Insight into Nursing Home Abuse and Neglect

How to Spot Abuse in Nursing Homes

Nursing home abuse happens more often than people wish to believe, and it is important to recognize and understand the warning signs. Common signs of abuse can be classified into two categories: emotional and physical. Being aware of your loved one’s emotional and physical status is important and can help you determine whether they are exhibiting any of the following signs of abuse:

Emotional signs of nursing home abuse:

Mood swings and emotional outbursts

Reclusiveness or refusal to speak

Refusal to take medications or eat

Unusual or sudden changes in behavior (fear of being touched, sucking, biting and rocking)

Poor physical appearance or lack of cleanliness

Physical signs of nursing home abuse:

Bed sores

Bruising, cuts or welts

Broken bones or fractures


Head injuries

Unexplained weight loss or weight gain (signs of malnutrition)


Frequent infections

Unexplained illness or infections

When you notice these changes in your loved one, the first step should be to contact the nursing staff to understand the problems. However, if you find it is difficult to get into contact with staff at the nursing facility, this can also be a sign of a problem. Lack of staff support is a common underlying cause of inadequate care. If it is clear that you have spotted signs of abuse, don’t hesitate to intervene. This may include making a hotline complaint to the licensing agency in the state. Contact an attorney and they will assist you by listening to your problems, looking at the facts, and advising you on the best decisions.

A Fair Settlement Often Means More Than Money

For most of our clients, reaching a settlement isn’t just about money; our clients aren’t filing lawsuits merely to recoup compensable losses. Instead, they file suit to hold wrongdoers accountable and to prevent others from having to bury their loved ones or wake up every day to a life that is forever changed. We understand that our clients aren’t only seeking reparations – they seek necessary change.

In some cases, our settlements include specific safety and administrative requirements for a particular care facility. For instance, we might require that a company pay to have a comprehensive care standards audit performed on its facility by an independent party. We have also required facilities to hire a consultant to make ongoing safety recommendations.

Obviously, settlement is not always the answer; some cases simply have to go to trial, and trials yield their own kind of accountability, as well as pressure for change and improvement. Regardless of the facts of your case, or the manner in which your legal matter may best be resolved, we are committed to ensure that full and fair compensation is paid, accountability is had, change is made, and future wrongdoing is deterred.

It’s important to pay attention to the language of a settlement in these cases. The terminology of settlement agreements can be confusing. Some include confidentiality or indemnification clauses or exclude factoring fees and other expenses. Our experienced team is well versed in these terms and will advocate for you and your loved one.

Nursing home safety awareness, more effective regulations, regulatory compliance and enforcement, and ensuring full and fair compensation for victims and their families are causes in which we are actively involved, and to which we are fully dedicated. Dollar, Burns & Becker is a law firm where clients can expect more than a fair verdict or settlement; they can expect a team dedicated to helping them make a difference.

If the Unthinkable Happens – Time is of the Essence

No one expects you to know the important next steps if you or a loved one has been abused by a nursing home. It’s called the “unthinkable” because none of us thinks this kind of tragedy could happen to us. Nobody is ever prepared for this sort of life-changing event.

That’s why it’s crucial you seek expert legal counsel as soon as possible after abuse. Immediate investigation and making sure critical evidence is neither disturbed nor destroyed are extremely important, because time-sensitive physical evidence, records from the facility’s database and any electronic footage or correspondence are often critical components of your case. An attorney can also ease your burden by working directly with police agencies and insurance companies for you.

It doesn’t matter where you’re from or where the abuse happened; we help victims all over the country and can meet with you in person to discuss your situation, and begin assisting you as soon as we are contacted.

Let us be your voice.

The time immediately following the discovery of abuse can be difficult, confusing and overwhelming. Insurance and legal representatives and police will likely want to question you. Not all victims want to tell their story or relive what happened. Whether it happened to you or a loved one, you’re likely shaken up, traumatized or even in shock. If the victim has been hospitalized, they could be taking medication that impairs their thinking and ability to communicate. It’s not the best time to answer probing questions.

In a serious incident involving a large facility, immediate steps are often taken with the intent of reducing the facility’s liability. Even if you are represented by counsel, you still may be contacted directly. Any calls of that nature should be directed to your attorneys. When they talk to an attorney experienced in neglect and abuse cases, they know right away you won’t accept anything less than fair and just compensation for abuse, which, in addition to money damages, also often includes requirements for the facility to incorporate new safety policies, safety audits, background checks, or an overhaul of the company’s abuse prevention protocols.

I’m worried I can’t afford a strong legal team.

You needn’t worry about expense. Dollar, Burns & Becker works on a contingency basis only, which simply means you are not charged for the hours we spend on your case. Instead, we are paid a percentage of the compensation we secure for you.

Our track record in this very specialized field is well-documented. Make sure the legal team you decide to work with is well-qualified to represent you. For a free initial conversation, just give us a call. Our toll-free number is 877-816-2600.

When it matters most, we’re with you all the way.

When You Suspect Nursing Home Abuse

More than 3 million elderly Americans currently reside in nursing homes or utilize nursing home services, and this number is expected to grow as the baby boomer generation ages. As the population shifts and expands, we hope to see more attention paid to an issue that affects millions of people: nursing home abuse and neglect. For many, this has already become a concern. If you suspect your loved one or a resident is being abused or neglected, there are steps you can take to open an investigation and get them the help they deserve.

Signs of Abuse

According to the U.S. Department of Health and Human Services’ Administration on Aging, the most important step you can take to prevent elder abuse is to stay involved in your loved one’s life. This way, you’re able to monitor them for signs of abuse or negative changes. Some signs of abuse or neglect include:

Bruising, cuts or abrasions that are not easily explained.

A noticeable change in personality, such as withdrawing from activities, or unusual depression.

Sudden changes in overall health or well-being. Indicators typically include weight loss or hygiene changes.

A shift in normal relationships. For instance, your loved one refuses to speak to a caregiver or quits communicating with companions.

Reaching Out

If you suspect abuse or neglect, consider changing the routine of your visits. Try showing up at a different time of day and you may witness a very different environment than what you are used to seeing.

It is important to know there are state and local resources and organizations dedicated to preventing and stopping elder abuse.

Kansas Elder Abuse Hotline: 1-800-842-0078 or click here.

Missouri Elder Abuse Hotline: 1-800-392-0210 or click here.

Illinois Elder Abuse Hotline: 1-866-800-1409 or click here.

If you have questions or concerns and need to take the next step in protecting your loved one, don’t hesitate to contact me. Taking legal action is a significant but often necessary step in keeping loved ones safe and preventing abuse.

For more information and to learn more about signs of elder abuse, visit the National Center on Elder Abuse website.

Medicare Changes Raise the Bar for Nursing Home Ratings

By Dollar, Burns & Becker

In February 2015, the Centers for Medicare & Medicaid Services (CMS) implemented changes to the nursing home rating system. The five star rating system sets the bar for nearly 16,000 nursing homes across the country. Families rely on the system as they choose the best facility for the care of their loved ones. Criteria include the processing and analysis of standards of care regarding performance on quality measures, staffing levels and health inspection results.

Recent reforms to the system were made in light of a growing number of five-star ratings that didn’t match up to patient outcomes. The old ratings were often self-reported by the nursing homes and easily skewed. According to a New York Times article, about “80 percent of the nation’s nursing homes received a four- or five-star rating on their quality measures score (before the changes); afterward, nearly half did.” As a result, staffing scores decreased significantly with the new changes to the system.

Per CMS, a few of the main changes to nursing home star ratings involved:

• Improved calculation and verification of staffing levels. We find that staffing is a strong indicator of quality levels in nursing homes and certainly tied to a family’s peace of mind.

• Raised standards for achieving higher ratings on the quality measure dimension on the Nursing Home Compare website.

The administration of antipsychotic medications in relation to diagnoses that do not warrant use. Two quality measures regarding antipsychotics for short-stay and long-stay patients will now be configured into the quality measures star rating.

If you, a family member, or a friend is considering a nursing home placement, these changes are good news. But, of course, the rating system is not the only measure that should be taken when selecting a facility. For more on choosing a nursing home, check out one of my previous articles right here.

Putting the health of someone you love into another’s hands is never an easy decision but an easier one to make when you’re informed. If you have questions or concerns about your loved one’s nursing home, please do not hesitate to give us a call. 

Take a Proactive Approach to Personalized and Attentive Nursing Home Care

Even though you’ve gone through the process to find the right nursing home for your friend or family member, there’s more you can do to ensure they have the best care possible. This creative approach was recently shared with me by one of my clients.

Create a one-page introduction for the resident or future resident. Similar to a short biography, these introductions provide a lot of useful information for nursing home caregivers. Even if your loved one is already living in a nursing home, these notes to caregivers are something you can and should do.

They will encourage the staff get to know your loved one beyond the basic information they would normally receive in a medical chart. Mostly, it demonstrates to the nursing home staff that there are people who care about this person’s health and his or her well-being, enough to go above and beyond. The written notes will keep your wishes, and the resident’s wishes, front and center, even when you can’t be there to advocate in person. Finally, by creating this paperwork, you help remove the possibility that a staff member could claim that they “didn’t know” about your friend or family member’s needs or preferences.

These introductions aren’t hard to create. Use the following examples to help create one of your own:

• Include a recent photo of your loved one. Place the image at the top of the page to make it clear whom you’re discussing.

• Write it in first-person tense, as if your loved one had written it him or herself. If possible, engage him or her to either write it or assist you so nothing important is left out.

• Tell a little about the person’s life, such as their family’s names, their former career and hobbies they enjoy.

• Explain what sort of foods they prefer, and what beverages they like to drink, including when and how often. For instance, it might be important to say they love an early breakfast, or a late snack. List allergies and foods they simply don’t like.

• Emphasize that there’s nothing wrong with their mind, if that’s the case, and that they understand everything that’s said to them. If they’re talkative, mention that. The opportunity for their caregivers to know them on a personal level can only improve the care they receive.

• If religion is important, mention it.

• Everyone has favorite television shows, magazines or authors. If the resident is going to be there awhile, it’s important that they aren’t cut off from things they love. Don’t forget to mention if your loved one uses glasses for certain activities.

• Personal preferences for certain types of pillows, or how many blankets to put on the bed, are helpful.

• Even though caregivers know that residents need to be turned or have their positions changed every two hours, it doesn’t hurt to remind the staff.

• List and explain any health issues you can think of, and don’t assume everyone will read the resident’s chart or be familiar with their case.

Lastly, thank the caregiver in advance for the wonderful treatment they provide and how important that is to you and to the resident. With your effort and the understanding of the staff, the time your loved one spends in a nursing home can be peaceful and restorative.

I’m passionate about doing everything I can to ensure our elders have a really good experience moving to a place where they can get the support and care they deserve. Sometimes, elderly people don’t have a voice. We can be their voice. Please don’t hesitate to contact me with any questions or concerns you have about your loved one’s nursing home experience.

Choosing the Right Nursing Home

By Dollar, Burns & Becker

The question I am asked more than any other is, “How do I choose the very best place for my family member or close friend who needs to move out of their home and into a facility that offers assistance?” It’s a good question, frankly, because it is one of the most important decisions you’ll ever make.

The good news is, it’s not as daunting as you may think. There are resources you can rely on to make the decision more clear. Our federal government regulates the nursing home industry, and provides research you can use to make an informed decision. This is one of those times your tax dollars really do work to your benefit.

If you visit, you’ll find incredibly useful information about every nursing or convalescent facility in your area, to help you make a truly informed decision.

Noting the differences in facilities is important. You can compare their size, overall ratings, and how they were rated on government-mandated health inspections by the Department of Health & Senior Services. You will also be able to see their staff-to-resident ratio and quality measures. Most importantly, you can see if any complaints have been lodged against them and, if so, how many, over what period of time, and what was done to resolve the complaint.

Some things to consider:

• Independent vs. chain – Many of my clients have had success with smaller, locally run homes that have an established track record.

• Small vs. large – I think smaller is better as long as there is a good staff-to-resident ratio.

• Nonprofit vs. for profit – Because they are not driven by profit, I’ve found nonprofit facilities may be less likely to cut corners.

• Religious vs. non-religious – In my experience, I’ve found that nursing homes with a religious affiliation tend to have better care than those that do not. It’s not true in every case, but generally speaking it seems to work that way.

Even if you don’t immediately find the perfect place, hopefully you will feel better knowing the real story about how the facilities in your area operate now and in the past.

I suggest narrowing your choices to three or four, then visiting them in person to give them your own “eye test.” Visit with their administrators and ask questions. Trust your intuition.

Personal experience and references are also incredibly valuable. Talk to friends or people you know about what experiences they’ve had with their family members.

And remember, I’m here to help you, too. I have seen the good and the bad here and all over the country. I am passionate about doing everything I can to ensure our elders have a really good experience moving to a place where they can get the support they need. Isn’t that something we all deserve? This is one decision where you want to be as well informed as you can be.

The Importance of Nonpartisan Judges

By Tim Dollar

If the people of Jackson County reach the point where they no longer have confidence that our judges are impartial and free of prejudice, our legal system will collapse. We can never allow that to happen.

That’s why the Missouri Nonpartisan Court Plan was created years ago, to ensure the public is served by qualified, impartial and nonpartisan judges. When we allow money to determine who our judges are, or allow it to influence those we have elected to be judges, we are sowing the seeds of injustice. All attorneys should be able to try their cases in front of a judge who is free from obvious political biases.

Under Missouri’s Plan, nonpartisan judicial commissions are created at every level of the legal system to review applications and help seat potential judges. After a rigorous selection process, we narrow the list to those we consider the three best candidates, and forward those names to the governor. Following a careful review, the governor chooses the best candidate in his or her opinion. Periodically, the public decides in general elections whether or not a judge continues.

I was elected by my peers to serve on one of these commissions for six years.

In all of those years, not once did any of the commissioners I served with ask a candidate about his or her political affiliation. We never had any idea whether the candidates who appeared before us were Democrats, Republicans or independents; and that’s how it should be.

It probably won’t surprise you that the Missouri Plan has powerful opponents who want to dismantle it for political reasons. A few people, who would benefit from judges they controlled, are largely behind these efforts. To date, we have been able to defeat these attempts and it’s a good thing for everyone that we have.

I am a strong advocate for the plan. While not perfect, I believe it is the best way to make sure our judges are fair and impartial. Most of the time, we get it right. And when the public feels otherwise, they can vote any judge out of office.