For the first time, the federal government established a consistent national framework to ensure that nursing home residents receive adequate care and that their basic rights are protected.

The NHRA set minimum care standards, introduced a bill of rights, and required facilities to provide high-quality care as a condition for receiving federal funding. This legislation became a turning point for resident care, promoting accountability, dignity, and safety in nursing facilities nationwide.

Overview of the Nursing Home Reform Act

Part of the OBRA

The NHRA was passed in 1987 as part of the Omnibus Budget Reconciliation Act (OBRA), after widespread reports revealed serious failures in nursing home care nationwide. 

The federal government responded by enacting the NHRA to protect residents from neglect, abuse, and inadequate care, especially in facilities receiving Medicare or Medicaid funding.

This federal law introduced enforceable care standards, mandated comprehensive care plans, and established the bill of rights for nursing facility residents. It also required routine state monitoring, unannounced surveys, and consequences for facilities providing substandard care. 

The NHRA remains a foundation for nursing home reform, aimed at ensuring proper care and dignity for elderly and vulnerable residents in long-term care.

The Nursing Home Residents’ Bill of Rights

The NHRA established the Nursing Home Residents’ Bill of Rights to protect individuals living in nursing homes that receive Medicare or Medicaid funding. These rights guarantee dignity, privacy, and freedom from physical or mental abuse, including protection against unnecessary restraints. 

Residents also have the right to participate in their own care decisions, maintain their personal belongings, and manage their financial affairs. They may join resident and family groups, receive visitors, and voice grievances without fear of retaliation. These protections promote self-determination, proper care, and respect for every nursing home resident’s well-being.

Ensuring Quality Care in Nursing Homes

NHRA set a clear expectation that nursing homes receiving funding through Medicare or Medicaid must provide services to help residents reach or maintain their highest practicable level of physical, mental, and psychosocial well-being. This standard goes beyond basic care—it requires facilities to tailor their services to each resident’s unique needs and goals.

Facilities must develop comprehensive care plans, ensure adequate nursing home staffing, and offer access to necessary medical, therapy, and social services. The focus is on providing proper care that supports both health and independence.

Whether a resident is recovering from surgery or living with chronic conditions, the NHRA ensures that the facility has a legal duty to promote the best possible outcomes, not just prevent decline. Failing to meet this standard may be considered neglect under federal law.

Addressing Elder Abuse and Neglect

The NHRA places a legal obligation on nursing homes to protect residents from elder abuse, neglect, and exploitation. Facilities must have policies in place to prevent harm and respond immediately to any allegations of abuse. This includes protecting residents from mistreatment by staff members, visitors, or other residents. 

The law prohibits physical restraints, involuntary isolation, and any form of punishment or intimidation. When abuse or neglect is suspected, facilities are required to investigate and report the incident promptly. Failure to do so can result in penalties, loss of funding, and legal action by families.

Enforcement Issues and Compliance Monitoring

To ensure nursing homes follow the standards set by the NHRA, the law requires unannounced surveys and inspections conducted by state monitoring agencies. 

These surveys evaluate whether facilities are providing proper care, respecting residents’ basic rights, and complying with federal law. If violations are found, facilities may face enforcement actions such as fines, denial of funds, or temporary state management.

Despite these tools, enforcement remains a challenge. Limited resources, inconsistent oversight, and delayed responses to complaints have allowed some nursing home facilities to continue delivering substandard care. In some cases, serious issues are uncovered only after harm has occurred.

Strengthening compliance efforts, increasing penalties, and supporting resident and family groups remain essential to ensuring the law’s protections are fully realized and that nursing home quality is not compromised.

The Role of the Federal Government in Nursing Home Reform

The federal government, primarily through the Centers for Medicare & Medicaid Services (CMS), oversees the implementation of the Nursing Home Reform Act. CMS sets national standards for quality of care, monitors compliance, and works with state agencies to conduct unannounced surveys and investigate complaints. 

Facilities that fail to meet federal requirements may lose access to funding. CMS also collects data, tracks violations, and publishes reports to keep residents and families informed. This federal oversight is critical to enforcing care standards and ensuring that all residents receive adequate care in safe, respectful environments.

State Laws Complementing the NHRA

While the Nursing Home Reform Act establishes minimum federal standards, many states have enacted additional laws to strengthen protections for nursing home residents. 

These state-level regulations often expand on the residents’ rights outlined in the Bill, introduce stricter staffing requirements, or mandate faster reporting of suspected nursing home abuse and neglect.

Some states allow for more significant legal action by families or impose higher penalties for substandard care. Others enhance transparency by publishing inspection results or maintaining watchlists of poorly performing nursing facilities.

State laws also help ensure that local concerns, such as access to social services, cultural needs, or specific resident care issues, are addressed alongside federal law. Together, state and federal oversight work to promote proper care and protect nursing home residents’ health, dignity, and self-determination.

Recognizing Violations of Residents’ Rights

Spotting violations of the Bill of Rights can help prevent further harm. Common warning signs of abuse in a nursing home include unexplained injuries like bruises, cuts, or bedsores, especially when staff offer vague or conflicting explanations. 

Sudden behavioral changes—such as withdrawal, anxiety, or fear of specific caregivers—may signal emotional abuse or neglect. Unsanitary conditions, including dirty bedding, foul odors, or unchanged clothing, point to a failure in basic care. 

Residents being ignored, overmedicated, or excluded from care decisions may also indicate violations of their rights under the Nursing Home Reform Act. Families should act quickly if these signs appear.

Legal Recourse for Violations of the NHRA

Residents and their family members can pursue legal action when a nursing home fails to comply with the NHRA. Options include filing a complaint with the state survey agency or the CMS, which may trigger inspections, penalties, or loss of funding for the facility.

In more serious cases involving nursing home abuse, neglect, or injury due to inadequate care, families may choose to file a civil lawsuit. These claims can help recover damages for medical costs, pain and suffering, and loss of dignity.

Working with an experienced attorney can help families understand their rights under federal law, gather evidence, and hold nursing home facilities accountable for violating the Bill of Rights or providing substandard care.

The Impact of the NHRA on the Quality of Care in Nursing Facilities 

Since its passage, NHRA has driven significant improvements in nursing home care. Facilities must maintain proper staffing levels, develop personalized care plans, and provide services supporting nursing home residents’ physical and emotional well-being. 

The law also led to a sharp reduction in the use of physical restraints and emphasized resident autonomy, giving individuals more control over their daily lives and medical decisions. By establishing clear standards and accountability, the NHRA has helped shift the focus in nursing homes from institutional care to dignified, resident-centered care.

Challenges and Criticisms of the NHRA

While the NHRA set necessary national standards, its goals haven’t been fully achieved in every facility. One of the biggest challenges is inconsistent enforcement. While the law requires state monitoring and unannounced surveys, oversight varies widely by state, and some violations go unchecked for too long.

Resource limitations, staffing shortages, and lack of public awareness can also weaken compliance. In some cases, nursing homes continue to provide inadequate care while technically meeting minimal federal requirements.

Critics argue that penalties for substandard care often aren’t substantial enough to force meaningful change. Others point to the need for updates that reflect modern resident care needs and expanded protections for vulnerable nursing home residents.

Improving enforcement and closing compliance gaps remains essential to achieving the NHRA’s original vision of proper care in every facility.

The Future of Nursing Home Reform

As the needs of residents evolve, lawmakers and advocates are calling for updates to the NHRA. Proposed reforms focus on improving nursing home staffing levels, increasing transparency in ownership and operations, and strengthening enforcement tools to better address substandard care. 

There’s also momentum to expand resident access to mental health services, reduce unnecessary hospital transfers, and promote more individualized care plans. With an aging population and ongoing concerns about nursing home quality, future changes aim to reinforce the NHRA’s mission—ensuring that all residents receive safe, respectful, and proper care.

The Importance of Advocacy and Legal Support

Enforcing the rights guaranteed under the NHRA often requires action from both advocates and legal professionals. When nursing homes fail to meet their obligations, families and residents need trusted support to hold facilities accountable.

Legal advocates help identify violations of the Bill of Rights, pursue justice for victims of nursing home abuse, and compel facilities to correct inadequate care. They also assist with filing complaints, interpreting federal law, and guiding families through the complex process of pursuing compensation.

Attorneys and advocacy organizations play a vital role in upholding the promise of the NHRA, ensuring that residents receive high-quality care and are treated with the dignity, respect, and protection they deserve.

How Our Law Firm Can Assist You

If you believe a loved one’s rights under the NHRA have been violated, our team at Nursing Home Law Center is here to help. We have extensive experience handling cases involving nursing home abuse, neglect, and violations of the Bill of Rights for nursing facility residents.

Our nursing home abuse attorneys are committed to protecting residents and holding facilities accountable for providing substandard care or failing to follow federal law. We offer free consultations and work on a contingency fee basis, meaning you pay nothing unless we recover compensation for you.

To speak with a qualified lawyer today, call us at (800) 926-7565 or fill out our contact form. Let us help you take the next step toward protecting your family member’s rights and well-being.

However, when an administrator fails to perform these duties, it can contribute directly to abuse and neglect, making them a key focus in many elder abuse investigations.

Managing Staff and Nursing Services

Nursing home administrators supervise hiring, training, and oversight of nurses, aides, and other care professionals. They lead employee meetings, manage schedules, and ensure services are delivered according to care plans. 

When they fall short — through negligent hiring, inadequate training, or failure to address known issues — residents suffer. In many nursing home abuse cases, attorneys uncover patterns of poor staffing or oversight tied directly to administrative failures.

Overseeing Care, Compliance, and Operating Procedures

Administrators must ensure the nursing home meets federal and state care standards. This includes maintaining a facility license, working with clinical teams on infection control, and developing internal operating procedures that comply with laws like the Federal Nursing Home Reform Act. 

Failure to develop standards for cleanliness, supervision, or medication safety often forms the basis of legal claims when residents are harmed due to neglect.

Communication with Families and the Governing Board

Nursing home administrators are expected to act as liaisons between care teams and families, responding to concerns and ensuring transparency. They may also report to a facility’s governing board, especially in chain-operated nursing homes. 

In many lawsuits, administrators are held accountable when they ignore complaints or conceal signs of emotional abuse, mismanagement, or negligence.

Legal Accountability and Business Oversight

Alongside managing finances and programs, a home administrator must balance care with compliance. When business decisions result in unsafe care or financial exploitation, they may face legal scrutiny. 

Nursing home abuse and neglect lawyers often investigate whether cost-cutting, poor oversight, or policy failures by administrators contributed to a resident’s injury or death.

Holding Nursing Home Administrators Accountable

If your family member has suffered harm in a nursing home, our team can help. At Nursing Home Law Center, we investigate administrative failures and pursue justice for victims of abuse and neglect. Contact us for a free consultation — no fees unless we win.

For the families of loved ones who experienced abuse in a nursing home, you do have legal options that can help with the situation. Filing a lawsuit against the facility, for example, may provide compensation that can pay for damages like medical bills or relocating your loved one to a better facility.  

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Active Support Surface – Active support surfaces can provide advanced support for seniors, such as beds that automatically adjust their orientation and pressure to relieve stress and prevent bed sores. 

Activities of Daily Living – Activities of daily living include any activities related to maintaining basic health and safety. For example, bathing maintains basic health, while home cleaning maintains basic safety in the living environment. 

Acute Care – Acute care is advanced care, often provided by a skilled nursing facility, for an injury or illness from which a patient can recover with the right amount of care and support. 

Administrative Agencies – Administrative agencies are government oversight organizations that focus on a specific area of government, such as nursing administration or nursing homes. A skilled nursing facility, for example, falls under the jurisdiction of the state’s nursing and medical care oversight administration. 

Admissible Evidence – Admissible evidence is any evidence allowed by the court. Some forms of proof and anything found while violating evidence collection and handling laws may be inadmissible in court. 

Adult Day Care – Adult day care is a daily care program for adults. Many seniors who still live at home are enrolled in adult day care so they are not alone during the day and stay active, which can prevent mental and physical decline as they age. 

Advance Directive for Healthcare – An advance directive is any documentation you create that tells care providers what medical care decisions you want when you lose your ability to make decisions. For example, a living will designates who your power of attorney and medical proxy will be, as well as instructions for your care under specific circumstances. 

Advanced Bedsore – An advanced bedsore or Stage 4 bedsore is a bruise that degrades the skin completely, exposing bone and affecting all layers of skin above it. 

Adverse Drug Side Effects – Adverse drug side effects are reactions to medication that are unintended. In many cases, this happens when multiple medications are taken at the same time and have a reaction to each other. 

Affirmative Defense – An affirmative defense is a legal practice where you claim another situation or condition is the cause of whatever problem is addressed in a court case. For example, pleading insanity when charged with a crime is an affirmative defense because you claim that your mental condition is the cause. 

Agranulocytosis—Agranulocytosis is a condition in which the bone marrow does not produce enough white blood cells. Without enough white blood cells, the body’s immune system is weaker, increasing the chance of infection or advanced illnesses. 

Air Embolism – An air embolism is a blockage in your veins caused by an air bubble. It is a possible side effect of improperly prepared injections. 

Air Fluidized Therapy – Air fluidized therapy allows people at high risk of bedsores or severe burns to regenerate healthy tissue more easily. The patient lies on a bed made of tiny glass beads suspended in air, which reduces pressure on the skin and allows blood to flow freely throughout the body. 

Albumin – Albumin is a protein that dissolves in water, coagulates when heated, and can dissolve in concentrated salt solutions. Albumin is often used to increase blood plasma when it is critically low, such as after a serious injury with blood loss or extended cases of malnutrition. 

Alginates—Alignates is a wound dressing made from seaweed. It is designed to keep the wound moist to promote healing and to be lightweight. 

Alternating Pressure – Alternating pressure is when pressure is applied from opposing directions. This method is used for many reasons, including to release muscle tension or prevent bedsores from developing by changing positions or releasing built-up fluids. 

Alzheimer’s Disease – Alzheimer’s Disease is a mental condition that causes brain function to deteriorate over time. It is often compared to dementia, and patients tend to lose access to their memories and the ability to form new ones. 

Amputation – Amputation is the surgical removal of part of the body for medical reasons. 

Amyloid Protein—Amyloid proteins are a group of proteins that do not dissolve in water or other fluids. They form naturally in the body as part of different bodily functions and can be stained and monitored in medical tests for various diseases. 

Amyloidosis – A condition where amyloid proteins build up in organs. This buildup can interfere with organ function and needs to be treated quickly to prevent permanent damage. 

Anemia – Anemia is a condition in which red blood cell count drops below normal. It can be a sign of many conditions and is often one of the first things doctors look for when diagnosing diseases. 

Antimicrobials – Antimicrobials stop the growth or kill off microorganisms. They are often used to sterilize medical tools, areas, and wounds. 

Appellate Court – The Appellate Court or Court of Appeals reviews cases after a judge has already ruled on them. The goal is to see if any mistakes were made in the process or by the judge that warrant a retrial or other action to undo the damage the previous ruling caused.

Appendicitis – Appendicitis is a condition in which the appendix, a small organ in the body, is inflamed. It can be caused by an infection, injury, or other causes and can be painful. It is often treated with an appendectomy, where the appendix is removed since it is unclear if it provides any useful function in the body. 

Arbitration – Arbitration is a legal process in which, instead of filing a lawsuit and going to court, the two parties meet with a mediator to resolve the problem. In many contracts, an arbitration clause says you forego your right to sue in favor of going to arbitration instead. 

Arbitration Agreements – An arbitration agreement is a contract that says you agree to go to arbitration instead of suing someone. Arbitration happens with a mediator who can make legal decisions for the court to resolve problems without going to court. 

Asphyxiation – Asphyxiation is a condition where your body is deprived of oxygen, leading to cell damage or death. It is often the result of choking but can be caused by other means. 

Aspiration – Aspiration is a condition in which a person’s airway is blocked, making it impossible to breathe. It is commonly referred to as choking. 

Aspiration Pneumonia – Aspiration Pneumonia deprives your body of oxygen by breathing something into your lungs that stops them from absorbing air. This can happen with dust, sawdust, and other fine particulates that clog the nodules in your lungs and prevent them from pulling in oxygen. 

Assisted Living Facility – An assisted living facility supports older adults with daily living activities, such as meal preparation, and monitors residents’ health and safety. An assisted living community primarily provides non-medical care and coordinates with outside organizations to provide physical therapists, speech therapy, and other services. 

Autolytic Debridement – A medical treatment that uses the body’s own enzymes and moisture to rehydrate and soften eschar and slough on a wound. 

Autonomic Dysreflexia – A medical emergency involving an overreaction of the sympathetic nervous system, usually resulting from a spinal cord injury or disease.

Autonomic Nervous System – The part of the peripheral nervous system that controls heart rate, salivation, sweating, urination, and sexual arousal. 

Autopsy – A medical examination used to determine the cause of death or progression of a disease of the deceased.

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Battery – A beating or physical violence, including fulfilling threats.

Bed Alarm – A notification system to alert health care professionals that a patient has gotten out of bed.

Bed Rail Entrapment – A serious situation when someone gets caught, trapped, or entangled in the space around the bedrail, mattress, or hospital frame. This can lead to serious injuries and/or death. 

Bed Sore – A severe wound that develops in patients with limited mobility that starts as a small area of discoloration and progresses rapidly to a serious open wound.

Bedridden Patients – Patients who are unable to get out of bed due to an illness for an extended period of time.

Bedsore Lawsuit – A civil lawsuit brought by family members or an estate against a nursing home, hospital, or assisted living facility responsible for causing a bed sore.

Bench Trial – A trial without a jury where the judge decides. 

Beneficiary – The person entitled to receive benefits or proceeds from a will, trust, insurance policy, retirement plan, contract, or annuity. 

Blood Transfusions – The process of transferring blood or blood products to a patient. 

Board and Care Home – Board and care facilities are small assisted living facilities that do not provide nursing care but provide daily living assistance to older adults who need some additional support. 

Bone Infection – An infection of the bone caused by bacteria that invades the bone, causing it to disintegrate and harm the local blood supply. This makes it difficult for antibiotics to reach the infection.

Braden Scale – The measurement system to classify bed sores.

Bruise – Area of skin discoloration caused by the breakage of tiny blood vessels that leak into the soft tissue beneath the skin. 

Burden of Proof – The duty to provide facts or facts in dispute in an issue raised in a lawsuit. 

Burns – Chemical or physical damage to the skin that destroys it at a cellular level, leaving patients with lasting damage depending on the intensity of the burn. 

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C difficile – C difficile is an intestinal bacteria that causes diarrhea and colitis when antibiotics eliminate healthy bacteria. 

Call Lights – A hospital or nursing home notification system that alerts medical professionals when a patient needs help or health-related services immediately.

Capacity – The legal authority or mental ability to make decisions.

Caps on Damages—Some states have monetary limitations on how much can be recovered in personal injury or wrongful death cases. 

Care Centers – Sometimes referred to as Residential Care Facilities for the Elderly (RCFE), care centers provide personal care services to older adults who cannot live on their own due to chronic illness, permanent injury, or other conditions. Unlike the other healthcare facility choices a senior can choose, there is no medical care provided and they must relocate patients who need higher levels of care, such as continuing care retirement communities or nursing homes. 

Care Manager – A health care professional who oversees long-term care services for older adults. 

Care Plan – A written plan of patient care and discharge planning that communicates patient needs between various members of a care team.

Caregiver – A person who provides assistance to an adult who needs help with any activities of daily living, whether a registered nurse or family caregiver. 

Case Law – Laws already established by previous court decisions from state courts, appellate courts, federal courts, or the U.S. Supreme Court. 

Catheter – Medical device used to drain urine from a patient’s body.

Cause of Action – The facts that give someone the right to seek relief in court.

Cellulitis – A bacterial infection in the skin and tissue that spreads. It often starts as a small tender area followed by swelling, redness, chills, fever, sweating, and swollen lymph nodes.

Cerebral Palsy – Group of non-progressive and non-contagious motor conditions that cause physical disability.

Certified Nursing Assistant – A trained and certified professional who helps nurses by providing non-essential medical assistance. 

Cervical Fracture – A broken cervical vertebrae in the neck, which can be catastrophic and cause paralysis or death.

Chemical Debridement – A procedure that dissolves necrotic tissue by using enzymes and other compounds.

Choking – The partial or complete obstruction of the airway due to a foreign object.

Cholecystitis – Inflammation of the gallbladder. 

Chronic Pain – Pain that lasts more than three months.

Civil Lawsuit – A lawsuit filed in civil court to recover damages from a liable party on behalf of the victim. 

Claim – A legal process where a lawyer states the damages you suffered and what they believe the compensation should be. 

Class Action – A lawsuit filed on behalf of multiple plaintiffs, usually a very large group of people all affected by the same problem caused by the same organization. 

Clear and Convincing Evidence – Evidence that provides an exact and clear picture of the situation, leaving little room for doubt as to what it is and what it means. 

Clinitron Bed – A specialized bed that uses air fluidized therapy and low air loss therapy to relieve pressure and reduce pain from bed sores.

Clogged Breathing Tube – When a tube used for breathing is blocked by bubbles or solids in the tube. 

Clogged Feeding Tube – When a tube used for feeding is blocked, either by air bubbles or solids that are trapped because they are too large to pass through.

Closed Cell Foam – A foam used in supportive devices made of a non-permeable structure that has a barrier between the cells to prevent gasses or liquids from passing through the foam.

Closing Argument – The final statements made in a case, usually to summarize one side’s point of view on that case. 

Coefficient of Friction – A measurement of friction between two surfaces.

Cognitive Impairment – When someone’s ability to think is reduced due to medications, drugs, injuries, or health issues.

Colostomy – A surgical procedure that provides an alternative way for feces to exit the body through a stoma. 

Coma – A state where a person’s body is effectively asleep and unable to wake up. Brain activity may or may not have stopped, and this condition can be medically induced to prevent further pain or damage. 

Common Law – The basis of law derived from old English common law standards when the U.S. was formed.

Comparative Fault – When the court determines that both sides share fault in the situation and determine how much fault each side has. In states that use a comparative fault model, this can impact the outcome of a case. 

Contingency Fee – A fee for services payable only if there’s a favorable outcome, such as a jury award or settlement.

Continuing Care Retirement Community – Continuing care retirement communities allow older adults to age in place, providing increasing levels of care as needed.

Contractures – A condition of the loss of joint motion due to changes in non-bony tissue, such as muscles, ligaments, and tendons.

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Damage Cap – A limit on the amount of damage and compensation you can receive for a specific claim. 

Damages – The impact of an action caused by another person. In court, damages are listed in claims to recover compensation. 

Debridement – A medical procedure used in wound care to remove non-living tissues from wounds, including bed sores and burns.

Declaratory Judgement – A definitive judgment by a court that clearly states the case’s outcome and the compensation required. 

Default – When a party fails to meet the minimum requirements of their responsibilities. In court, a default happens when one of the parties fails to meet their requirements, and the court takes the required action in response. 

Default Judgement – When a judge enters a judgment automatically when a party fails to meet their requirements. 

Dehydration – A serious condition occurring when the body doesn’t have enough fluid, caused by vomiting, diarrhea, and nursing home neglect. Severe dehydration is a life-threatening emergency. 

Dementia – A group of diseases that cause cognitive decline and memory loss. Dementia impacts a person’s ability to do normal daily activities associated with independent living, including dressing, eating, and emotional control. It includes Alzheimer’s disease. 

Duoderm – A special wound dressing used to keep healing wounds moist and protected.

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Economic Damages – Financial losses that directly correlate to expenses caused by an injury, such as medical expenses, lost wages, and replacing damaged property.

Elder Abuse – The unintentional or intentional abuse or neglect of an older adult.

Elder Care – Care for seniors who are not able to handle the daily activities of living on their own. 

Emotional Abuse – A type of abuse where an abuser manipulates the emotions of the victim, usually as a means of causing mental pain or exerting control. 

Envelopment – The ability of a supportive surface to mold or conform to a patient’s body. Skilled nursing facilities assess envelopment to determine if a supportive surface is safe for a patient who is at risk for developing bed sores.

Eschar – The dry scab or slough that forms on the skin during wound healing or due to exposure to a corrosive or caustic substance.

Escrow – A type of account where money is held during a transaction by a third party that can be trusted to complete the transaction when the requirements are met without taking sides.

Exudate – When inflammation causes a fluid high in protein and cellular elements to excrete out of blood vessels and into nearby tissue.

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Fall During Transfer – When a patient falls while being moved from one space to another. 

Fatigue – This is a characteristic of a support surface over an extended period of time, often caused by chemical exposure, heat, prolonged use, or physical force.

Fecal Impaction – When fecal matter clogs the intestines as it builds up in a specific place. 

Financial Abuse – When someone, often a caregiver, makes unauthorized purchases or steals money from older adults. 

First-Degree Burn – First-degree burns affect the outer layer of skin only. They heal on their own over time as the skin cells are replaced by skin from the lower layers. 

Flap Reconstruction – A breast reconstruction surgery used after a mastectomy that involves the creation of a skin flap using tissue from elsewhere to create a pocket for an implant.

Flesh Eating Bacteria – Bacteria that feed on flesh and require quick medical intervention to treat. 

Force – The measure of push and pull that health care providers need to monitor to prevent bed sores.

Friction – The resistance to motion in parallel directions on two surfaces, which is important to analyze when determining a patient’s risk of developing bed sores.

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Gangrene – A condition that causes an area of the body to die due to cut-off blood supply.

Glucose – Sugar products used by the body for a quick and easy source of energy.

Grand Jury – A group of citizens who investigate potential criminal activity and decide whether charges should be brought.  They do not determine guilt or innocence.

Guardian – A person or entity responsible for another individual. 

Guardianship – The legal status of being a guardian or being responsible for another person

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Health Care Directive – A statement of your desires and instructions for how your care should be handled, often used when you are unable to manage your own healthcare. 

Health Care Proxy – A person or entity legally responsible for your medical decisions if you are incapacitated. 

Hearsay – An out-of-court statement (usually by a third party) offered in court to prove the truth of what it is asserting. 

Hemorrhage – Bleeding inside the body requring medical intervention to address. 

HIPAA – The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects patient health information and electronic health records.

Hospice Care – Medical care and pain management for a patient who is not expected to recover from their illness. 

Hospital – A major medical facility providing advanced care and emergency care options for the surrounding area. 

Hospital Error – When hospital staff make a mistake that impacts the patient. 

Hung Jury – A jury that cannot reach a consensus according to the rules of the court case, leading to the case being retried or dismissed. 

Hyperreflexia – A condition with overactive reflex responses.

Hypoperfusion – A condition of diminished blood flow through an organ.

Hypotension – A condition with lower blood pressure than usual.

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Immersion – The measure of a patient’s depth of penetration into a supportive material.

Immunity – The inability to pursue legal action against certain entities, such as certain government agencies and municipalities. 

Impeachment of a Witness – To attack the credibility of a witness with evidence introduced to cause a judge or jury to question the witness’s believability. 

Implied Contract – An inferred contract that is not written down but created by law, such as the implied contract you have with the electric company by using your utilities. 

Inadmissible – Evidence that can not be used in court for technical reasons. 

Incapacity – The lack of legal ability to act.

Incompetent – Being unable or unqualified to do a job. 

Incontinence – A condition where a person loses the ability to control urination or defecation. 

Independent Living Facility – Unlike a skilled nursing facility where residents need medical care, independent living allows seniors to live together in a group setting even though they can manage their activities of daily living on their own. 

Indigent – Needy or impoverished.

Injunction – A court order prohibiting a defendant from doing something they are threatening or attempting to do.

Insolvent – When the debt of an entity exceeds the value of all its assets.

Insulin – Hormone that helps convert glucose to glycogen and lowers blood sugar levels.

Integrated Bed System – A single bed unit with a bed frame and support surface integrated into one.

Intentional Tort – An intentionally committed act.

Interlocutory – Temporary and not final.

Interrogatories –  A set of written questions used in the discovery process.

Intervention – An action that allows a third party to be added to a lawsuit.

Involuntary Seclusion – Secluding a resident of a nursing home or assisted living facility against their wishes or the wishes of their health care agent.

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Joint and Several Liability – The legal doctrine that makes each of the parties responsible for an injury liable for all damages awarded in a lawsuit if the other responsible parties cannot pay.

Judgment – The official ruling from a court.

Jurisdiction – The geographic area where a court has the power and authority to hear a case.

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Kennedy Terminal Ulcer – A specific type of rapidly onset pressure ulcer common in patients as they near the end of their lives.

Kidney Failure – Also known as renal failure, it is the most serious stage of kidney disease where the kidneys are no longer able to remove waste and excess water from blood.

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Liability Insurance – Insurance that provides coverage if you are found liable for someone’s injuries. Companies carry liability insurance to protect themselves from lawsuits. 

Licensed Practical Nurse – A licensed nurse with an elevated level of skills. LPNs are licensed to provide nursing care in a variety of situations that other caregivers are not. 

Lien – A legal claim against a property for unpaid wages, costs, or damages. They are often placed against houses where, for example, upgrades by contractors have not been paid for. 

Litigation – The legal process of filing a lawsuit against another party. 

Living Trust – A legal structure where assets are placed in a legal framework and overseen by a manager called a trustee. People with serious illnesses or large estates often use a trust to more effectively manage assets and create a layer of legal protection. 

Long Term Care – Care for someone that is ongoing past their initial treatment. 

Long Term Care Hospital – A facility that specializes in long-term care. 

Long Term Care Insurance – Insurance designed to help cover the costs of long-term care. 

Long Term Care Ombudsman Programs – Ombudsmen oversee treatment programs and long-term care organizations, ensuring compliance with regulations and that patients are treated appropriately.

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Malnutrition – Not receiving enough nutrients to remain healthy. 

Mechanical Load – The stress that a material can handle before it buckles or breaks. 

Mediation – A method of resolving issues by meeting with a neutral authority to discuss the matter and try to find a solution. 

Medical Malpractice – Medical mistakes by medical staff that injure a patient and should have been avoidable under normal circumstances. 

Medical Negligence – Medical staff acting irresponsibly or negligently, leading to patient injuries. 

Medicare and Medicaid Programs – Government programs for seniors over 65 and those with low incomes, disabilities, or injuries that help pay for medical costs. 

Medication Error – A mistake in the application of medication leading to patient injuries. 

Medication Overdose – Taking too much of a medication leading to adverse effects. 

Mental Institution – A facility specifically committed to the housing and care of people with mental illnesses that require treatment. 

Mesothelioma – A type of cancer linked to extensive exposure to asbestos. 

Minimum Data Set – The smallest amount of data that can be used to create reliable and effective results in a study. 

Minimum Staffing – The minimum number of staff members needed to run a medical facility according to legal or practical guidelines. 

Miranda Warning – A notification process used by law enforcement to remind people who are being arrested of their basic rights.

Mistrial – When a trial is stopped and the verdict is discarded for technical reasons. 

Mobility Aids – Tools designed to help people move around when they have injuries, disabilities, or other impediments to their mobility. 

MRSA – A serious infection often acquired in hospitals that is immune to most kinds of anti-bacterial and anti-viral sterilization methods.

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Necrotic Tissue – Tissue that is dead and begins to rot, posing a risk to the rest of the body. 

Necrotizing Fasciitis – A tissue infection that eats away at the body’s tissue, killing and and causing widespread cell destruction as it spreads through the body. 

Neglect – Neglect is one of the most common forms of elder abuse that happens in nursing homes, often as a result of understaffing. It is when residents do not receive the personal care or attention they need, such as remaining in soiled diapers or not being fed appropriately.

Non-Economic Damages – Damages not tied to a specific cost, such as loss of consortium in a civil case. 

Non-Jury Trial – A trial with no jury, usually leaving the judge to determine the outcome. 

Non-Profit Nursing Home – A nursing facility that provides nursing care for patients and is registered as a non-profit company. 

Notary Public – A person certified to be a legal witness to the signing of documents. 

Nurse Turnover – The rate at which a facility loses and hires new nursing staff.

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Objection – A procedural option in a court case where a lawyer can claim that a procedure used in court is invalid. Objections must be confirmed and corrected or overruled by the judge. 

Occupational Therapy – A type of therapy that helps patients recover the ability to do specific tasks after an injury. 

Overrule – The action of a judge deciding that an objection in a court case is invalid.

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Pad – A device used by medical professionals to alleviate pressure and to protect an open wound when a patient has bedsores.

Pain and Suffering – A common type of non-economic damage to compensate for physical pain related to an injury.

Palliative Care – Care for patients designed to manage pain and provide long-term support without trying to cure the patient of their illness. 

Paralysis – The inability to move a segment or segments of the body. 

Paraplegic – A person who is paralyzed in the lower half of their body, affecting both legs.  

Parkinson’s Disease – A degenerative brain disorder that slowly erodes the patient’s ability to control their body, often resulting in shaking and the loss of fine motor skills. 

Peripheral Neuropathy – A loss of peripheral vision (vision around the sides of your eyesight), due to the gradual degradation of optical nerves. 

Physical Abuse – When caregivers or other older adults hit, strike, kick, bite, or hurt a senior citizen. 

Physical Therapy – Body training designed to repair and strengthen parts of the body to regain their normal function after an injury or surgery. 

Precedent – Legal history that sets the standard for a particular segment of the law. 

Premises Liability – Legal responsibility for people’s safety while on your property. 

Pressure – Pressure is the force per unit area exerted perpendicularly to the plane of interest. In older adults in long-term care facilities, it is an important factor that must be monitored to prevent the development of bedsores.

Pressure Redistribution – A way medical professionals reduce the risk of bedsores by reducing pressure on flat surfaces by redistributing it.

Pressure Sore – Damaged skin caused by a lack of blood flow due to pressure on the affected area. 

Pressure Ulcer – An area of skin that breaks down and opens up when you are left in one position for an extended period of time without being moved.

Pretrial Conference – A conference between parties before a trial and the judge to handle any pretrial processes. 

Primary Care Provider – The medical provider that handles the first line of care, often treating basic illnesses and referring patients to specialists. 

Product Liability – Legal responsibility for products manufactured and or sold buy your business. 

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Qui Tam – The provision of the Federal Civil False Claims Act allows nursing home employees to file a lawsuit on behalf of the U.S. government against a nursing home or other company that fraudulently uses government funds.

Qualified Medicare Beneficiary Program – A government program that provides coverage to low-income Medicare recipients to help pay for prescription medication and other medical costs. 

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Qualified Medicare Beneficiary Program – A government program that provides coverage to low-income Medicare recipients to help pay for prescription medication and other medical costs. 

Qui Tam – The provision of the Federal Civil False Claims Act allows nursing home employees to file a lawsuit on behalf of the U.S. government against a nursing home or other company that fraudulently uses government funds.

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Residential Care Facilities for the Elderly – Facilities designed to provide care specifically for seniors who need ongoing, long-term support, can no longer live by themselves or need extended nursing care. They move into and live at the facility. 

Respite Care – Care designed to relieve primary caregivers, such as family members, so they can rest and recover while their loved one is still cared for. 

Restraint – A device used to restrict the movements of a person, usually used when that person is a danger to themselves or others.

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Second-Degree Burn – A second-degree burn affects the outer two layers of skin and can be potentially life-threatening if infected. To repair and heal, patients often undergo skin grafts and other medical interventions. 

Sepsis – Also known as blood poisoning, sepsis is a serious medical condition characterized by whole-body inflammation due to infection in the blood, urine, lungs, skin, or other tissue.

Serum Osmolality – This blood test shows the amount of chemicals dissolved and absorbed in the liquid part of blood. It is used to test for a range of conditions, including dehydration and poisoning. 

Shear – Shear measures the force per unit exerted on a parallel plane of interest. In the case of assisted living facilities and nursing homes, it’s an important characteristic for considering the right supportive surfaces to prevent bed sores.

Shear Strain – This is the calculation of damage to a supportive surface from shear stress.

Skin Care Assessment – A written assessment of a patient’s skin around a wound to document how it is healing or regressing. It often includes size, color, shape, and texture. 

Squamous Carcinoma – A form of skin cancer that starts as a bump or red scaly patch. It is often found on ears, faces, and lips. 

Staph Infection – Staph infection is caused by staph bacteria and can lead to mild to severe illnesses.  

Stage 1 Bed Sore – A stage 1 bed sore features skin temperature changes, redness or blue and purple coloring, and tissue changes. It is a sign that healthcare providers should take prompt action to stop the quick progression of a more serious bed sore.

Stage 2 Bed Sore – A stage 2 bed sore features some loss of the top layer of the skin, the epidermis. The sore looks more like a blister or abrasion. 

Stage 3 Bed Sore – A stage 3 bed sore features damage or death to subcutaneous tissue. It looks like a deep crater with black edges.

Stage 4 Bed Sore – A stage 4 bed sore features total skin loss, tissue death, and damage to muscles, bones, joints, or tendons. These bed sores look like deep openings with exposed bone and connective tissue.

Statute of Limitations – The statute of limitations is how long you have to file a claim after an injury or death. It varies from state to state.

Strep Infection – Contagious diseases caused by naturally occurring skin bacteria that invade the body. Some forms of strep infections can be deadly.

Support Surface – A device used to redistribute pressure on a person’s body, such as a pressure-relieving mattress or seat cushions.

Surgical Debridement – A wound care procedure where dead tissue is removed from a wound using a surgical tool.

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Testamentary Capacity – The legal ability, or lack of ability, to modify or change someone’s will based on their mental and physical condition. 

Testator – The person who created the will (i.e. the person the will was made for).

Third-Degree Burn – Third-degree burns affect all three layers of skin and need medical intervention to heal. These are life-threatening injuries and are very painful to treat and recover from as the nerves are heavily damaged and exposed. 

Tissue Tolerance – How skin and supporting body structures endure and handle the impact of pressure without adverse reactions.

Tolling of Statute of Limitations – A suspension of the statute of limitations, the time limit that you have to file a lawsuit, based on mitigating circumstances. That means you can file a lawsuit even after the date passes. 

Tort – Any action that causes damages to a person or their property that can lead to legal action under civil law. 

Tort Reform – The movement to change the rules for what qualifies as a lawsuit in an effort to reduce the number of frivolous or unnecessary lawsuits.

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Ultra Sound Assisted Wound Therapy – Medical process to remove damaged tissue from deep wounds using ultrasound technology.

Unstageable Bed Sore – A dangerous bedsore that displays full tissues loss and has dead cells and hard scaps at the base of the sore. A fluid excretes out of this type of bedsore.

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Vacate – To invalidate or erase an action by the court or in a legal process. 

Ventilator – A device that helps people breathe when they are not able to on their own. 

Venue – The place where an incident occurs. 

Verdict – A final judgment by a judge or jury in a legal case determining the outcome of the case. 

Veterans’ Administration – An organization focused on providing medical and legal support to veterans.

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Waiver of Immunity – A legal contract that removes an entity’s immunity to legal action. 

Will – A legal document stating how your assets should be handled after your death. 

With Prejudice – A legal term meaning a decision is final and further action can not be taken.

Without Prejudice – A legal term meaning a decision is not final.  If a case is dismissed without prejudice, it can be refiled at a later date. 

Wound Documentation – A detailed medical record describing the wound, stage, size, location, tracts, drainage, odor, wound edges, surrounding tissue, signs of infection, and patient education.

Wound Vac – Wound care equipment that uses negative pressure to help heal an open wound and close it from the inside.

Writ of Certiorari – The legal right of higher courts to review and possibly overturn the decisions by lower courts. 

Wrongful Death – A type of civil case family members can file after a loved one has died as the result of negligence or willful harm.

Contact a Nursing Home Abuse Law Firm

Dealing with nursing home abuse isn’t something you should take on by yourself. Get help from a qualified nursing home abuse law firm to make sure that your lawsuit is handled correctly. 

At Rosenfeld Injury Lawyers, we work with the families of nursing home abuse victims to seek compensation for their damages. Contact Rosenfeld Injury Lawyers for a free consultation by filling out our contact form or calling toll-free at (888) 424-5757.