Being responsible for the health and safety of another person is always hard, especially when it’s your aging parent or another beloved family member. When they need more care than you can give, you turn to a nursing home or assisted living facility to provide that 24/7 help they require. Even after you’ve done your research and made the most informed, best decision you can, you worry. Because you’ve heard the stories about nursing home abuse and neglect, beatings, sexual abuse, over-medication. If your worst fears have come true and you believe your loved one has been abused or injured while in the care of a South Carolina nursing home or assisted living facility, call the nursing home abuse lawyers at The Louthian Law Firm.
At this point you may just have your suspicions, without hard proof. Or you may have been faced with undeniable evidence and moved your loved one out of there. In either case, Bert Louthian can help you with the next steps. Your loved one deserves better, and they could be entitled to compensation for the harm they’ve suffered.
Call (888) 359-2807 or fill out our contact form to tell us what’s on your mind. We have decades of experience helping people who have been harmed by nursing home abuse and negligence. And we offer free consultations, so you don’t have to add lawyer’s fees to the list of your worries.
We care about protecting our elders and others who are vulnerable. Let us help you achieve justice when negligent or malicious people harm your loved ones. Speak to Bert Louthian, a South Carolina nursing home abuse and personal injury attorney who gets results. Contact us today.
How Common is Nursing Home Abuse?
Elder abuse is a cruelty so abhorrent that it is almost unfathomable. It’s difficult to imagine someone cruel enough to physically assault a senior citizen, especially when the assaulter is a healthcare provider and the victim is a nursing home resident. In theory, nursing homes exist to provide for the wellbeing of those who most need it. Unfortunately, in practice, these facilities don’t just fall short of that objective, they often do the exact opposite and cause significant physical or emotional harm to those they’re supposed to be caring for.
The abuse and neglect of nursing home residents is far more common that most people would like to believe. Before we look at what we know and what we don’t know about nursing home abuse, let’s look at some facts about nursing home care in the United States.
The State of Nursing Homes in the U.S.
There are approximately 1.4 million nursing home residents in approximately 15,600 nursing homes in the United States. About 60 percent of those facilities are for-profit, though Medicaid pays for most of the nursing home residents’ care.
The percentage of older Americans who occupy nursing homes has fallen dramatically over the past few decades. In fact, according to the Centers for Disease Control and Prevention, from 1977 to 2014, the number of nursing home residents aged 65 and over per 1,000 population fell by about one-half. Over that same period, the number of nursing homes have declined by 15 percent.
What these numbers tell us is that the nursing home industry in the United States is largely made up of private enterprises using government funds and that the industry, though still heavily relied upon by older Americans, has been in decline over recent years. This helps set the stage for what many safety advocates believe is a system plagued by nursing home resident abuse and neglect.
What is Known About the Prevalence of Abuse in Nursing Homes
It’s important to understand that existing research about nursing home abuse in the United States is often outdated, and it is conducted too infrequently. However, here are a few things that studies have shown, according to a research brief by the National Center on Elder Abuse:
- A report from 2001 found that one-third of nursing homes were host to resident abuse.
- A study of resident interviews in 2000 revealed that 44 percent of patients said they had been abused.
- More recently, a 2010 study found that over half of nursing home staff admitted to mistreating older residents.
- Around one-third of abuse complaints in our nursing homes concerned physical abuse.
An in-depth piece from CNN in 2017 also provided some startling revelations about sexual abuse in nursing homes. CNN found “that the federal government has cited more than 1,000 nursing homes for mishandling or failing to prevent alleged cases of rape, sexual assault and sexual abuse at their facilities” from 2013 to 2016. As CNN points out, many rape victims don’t report sexual assault, so the numbers are likely significantly higher.
Unreported Abuse is A Major Problem in the U.S.
What we know about nursing home abuse is disturbing, but just as alarming is what we don’t know. For example, an alert from 2014 given by the Office of Inspector General in the Department of Health and Human Services said that about 28 percent of serious cases of nursing home abuse are not reported to the police, which violates both federal and state law, as reported by NPR.
Not only do these matters not get reported to the police, they are sometimes handled in a way that essentially covers up the wrongdoing. For example, the assistant regional inspector general interviewed by NPR told a story about a female nursing home resident who was badly bruised after a sexual assault, something that should have been reported to the police within two hours. After the family of the victim reported the incident to the police, the facility reached out to the police to say that they didn’t need to come to the facility to investigate.
Why Elder Abuse is So Common
There are several reasons that abuse and neglect occur so frequently. First is the fact that many senior citizen nursing home residents are easy prey for predators. These residents often have dementia or other conditions that make it difficult for them to speak up about their abuse. Even if they do complain, it’s not a given that their complaints will be taken seriously.
Second, nursing homes are often understaffed. Pay also isn’t great for workers at nursing homes, which means that these facilities often rely on less-experienced or under-qualified workers. CNN also reported that these facilities fail to staff supervisors during second and third shifts, when abuse is more likely to occur.
Abuse Comes in Many Forms
Nursing home abuse includes more than physical and sexual assault. Neglect is also common in nursing homes. Failure to provide adequate food and water is also a form of abuse, as is the over-prescribing or administering of harmful medications. This has been a frequent problem in nursing homes, where staff often give residents antipsychotic drugs that increase the resident’s likelihood of suffering a serious injury.
Staff can also be abusive if they scream, insult, demean or otherwise inflict emotional or psychological harm to a resident. These types of abuse are even more difficult to detect because there will be no physical sign that abuse has occurred, though family members might notice that their loved one appears depressed, withdrawn or anxious.
Nursing home abuse is not committed only by staff. Resident-on-resident nursing home abuse is likely just as common as abuse at the hands of staff members. But just because another resident is perpetrating abuse, it doesn’t mean the facility carries no responsibility. In fact, it is a nursing home’s duty to provide for the safety and security of its residents, which includes protecting a resident from abuse at the hands of another resident.
Causes of Nursing Home Injuries
Chemical restraint is one of the most devastating forms of nursing home abuse in South Carolina.
Chemical restraint is the unnecessary administration of antipsychotic or sedative medications to subdue residents, to make them more pliant and to make them easier to care for. Benzodiazepines and haloperidol are among the drugs used for chemical restraint in nursing homes.
Chemical restraint can be difficult to detect and it severely impacts the freedom and health of affected residents. Taking unnecessary drugs can be dangerous. Payment for the drugs can be expensive, and patients are deprived of their ability to act of their own free will.
South Carolina nursing homes must provide patients with information about their rights, including posting a residents’ bill of rights. Among those rights is the right to be free from chemical restraints used for the convenience of the nursing home staff.
Federal regulations also establish rules regarding the use of antipsychotic drugs. According to 42 CFR 483.25, nursing homes must not give patients unnecessary drugs, including antipsychotic medications.
Nursing homes may administer these drugs to:
- Make patients more sedate and easier to control.
- Limit complaints or poor behavior caused by excessive heat, overcrowding and noise.
- Make patients more accepting of changes in their routine.
- Stop the taunting or abuse of other patients or make a patient indifferent to taunting/abuse
- Calm agitated or upset patients.
- More easily solve mental health problems that could be addressed with proper mental health assistance.
Consequences of chemical restraint in nursing homes
- Chemical restraint in nursing homes has many serious consequences:
- It is dangerous to patients, especially when antipsychotics are prescribed in conjunction with other drugs. Delirium and falls leading to concussions or other injuries are common. When given to dementia patients especially, the FDA warns that the use of atypical antipsychotic drugs increases the risk of death.
- Other health problems or abuses can be masked when patients are subdued and unable to complain or recall incidents of abuse or problems to family members or others who could provide help.
- It is expensive. According to the Department of Health and Human Services report, Medicare spent $309 million on claims for residents prescribed atypical antipsychotic drugs.
It’s a medical fact that common infections in nursing homes are largely avoidable. Such infections are responsible for one-fourth of the medical injuries that happen to Medicare residents of nursing homes.
A generation ago, the average hospital stay was 7.3 days (1980). In 2012, stays had shortened to 4.5 days. Extra time in the hospital decades ago meant that patients could more fully recuperate before going home. These days, patients are released to nursing homes and rehabilitation facilities to finish recuperating. The patients sometimes have surgical wounds that have not closed, or they are in weaker condition and thus more susceptible to infections. They often require ventilators and other medical equipment such as urinary catheters that can create healthcare-acquired infections (HAIs).
Nursing homes are frequently understaffed or may have inattentive staff. Basic practices such as washing hands and isolating contagious residents are frequently ignored. Staff are also often strongly discouraged from calling in sick. When sick staff attend nursing home residents, those with weakened immune systems end up exposed to illnesses that, while mild for a healthier person, could cause severe illness in a frail and ill elderly person.Combine all of these factors with lax oversight from the Centers for Medicare and Medicaid Services (CMS), and it’s a wonder that more nursing home residents are not dying from infections.
Examples of common infections among nursing home residents include:
Urinary tract infections (UTIs)
UTIs are the most reported infection in nursing homes. While many of these infections are CAUTIs, or catheter-associated urinary tract infections, nursing home residents without catheters also suffer from UTIs at a higher rate than the general population in hospitals. This is partially due to normal aging changes.
The worst thing about UTIs in the elderly is that fully half of the blood infections they can develop—also known as sepsis—are related to a urinary tract infection. Sepsis develops when the body is overwhelmed by infection, creating an exaggerated immune system response that can quickly turn fatal. Each year, sepsis kills over a quarter-million persons.
Pneumonia caused by Streptococcus pneumoniae is the most deadly infection in nursing homes. Approximately 1.4 out of 1,000 persons in the U.S. as a whole will catch an infection of the lower respiratory tract or pneumonia, but 33 out of 1,000 nursing home residents will become infected with pneumonia. Nursing home residents who have feeding tubes are the most susceptible to the disease. Elderly patients often do not show the same symptoms as younger persons, so diagnosis can be delayed until it is too late.
Clostridium difficile infections (CDIs)
CDIs are the fastest-growing type of infection in nursing homes. C-diff cases have doubled in their prevalence since 2000 and cause a much larger proportion of deaths than would normally be expected. C-diff often arises because the patient has gone through a round of antibiotics which kills the good bacteria in the gut, leaving the door wide open for the extremely antibiotic-resistant C-diff to take over.
Flu is the most preventable infection in nursing homes and is still a leading cause of death among residents. Persons over 65 account for 90 percent of the annual deaths that can be traced to influenza. The close proximity of residents makes it easy for the flu to be transmitted. Studies have shown that the incidence of flu goes down when both residents and staff receive flu shots.
Methicillin-resistant Staphylococcus aureus (MRS) and Group A Streptococcus (GAS)
Both GAS and MRSA are the infections most closely associated with environmental factors in nursing homes. These two microbes are implicated in infections resulting from pressure ulcers (bed sores) and can lead to sepsis. Among nursing home populations, 58 percent of residents carry MRSA, and both MRSA and GAS can live on dry objects for more than six months. It’s critical that nursing homes minimize contamination among weakened and infected patients by practicing basic hygiene such as washing hands between patients and isolating contagious persons. MRSA, as its name implies, is especially problematic because of its resistance to most antibiotics.
Medications are an important and integral part of the care provided to residents of assisted living centers and skilled nursing facilities. One study found that an average of 6.7 medications are ordered per elderly resident, with 27 percent of residents taking 9 or more. Medicaid data showed that in one state, during a 30-day period, 68% of long-term care patients had received 9 or more prescription drugs, and 32% had received 20 or more!
Obviously, the more medications a patient is supposed to be given, the greater the risk that mistakes will be made. Patients who cannot, or are not allowed to, self-administer their medications are at the mercy of staff who may be overworked, underpaid or poorly screened.
What types of mistakes cause adverse drug events?
- Dose omission
- Overdose/multiple dose
- Under dose
- Wrong product strength
- Expired order
- Wrong documentation
- Wrong product
- Wrong time
- Wrong patient
- Wrong duration
- Monitoring error
- Lab work error
- Wrong technique
- Wrong form of product
- Expired product
- Wrong rate of administration
- Wrong route
In addition to having a large number of drugs and doses to administer, nursing home personnel make medication errors for a number of other reasons, including being distracted or interrupted by other demands.
It is not unusual for a nursing home resident to be hospitalized, perhaps due to a fall or illness, where the doctor will make changes in his or her medication regimen. When the patient is released back to the residential facility, the revised orders may not be properly communicated. Sometimes there is confusion about whether a previously prescribed drug has been withdrawn or is to continue.
Lack of communication between nursing shifts also leads to the potential for incorrectly giving patients their medications, and busy nurses don’t always sufficiently note and describe patient complaints or observations that could indicate a problem with medication.
What happens when patients are given wrong meds or wrong doses?
Not only can medication errors deprive the patient of the full benefit of the ordered drug therapy, they can expose the patient to potentially harmful conditions, such as medication interactions, depression, confusion, immobility, falls, and related hip fractures.
The drugs most often associated with preventable adverse drug events are cardiovascular medications (24.5%), diuretics (22.1%), nonopioid pain meds (15.4%), hypoglycemics (10.9%), and anticoagulants (10.2%).
Some adverse reactions are considered significant but not serious — skin rash, a fall without associated fracture, hemorrhage not requiring transfusion or hospitalization, and oversedation. Examples of serious consequences are hives, a fall with an associated fracture, hemorrhage requiring transfusion or hospitalization but without hypotension, and delirium. Sometimes a medication error can be life-threatening and produce hemorrhage with associated hypotension, hypoglycemic encephalopathy, profound hyponatremia, and acute renal failure requiring hospitalization.
It’s Vital to Act Quickly Once Abuse Has Occurred
Family members of an abused nursing home resident should notify the authorities and contact an attorney as soon they discover abuse has happened. A prompt report ensures that the authorities will have a record of the incident and potentially spare the resident from further abuses.
If you or your loved one has been abused in a nursing home in South Carolina, contact personal injury attorney Bert Louthian to learn more about your legal options. Call us today at 803-592-6231 or fill out our online contact form to schedule a free consultation.
FAQs on Nursing Home Abuse in SC
Are you concerned about placing a loved one in a continuing care facility? Do you currently know someone in a nursing home and have reason to be worried? Our FAQs (Frequently Asked Questions) might help you with some of your concerns.
How common is nursing home abuse in South Carolina?
While it is possible that many cases of nursing home abuse, neglect and exploitation go unreported each year, we do have some idea of the prevalence of the problem through the statistics compiled by the state’s Adult Protection Coordinating Council, a group composed of 21 public and private organizations and consumers. The Council’s data shows the following numbers of complaints filed during 2015:
- 4,904 cases were reported to Adult Protective Services.
- 1,930 complaints were made to the State Long-Term Care Ombudsman.
- 37 complaints were made to the Medicare Fraud Control Unit.
Does nursing home abuse affect only the elderly?
Not at all. Although the majority of people living in nursing homes are age 65 and over, people with other types of serious disabilities, such as traumatic brain injuries, may also reside in nursing homes because their families cannot care for them at home. The South Carolina Vulnerable Adults Investigation Unit of the State Law Enforcement Division, or SLED, received 929 complaints of nursing home abuse for patients of all ages in 2015. Some of the categories with alleged problems include:
- 352 complaints concerning a death
- 161 complaints concerning physical abuse
- 151 complaints concerning substandard care
- 33 complaints concerning psychological abuse
- 29 complaints concerning neglect
- 26 complaints concerning some kind of exploitation
- 19 complaints concerning sexual abuse.
I just learned that the nursing home employee who abused my loved one has a criminal record. Shouldn’t the facility have checked on that before hiring them?
According to a recent report by the U.S. Department of Health and Human Services, 92 percent of nursing homes employ one or more individuals who have been convicted of at least one crime. In South Carolina, anyone who is paid by or who has a written contract to provide “hands-on” care to a resident, patient, or client must have a criminal background check. Most applicants qualify for only a state check; federal checks are required only of applicants who have not been a resident of South Carolina or another state for at least 12 months. The decision of whether or not to employ a person after having the background check done is left up to the employer. However, there are a few notable exceptions, including this one: A facility, if it wants to secure and keep a SC state license to run a nursing home, cannot hire any person who was ever convicted of, or who pled “no contest” (nolo contendere) to, a charge of “child or adult abuse, neglect, or mistreatment, or any other felony.”
What kinds of abuse can happen to my loved one?
Any of the following behaviors or actions can be classed as abuse, and any caretaker in any facility or care situation can be guilty of them:
- Physical abuse: inflicting physical injury or pain
- Sexual abuse: any unwanted sexual contact
- Emotional or psychological abuse: intimidation, threats of abuse, verbal harassment, name-calling
- Willful deprivation: withholding food, liquids, or medication deliberately, including pain medication
- Financial exploitation: misuse or theft of the patient’s financial resources
- Passive neglect: not providing things essential to life, such as food, shelter, clothing, and medical care
- Confinement: the use of restraints when there is no medical basis or need
- Chemical restraint: overmedication with anti-psychotic drugs. One-third of all nursing home patients are given anti-psychotic drugs.
What signs could indicate that a nursing home resident has been abused or neglected?
If you observe any of the following signs with regard to your loved one who lives in a nursing home or assisted living facility, you would be wise to explore the situation to determine whether the facility is properly caring for them:
- Weight loss, malnutrition or dehydration
- Unexplained bruises, wounds or dislocations
- Bloody or torn clothing or bedding
- Fearfulness and other personality changes
- Frequent illnesses or infections
- Unexplained sexually-transmitted diseases, or injuries to the genitals, anus, breast, or mouth
- Agitation or fretting
- Wandering or attempts to “escape”
- Depression or unresponsiveness
- Unusual or unexplained financial transactions
- Insufficient staff, such as one nurse’s aide to care for as many as 30 patients
- Seeming distrust, paranoia, or fear of the staff by the patient
- Aggressiveness or distrust of visitors on the part of staff, especially if they won’t leave you alone with the patient.
Who regulates nursing homes in South Carolina?
Nursing homes must be licensed by the SC Department of Health and Environmental Control, which sets standards they must meet in many areas, such as training, record keeping, medication management, food service, infection control, and building design. All facilities are subject to inspection or investigation at any time, without prior notice. These reports are available to the public upon written request.
South Carolina Nursing Home Bill of Rights
Many nursing home residents and their family members are unaware of their rights under South Carolina law. Residents of nursing homes have the right to expect quality care and treatment and the very basic right to be treated with dignity and compassion.
All assisted living facilities must clearly post a list known as the resident’s bill of rights where all residents can see it. Typically these rights will include:
- Medical rights: to be kept informed of health status and medication – and the rights of relatives to be kept informed of any change in a loved one’s health status or impending release;
- Physical rights: to be free of any physical abuse, sexual abuse, or verbal abuse, including use of physical or chemical restraints for the convenience of the nursing home staff rather than the avoidance of self-injury;
- Right to privacy: to receive and send mail, use the telephone, share a room with a spouse and keep personal belongings; and
- Financial rights: to handle one’s own money or designate an individual to handle finances, have access to financial records and statements, as well as information about nursing home fees.
If these rights aren’t being upheld, you should contact the South Carolina nursing home negligence attorneys at the Louthian Law Firm immediately. Quick action can help protect you or your loved one’s health and finances and stop further neglect and harm from taking place.
What should I do if I have a complaint?
If you have a concern about the operation of a facility, you can call the South Carolina DHEC at (803) 898-DHEC (3432). If you suspect that your loved one has been the victim of physical, sexual or psychological abuse, financial exploitation, neglect or abandonment, contact the SC Lieutenant Governor’s Office on Aging at (803) 734-9900.
More information on elder abuse can be found at the websites for South Carolina Adult Protective Services, the National Center on Elder Abuse, and the South Carolina Lieutenant Governor’s Office on Aging.
If you feel uneasy or anxious about what you observe at the facility, or if your loved one tells you they are being abused or neglected, you should consider investigating further.
Seeking Truth and Securing Justice for Your Loved Ones
When someone you care about has been hurt, it can feel like nothing will ever be right or fair again. When this happens, the nursing home injury lawyers at the Louthian Law Firm can review your legal options after a personal injury and work with you to determine the most appropriate next step.
Many South Carolina nursing home and assisted living facilities are part of larger corporations which have their own legal departments.
The corporation’s lawyers may try to dispute abuse and neglect claims, but we at the Louthian Law Firm have represented victims of neglect or abuse in retirement homes, and we understand how to deal with such negligent facilities and the attorneys who represent them. While a lawsuit cannot heal bedsores or restore someone’s health, a South Carolina nursing home abuse claim can help recover the large sums spent on a neglectful or abusive nursing home, as well as the medical bills created by that abuse or neglect. You may also be able to hold the abusers accountable for the pain and suffering they caused, for relocation costs, and for wrongful death.