I’ve written many times in this blog about how far too often I’m called by clients and prospective clients, reporting their suspicions that a loved one or friend in a nursing home is being neglected or abused.  As a Massachusetts nursing home neglect & abuse lawyer, I see these cases too often, and I can assure you that they are among the saddest – and most infuriating – of injury cases that I litigate.

Just yesterday, Massachusetts Attorney General’s office reported that it was imposing fines on seven Massachusetts nursing homes for substandard care, revolving around cases of patient neglect or abuse.  The fines range from a low of $30,000 to a high of $200,000.  As part of this civil settlement (and the civil nature of this action is key to this post,) these nursing homes will be – supposedly – required to “improve staff training”, conduct yearly self-audits of their progress, and report that progress to the attorney general’s office for the next three years.  While some might see this as severe disciplinary action against these nursing homes, as a Boston nursing home abuse attorney, I find these actions lacking in more severe punishment, and lacking in tougher oversight of these businesses.  Example ‘A’:  Exactly what does “improve staff training” mean?  It’s vague and nonspecific, as an attorney I have little idea of what it means, and I’m sure that these nursing homes don’t have any specific ideas, either.  Worse, Example ‘B’:  The “auditing” – i.e., oversight – that these nursing homes are required to follow up on, is self auditing – not auditing and oversight conducted aggressively submitting by an independent authority such as either the Attorney General’s office, or the Massachusetts Department of Public Health.  Expecting a nursing home to self-audit its “improvement” is like asking a physically abusive person to report to authorities that he doesn’t push anyone around anymore, and expecting that person to be honest.  If anyone in the Attorney General’s office thinks for one minute that these businesses will honestly, aggressively and diligently police themselves, I have a bridge I can sell them a bridge in Brooklyn.

What was needed here was criminal prosecution, not merely civil fines and ‘settlement agreements.’  The neglect and abuse that these nursing homes were found to have engaged in, was not merely ‘troubling’, but sickening:  One patient was dropped by aides, and broke her legs.  The staff knew about the injuries, but didn’t report it for over a day.  The patient died after suffering massive internal bleeding.  Two other patients bled to death after suffering cuts that were not attended to.  Another died from a fatal medication error, and others were negligently allowed to wander off the property.  Yes, hitting such substandard and negligent nursing homes with financial fines will hurt them – but only temporarily.   Financial penalties, alone, won’t be enough to stem the tide of Massachusetts nursing home neglect and abuse.  As an attorney who specializes in nursing home neglect & abuse cases, I see the failure of the state to criminally prosecute these businesses, as analogous to the state failing to criminally prosecute the Catholic church for failing to stop sex abuse of children and minors by clergy members – instead expecting church leaders to police themselves. Such myopia, and frankly, stupidity, is stunning.  Had criminal prosecution of church authorities been pursued a long time ago, that crisis never would have escalated to the level that it did.

Part of the Attorney General’s settlement this past week also bans Synergy Health Centers, a notoriously malignant nursing home chain headquartered in New Jersey that I have written about previously, from operating any nursing homes in Massachusetts that participate in state or federal health care programs, for the next seven years.  That’s more aggressive action, but notwithstanding, it’s long past time when nursing home operators should face criminal prosecution for cases of intentionally concealing and not reporting clearly egregious cases of patient neglect and abuse.  In the meantime, here are some reminders of what family members of nursing home patients can do to lower the odds that their loved one will suffer neglect or abuse:

Examine your family member’s bedding and sheets. Have they been changed?  Look for stains on them. Is there a chart next to your loved one’s bed or wheelchair, indicating when the patient has been re-positioned last? Is the chart signed by that (those) staff member(s)?

Let the nursing facility – and the Director of Nursing – know that you are keeping watch on your loved one. You can do this by supplementing the patient’s floor chart, with your own chart: Create columns for “Date”, “Name of Person Visiting”, “Mr./Ms. _____________’s Condition”; “Staff Member Complained To”; “Action Promised”, and “Corrective Action Taken”. Individualized, family-created charts like this, which are kept religiously next to your loved one’s bed, will make it very clear to the floor staff and senior management, that you are carefully watching both your loved one – and the staff and Nursing Director.

Do not visit your loved one at regular, predictable days and times: Shake it up, so that the staff never knows when you’re coming. If they know that you always show up predictable days and times, they’ll know how and when to cover-up any substandard care or neglect.  I advise my clients who have loved ones in nursing homes:  Be skeptical.  In my 25 years of representing victims of Massachusetts nursing home neglect and abuse, I’ve seen far too many examples of cover-ups and deception when it comes to patient care.