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When Can Nursing Homes Face Negligence Claims?

Chris Murray
Posted on: November 13, 2019 by Chris Murray

Millions of senior Americans receive medical treatment and care in residential nursing homes. By and large, nursing home residents are treated with compassion and dignity. Unfortunately, a rise in claims of abuse or neglect has negatively impacted the nursing home industry, leading to increased regulatory scrutiny. Although nursing home insurance is the foundation of risk management for long-term care facilities, managers and staff must be aware of the factors that may cause a resident or family member to file a negligence claim. Understanding these factors can contribute to a safer environment, not only for residents but for the caregivers on which residents depend. 

A Troubling Trend: Negligence Claims on the Rise

In a study conducted by the National Center on Elder Abuse, it was estimated that one out of every 20 nursing home residents has been the victim of injury or negligence. In actuality, the percentage of injury/negligence victims may be even higher; poor or non-existent reporting on the part of caregivers and a reluctance of residents to voice their complaints suggest that many cases are unknown to managers and residents’ family members. Neglect in nursing homes is considered one of the most common forms of elder abuse. 

As nursing facilities become more crowded, and many facilities are understaffed or underfunded, negligence claims have grown in number. Recent statistics compiled by the National Association of Nursing Home Attorneys (NANHA) show that about 5 million nursing home residents are abused each year; this figure includes nursing home negligence cases. 

Risk Factors for Nursing Home Negligence Claims

When a resident of a nursing home is the victim of negligence, he or she or a family member may pursue legal remedies against the facility. In these cases, certain legal standards may apply. In general, courts have agreed that if the plaintiff can show a breach of duty or care on the part of nursing home staff or managers, as well as actual injury or damages resulting from negligence, the nursing home may be found liable. Common risk factors that may lead to claims of negligence include:

  • Negligent hiring practices of staff members.
  • Failure on the part of managers to adequately supervise staff members/caregivers.
  • Failure to maintain premises that are free of hazards.
  • Failure to provide accurate and adequate medical care. 
  • Failure to provide safe accommodations, including both in medical care and in general upkeep/maintenance of facilities.
  • Inadequate safety and health policies.
  • Inadequate training of staff members in mitigating risks

It is important to remember that nursing home residents will be required to prove a breach in duty of care, such as the actions, inaction, or neglect of staff members, as well as actual harm resulting from the alleged negligence, for a lawsuit to be successful.  

Nursing home insurance offers liability protection against certain negligence claims, covering the expenses associated with legal defense of lawsuits. If the nursing home is found liable by courts, however, insurance premiums may skyrocket, not to mention financial penalties imposed by regulatory agencies overseeing the nursing home industry. Regulatory compliance cannot be overlooked; in worst-case scenarios, penalties can result in facilities losing their licensing or ability to participate in Medicare. 

It is imperative that nursing homes reduce or eliminate the risks that may lead to a negligence claim. Making sure that nursing home insurance policies are comprehensive enough to cover potential liability claims is always beneficial, as well.  By adequately training and retraining employees, removing hazards, and ensuring proper medical care at all times, nursing homes can better manage their risk exposures. 

About Caitlin Morgan

Caitlin Morgan specializes in insuring assisted living facilities and nursing homes and can assist you in providing insurance and risk management services for this niche market. Give us a call to learn more about our programs at 877.226.1027.

Posted in: blog Nursing Home