, but also the mental, and/or psychological well-being of the resident as well.

Nursing home abuse and/or neglect can take many forms, all of which are too numerous to list. The following, however, represent common examples of nursing home abuse and/or neglect:

· failure to provide proper nutrition and hydration
· failure to assist in personal hygiene when needed
· over-medication or under-medication
· failure to take reasonable precautions to prevent falls
· failure to answer call lights in a timely fashion
· failure to turn residents in their beds (leading to pressure sores)
· failure to take residents to the toilet (leaving them in soiled garments or beds)
· slapping or other physical abuse of the resident
· use of unwarranted chemical or physical restraints
· emotional or verbal abuse of the resident
· retaliation for making a complaint or filing a grievance
· failure to take adequate precautions to prevent injury to the resident
· failure to provide for appropriate medical care
· sexual assault or rape of the resident
· theft of the resident's money or other personal property

The foregoing list is only intended to set forth common examples of abuse and neglect. This list is by no means exhaustive.

Any one or more of the following could evidence nursing home abuse or neglect and warrants investigation:

· bedsores (also known as "pressure sores", "pressure ulcers", and "decubitus ulcers")
· skin rash · urine and/or feces odor
· lack of attention to resident's personal hygiene
· falls resulting from lack of adequate precautions or assistance
· skin tears
· bruises, contusions, or lesions
· bone fractures
· significant weight loss
· dehydration
· disorientation
· depression or isolation
· unexplained mood changes
· fear or anxiety
· unexplained refusal or inability to communicate
· presence of unjustified chemical or physical restraints

Given that the health and safety of the resident is at stake if nursing home abuse or neglect is suspected, the matter should be investigated immediately. If the matter cannot be resolved to your satisfaction by bringing it to the attention of the nursing home administrator and/or the director of nurses at the nursing home, you may seek the assistance of the government, private attorneys, and/or support and advocacy groups.

The Texas Department on Aging Long-Term Care Ombudsman Program helps long-term care facility residents and their families to resolve problems and differences with the facility staff by defining concerns, explaining rights and identifying possible courses of action. Ombudsmen identify, investigate, and resolve complaints made by or on behalf of residents. Their toll-free number is (800) 252-2412.

The Texas Department of Human Services regulates, licenses, and certifies nursing homes for Medicaid and Medicare. The TDHS also investigates abuse, exploitation and neglect in nursing facilities. Their toll-free hotline is (800) 458-9858.

The Texas Attorney General investigates criminal matters in Texas. The toll free number is (800) 621-0508. If one suspects criminal abuse or neglect, one may also notify their local law enforcement agencies.

Texas Department of Protective and Regulatory Services, Adult Protective Services: (800) 252-5400 (investigates exploitation by an alleged perpetrator living in the community)

Nursing Home Credentialing Department, Texas Department of Human Services: (512) 231-5215 (investigates and resolves complaints against administrators)

Texas Attorney General's Medicaid Fraud Control Unit: (800) 252-8011 (investigates and pursues legal action related to fraud against Medicaid)

Veterans Administration: (800) 827-1000

Private attorneys can bring civil actions against nursing homes and their agents who are responsible for neglect and/or abuse in order to recover damages for medical bills, pain and suffering, and mental anguish. Under certain circumstances, one may also seek punitive damages in a civil lawsuit in effort to deter such grossly negligent and/or fraudulent conduct in the future.

The Law Offices of Powless & George, P.C., the sponsor of this website, represents nursing home abuse and neglect victims and their families in cases across the State of Texas. The Law Offices of Powless & George, P.C. also offers free initial consultations to those who believe they, or someone they know, may have been the victim of nursing home neglect or abuse. You may email us or call us toll-free at 888) 922-2889.

Generally speaking, a victim of nursing home abuse or neglect has a limited time period in which they must pursue a civil lawsuit or be forever barred. The length of this period varies depending upon the type of claim one is making, although in many (if not most) instances, it is two years from the incident of abuse or neglect. There are exceptions, however; therefore, one who believes that they may have been the victim of nursing home abuse or neglect should always seek the advice of an attorney without delay in order to preserve their claim.

It is also advisable to consult an attorney as soon as possible for other reasons as well. Memories of the event(s) in question tend to fade in witnesses, potential witnesses may later be unavailable because they have moved, become incapacitated, etc.

The first step in pursuing a nursing home abuse or neglect case is suspecting that one may have been the victim of abuse or neglect. Many times the nursing home victim is not capable of communicating about the abuse or neglect. Therefore, one who develops a "gut feeling" that something is wrong should consult a qualified attorney to review the matter, who often will consult with medical professionals. This process often involves the obtaining and review of nursing home and medical records along with other pertinent information. If it is determined that one has a good case, the next step is usually to give written notice of the claim to the individuals or entities that are believed to have committed the abuse or neglect.

Because such determinations involve the professional judgment (based upon many factors and considerations) of medical experts and attorneys, it is recommended that one seek a "second opinion" from one or more qualified attorneys if told that one's case is without merit.

Some attorneys (including the sponsor of this website) will agree to handle nursing home abuse and neglect cases on a contingency fee arrangement. This means that the attorney will not charge an hourly rate for his services, but instead will be paid a percentage of the recovery in the event of a settlement or judgment. In many instances, such attorneys will also pay the case development expenses (such as expert fees, deposition costs, etc.) with the understanding that he or she will recoup such costs only in the event of a recovery. Therefore, one may be able to secure legal representation without having to pay any attorney's fees or expenses out of one's own pockets.

There is simply no easy answer to this question. The vast majority of all cases, including nursing home abuse and neglect cases, are settled prior to trial. Some cases are settled prior to the filing of a lawsuit, while others are go to trial. A nursing home abuse and neglect case, if litigated to trial, could last a number of years. One who pursues a nursing home abuse and neglect case should understand from the outset that a quick resolution cannot be guaranteed.

Generally speaking, a victim of medical malpractice (including nursing home abuse and neglect) has a limited time period in which they must pursue their claim or be forever barred. In Texas, this "statute of limitations" is generally two years from the date of the incident of malpractice. Certain exceptions do exist under the law in certain circumstances. For instance, the foregoing time period may be extended for certain individuals, including those who are incompetent when the malpractice occurred. Additionally, in certain instances, such as when a medical professional or nursing home conceals the incident of malpractice, neglect or abuse, victims are allotted additional time under the law to file a lawsuit. The foregoing exceptions are fact sensitive and require the analysis of a qualified attorney to determine if they are applicable.

A potential claimant should always seek the advice of an attorney without delay. In certain cases, there may also be other deadlines within the first two years that may also impact the case. For example, claims against government entities may require that the entity or entities be put on "notice" much earlier than the statute of limitations period. Furthermore, given that a medical and legal analysis must be done prior to filing a lawsuit, one should not wait until the statute of limitations period is nearing its end because the attorney may not have enough time to complete the review prior to its expiration.

It is also advisable to consult an attorney as soon as possible for other reasons as well. Memories of the event or events in question tend to fade in witnesses, potential witnesses may later be unavailable because they have moved, become incapacitated, etc.