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Nursing Home Residents Have New Grounds to Sue for Substandard Care

In a precedent-setting case, the 3rd Circuit Court of Appeals held that residents of county operated nursing homes could sue if they receive care that violates the terms of the law under the Federal Nursing Home Reform Amendments (FNHRA).

This is the first federal appeals court to recognize this right, allowing nursing home residents to sue their care providers directly, rather than rely on the state or federal government to bring a case. This is significant, as the court notes, because few nursing homes have been punished for substandard care.

Resident Suffers Bed Sores, Malnourishment, Sepsis and Death

The ruling in Grammer v. John J. Kane Regional Centers allows Melvinteen Daniels's estate to proceed with its lawsuit. The case alleges the 80-year-old resident of an Allegheny County, Pennsylvania, nursing home developed decubitus ulcers (bed sores), became malnourished, and eventually developed sepsis. She died because the nursing home failed to provide adequate care.

Congress passed this law as part of the Medicare and Medicaid Acts of 1987. The law provides for the oversight and inspection of nursing homes that participate in Medicare and Medicaid programs.

Prior to 1987, one of the only ways to punish nursing homes for substandard care was for state or federal authorities to decertify or withhold payment from the facility. Congress attempted to remedy the situation by creating stricter standards and the Third Circuit has determined that the language used in the legislation creates a right of the resident to directly sue to enforce those standards.

Essentially, Grammer creates a new cause of action for civil rights violations by permitting an individual who has been harmed by the failure of a nursing home to meet standards to sue to enforce those standards. With 1.5 million current residents in U.S. nursing homes, this is a significant and beneficial development.

Prior to this ruling a nursing home could do a risk-benefit analysis and decide to suffer the consequences -- if any -- of providing substandard care. Nursing homes could decide, for example, to save money by eliminating some positions and force remaining employees to work longer and harder. Now these types of decisions will be more difficult to make because nursing homes face expanded liability.

Lots of Cabs but Few Police

Think of the federal nursing home care standards as traffic laws, and the residents of nursing homes as passengers in cabs. A cab driver may occasionally violate traffic laws knowing the violation is not likely to be seen by police officers.

But now the passengers can sue the cab drivers for violating those traffic laws; instead of one police officer for every 1,000 cabs, there is one person in every cab that is capable of enforcing their civil rights under the FNHRA. When a business faces the higher likelihood of punishment for violating the law, the more cost effective decision is compliance.

If you or a member of your family has suffered because of inadequate care from a nursing home or long-term care facility, speak to an experienced attorney. You need a lawyer who will listen to your story, examine the facts and advise on the viability of a potential lawsuit.

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