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Your Guide to Nursing Home Ratings and Lawsuits (With Examples)

by Samreen Sheikh

 

Choosing a nursing home for a family member can be tricky, confusing, and emotional. Many families rely on the Centers for Medicare & Medicaid Services (CMS) rating system to evaluate nursing homes, often assuming a high rating ensures safety and proper care.


However, facilities with excellent ratings can still experience issues, as neglect, abuse, and inadequate staffing may occur even in highly-rated nursing homes. The CMS rating system was designed to provide consumers with a simple evaluation, assessing nursing homes based on health inspections, staffing levels, and quality of residential care, with each facility assigned scores and an overall rating ranging from one to five stars.

Nursing Home Ratings and Lawsuits (With Examples)

DOES A LOW RATING NECESSARILY MEAN THE NURSING HOME IS MALICIOUS?

Low ratings can raise alarms but don’t always signify harmful intentions. Ratings often stem from broader issues like staffing shortages or high employee turnover. Nursing homes across the U.S. struggle with significant staffing challenges, which can impact the level of care provided. Facilities that aim to deliver quality care may lack funds, caregivers, or other resources to fully support their residents.


Nursing homes with high ratings are not immune to violations and lawsuits. The Oaks at Avon facility has an overall five-star CMS rating but has still received violations related to medication errors and insufficient infection prevention. And despite its high overall rating, staffing issues still plague the establishment, giving it only a two-star staffing rating.

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NURSING HOME LAWSUITS EXPLAINED

When instances of neglect or abuse arise, families often have the option to take legal action against a nursing home. Lawsuits against these facilities are typically initiated when there is proof of neglect, abuse, or other mistreatment that causes harm to a resident. Common grounds for these lawsuits include physical abuse, neglect resulting in injury or health decline, financial exploitation, and medical malpractice, such as errors in medication administration or incorrect diagnoses.


In Oklahoma, an unusual legal case has been unfolding since 2016 (it’s still in litigation), when the family of a resident who passed away following an alleged fall decided to sue not just the nursing home itself but also its shareholders. This landmark decision could significantly influence the industry, potentially improving the safeguards for residents in nursing facilities.

Nursing Home Ratings and Lawsuits (With Examples)

THE PROCESS OF FILING SUIT AGAINST A NURSING HOME

A nursing home lawsuit generally consists of multiple stages and can take considerable time. Initially, families should seek advice from a qualified attorney to evaluate the strength of their case. Following this, attorneys will collect evidence, including medical records, witness testimonies, and expert evaluations.


The duration of a nursing home lawsuit can differ significantly, with many cases taking months or even years to conclude, particularly if they proceed to trial. Many cases are resolved through settlements, which can speed up the process. Families should be prepared for a potentially long but fulfilling journey if they feel their loved one’s rights have been compromised.

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WHAT TO DO IF YOU SUSPECT NURSING HOME ABUSE OR NEGLECT

If you have concerns about potential abuse or neglect in a nursing home, it’s vital to act quickly.

  1. Record any observations: Track any signs of injury, odd behavior, or noticeable changes in your loved one’s physical or mental well-being. Taking photos and writing down your observations can be very helpful.

  2. Speak with nursing home staff: Approach the staff at the facility and calmly share your concerns. Often, issues can be resolved through direct communication with the care team. If their response doesn’t satisfy you, move on to the next steps.

  3. Contact state regulatory bodies: Each state has a long-term care ombudsman responsible for looking into nursing home complaints. Reporting your concerns to the ombudsman can trigger an official investigation.

  4. Consult a lawyer: If the situation is severe or if state intervention doesn’t lead to improvements, it’s wise to consult a lawyer who specializes in nursing home abuse. An experienced attorney can help you understand your legal options and assess whether pursuing a lawsuit is the right choice.

Nursing Home Ratings and Lawsuits (With Examples)

While the CMS rating system can be a valuable tool for families assessing nursing homes, it’s just one part of the picture. Both well-rated and poorly-rated facilities can face challenges related to staffing, care quality, and even instances of abuse or neglect. If you suspect abuse or neglect, take swift action to safeguard your loved one and explore your options for seeking justice. Deciding to place a loved one in a nursing home is never easy, but it’s crucial to prioritize their safety and well-being.

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