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A nursing home should provide care that ensures the comfort, safety, and dignity of residents. California law protects residents from being denied proper medical care, unnecessarily restrained, left hungry or dehydrated, financially exploited, and more. Lanzone Morgan, LLP, is here to help whenever these rights are threatened.
Common Nursing Home Violations You Should Know About
Nursing homes must respect residents’ rights and provide safe, humane care. Despite the regulatory oversight in place, facilities sometimes fail to meet required standards. Below, we outline common violations and explain how to identify signs of substandard care at a nursing home.
Denying Proper Medical Care
California nursing home residents are entitled to timely and appropriate medical care to ensure their health and well-being are safeguarded. Examples of inadequate care include withholding prescribed medication, failing to follow individualized care plans, or neglecting to notify doctors about medical concerns. These lapses can cause serious health complications and may constitute neglect.
Facilities cannot withhold medical treatment or block necessary access to healthcare services. When medical care is denied or delayed without valid medical reasons, this constitutes a serious violation of resident rights and state law.
Restricting Family Visits Without Legal Justification
Nursing homes generally cannot block family visits, as residents have the right to maintain emotional connections and receive support from loved ones. Restrictions may be allowed only for legitimate health or safety reasons, and even then, they must be reasonable and clearly communicated. Unexplained or excessive limits on visits can indicate neglect or abuse and should be reported to ensure residents’ rights are protected.
Improper Use of Physical or Chemical Restraints
Using a device or substance to limit a nursing home resident’s movement for convenience or discipline violates state and federal restraint laws. The Nursing Home Reform Act of 1987 sharply restricted the use of physical and chemical restraints, allowing them only when medically necessary and with proper consent. Despite these protections, some facilities continue to use restraints for non-medical reasons such as convenience or staff convenience, which is unlawful.
Ignoring or Retaliating Against Complaints
Nursing home residents and their families have the right to voice concerns about care or living conditions without fear of retaliation or being ignored. Typical complaints involve inadequate personal care, medication errors, poor hygiene, unsafe or unsanitary living conditions, neglect, or abuse.
It is essential to document all reported issues, including details such as dates, times, and descriptions of incidents. These records can support future legal actions if problems persist. Facilities cannot retaliate against residents or families for filing complaints or reporting suspected violations.
Failing To Provide Adequate Nutrition and Hydration
Under state and federal laws, facilities are legally required to provide residents with sufficient food and fluids to maintain their health and ensure proper nutrition. Nursing home staff have a legal and ethical duty to watch for signs of dehydration and malnutrition. They must conduct regular nutrition assessments, provide balanced meals, monitor residents’ physical and cognitive abilities, and assist residents with physical challenges impacting eating and drinking.
Signs of malnutrition or dehydration include weight loss, dry skin or mouth, bedsores, slow-healing wounds, low blood sugar, electrolyte imbalances, and confusion. Families should pay attention to these warning signs and report concerns to staff promptly and to CDPH if the facility does not respond appropriately.
Financial Exploitation and Unauthorized Charges
Nursing home facilities cannot overcharge residents or access their funds unlawfully. Families should be alert to signs of financial abuse, which include unexplained withdrawals or charges, new names on accounts, sudden property transfers, and unpaid bills.
Some individuals may gain a resident’s trust and use coercion or manipulation to take money, property, or convince them to sign a power of attorney. Others may forge checks or steal a resident’s identity. Financial exploitation is a serious crime and should be reported to both facility management and law enforcement.
Discharging or Transferring Residents Without Proper Notice
A facility must notify the resident and their legal representative in writing before any transfer or discharge. The notice generally must be given at least 30 days in advance. However, some situations are exempt from the 30-day notice requirement, such as when the resident requires an immediate transfer due to urgent medical needs.
Improper discharge or transfer without adequate notice and planning violates resident rights and state regulations.
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Did You Know?
The Nursing Home Reform Act of 1987 requires nursing homes to provide services and activities to maintain the highest practicable physical, mental, and psychosocial well-being of each resident.
Protected Rights That Define What Nursing Homes Cannot Do
Residents of California nursing homes have rights granted and enforced by both state and federal regulations, including the following:
- Protection against abuse: Residents have the right to be free from verbal, sexual, physical, and mental abuse.
- Freedom from restraints: Physical or chemical restraints can only be used by facilities for medical reasons and with proper consent.
- Transfer and discharge rights: Residents can only be transferred or discharged under specific conditions, provided they receive notice and have a safe plan in place.
- Visitor access: Residents can see visitors of their choice at times that respect others’ rights and do not interfere with their own health and safety.
- Advocacy support: Residents may contact advocates, including a long-term care ombudsman, to resolve complaints.
- Right to complain: Residents and families have the explicit right to file complaints with facility management, CDPH, and other regulatory agencies without fear of retaliation.
California's Regulatory Framework
Nursing homes in California must adhere to both state and federal regulations. While California oversees its facilities through the CDPH, most nursing home funding comes through federal agencies like Medicare and Medicaid, which means the Centers for Medicare and Medicaid Services (CMS) also significantly influences how California nursing homes operate.
California State Regulations
California state regulations, set forth in Title 22 of the California Code of Regulations, provide detailed requirements covering various aspects of care delivery. These regulations establish specific standards for:
- Staffing ratios and qualifications
- Health and safety protocols
- Infection control procedures
- Emergency preparedness and planning
- Resident rights and dignity
- Medication management and administration
- Dietary and nutritional standards
- Physical environment and sanitation
These comprehensive state regulations ensure that facilities maintain consistent standards of care across the state
Federal Regulations from Medicare & Medicaid
Federal regulations, as outlined in the Code of Federal Regulations under the Centers for Medicare and Medicaid Services (CMS), establish minimum standards for nursing homes that participate in Medicare and Medicaid programs. These federal regulations cover critical areas such as:
- Minimum nursing staff standards and hours per resident day
- Quality of care requirements
- Resident rights and protections
- Administration and governance
- Infection control and prevention
- Safety and emergency preparedness
Compliance with these federal regulations is vital to ensure the provision of quality care and access to federal funding. Most nursing homes depend on Medicare and Medicaid reimbursement, making federal compliance mandatory for their operations.
Inspection and Survey Process
The CDPH conducts regular inspections and surveys to assess nursing homes’ compliance with both state and federal regulations. These surveys, known as the Standardized Survey process, evaluate multiple aspects of care, including:
- Resident rights and quality of life
- Nursing services and care delivery
- Dietary provisions and nutrition
- Infection control measures
- Physical environment and safety
During inspections, surveyors interview residents, staff, and families; review medical records and care plans; and observe daily operations. The findings determine the facility’s compliance rating and may result in citations, fines, and required corrective action plans for any deficiencies identified.
Complaint Investigation in California Nursing Homes
The CDPH takes a proactive role in investigating complaints filed against nursing homes to ensure the safety and well-being of residents. Complaints can be filed by:
- Residents themselves
- Family members
- Staff members
- Any concerned party, including anonymously
Upon receipt of a complaint, CDPH initiates a formal investigation, which may include resident and staff interviews, record reviews, and on-site visits to the facility. Depending on the severity of the complaint, immediate actions may be taken to protect residents from further harm. If deficiencies are substantiated, CDPH can impose penalties ranging from fines to license suspension or revocation, and may require facilities to implement corrective action plans to address identified issues.
Families who suspect violations should formally report them to CDPH, as this often triggers an official investigation and inspection at the facility.
Who Regulates California Nursing Homes?
The California Department of Public Health (CDPH) serves as the primary regulatory agency responsible for licensing and regulating nursing homes in the state. CDPH oversees the enforcement of laws, regulations, and standards to ensure compliance with both state and federal requirements.
Nursing homes must obtain and maintain licenses from CDPH, which involves rigorous processes including background checks, interviews, and comprehensive facility assessments. Compliance with specific regulations related to appropriate nursing home staffing levels, health and safety standards, medication management, and resident rights is paramount to maintaining licensure. Facilities that fail to comply with these requirements face potential citations, fines, license suspension, or revocation.
What Families Can Do if They Suspect a Violation
If families suspect a nursing home is violating a resident’s rights, they can take several steps to protect their loved one:
- Document Concerns: Record dates, times, what happened, and who was involved. Keep detailed written records of all interactions with facility staff regarding concerns or complaints.
- Contact Facility Management: Address issues directly with nursing home management and maintain a record of all conversations, including names of staff members and dates of discussions.
- File Formal Complaints: For serious or ongoing problems, report violations to the California Department of Public Health (CDPH). Complaints trigger official investigations and inspections. You can also contact a local long-term care ombudsman for assistance in resolving complaints.
- Seek Legal Guidance: Consult an experienced attorney to understand your options and protect your loved one’s rights. A nursing home abuse lawyer can help determine if you have grounds for legal action.
At Lanzone Morgan, LLP, our team of compassionate nursing home abuse attorneys can listen to your story, meet with your loved one, and guide you through the process of filing a nursing home abuse lawsuit. You may be eligible to recover substantial compensation.
"Our firm only represents residents of nursing homes, former residents, and their families. We are dedicated to representing the consumers and the victims of elder abuse. We are dedicated to holding nursing homes accountable and making sure that they provide quality care to their residents."
Lanzone Morgan, LLP Can Protect Your Loved One's Rights
Lanzone Morgan, LLP, is one of the leading elder abuse law firms in the United States. Backed by decades of experience, we have a strong record of holding nursing homes accountable and helping injured residents and their families recover more than $250 million in compensation.
Our compassionate elder abuse lawyers represent clients across California, serving communities in Riverside, Los Angeles, San Bernardino, and surrounding areas. Contact us online or call 888-887-9777 today for a free consultation.
The following content has been legally reviewed and approved by nursing home abuse attorney Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.