Choosing the right nursing home can make all the difference for a loved one’s quality of life. We should be able to trust that long-term care facilities have our loved ones’ best interests in mind. Unfortunately, that’s not always the case, and nursing home negligence is far too common. To protect your loved one, it’s important to do your research to identify red flags in nursing homes.
Start by using trusted resources such as Medicare’s Nursing Home Lookup and Care Compare, which provide ratings based on staffing, health inspections, and other key metrics. Also, consider checking reviews and rankings of nursing homes to see what others say about them.
What red flags in nursing homes should I look for?
If you notice any of the following at a nursing facility, it could be a sign that negligence is taking place:
High rates of infections and deaths
Many nursing homes experience outbreaks of serious infections such as MRSA, COVID-19, Norovirus, urinary tract infections, and pneumonia. When visiting a facility, watch how staff handles sanitation. Dr. Gary Small from Hackensack University Medical Center sheds light on the importance of hygiene to prevent infections, especially for residents with weakened immune systems.
“Do they wash their hands before and after handling a resident? If they don’t, this poses an infection risk, which is a big concern for older adults with weakened immune systems,” said Dr. Small.
Delayed response times
The call light is a lifeline for nursing home residents. It connects them to comfort and prompt assistance in emergency situations. Regulations from the Centers for Medicare and Medicaid Services (CMS) require that every resident has easy access to a call light at all times. Without it, they lose access to timely care and, in some cases, life-saving support.
When touring a nursing home, pay close attention to how call lights are handled:
- Check for active call lights: Are lights on frequently, signaling residents are waiting for help?
- Observe staff response: Are call lights answered in order, color-coded, or prioritized by need?
- Note response times: How long are lights on before someone responds?
It’s normal to see more call lights during busy times like shift changes or meal times, but constant, unanswered lights at all hours are a red flag. Each unanswered light could mean a resident in urgent need.
Staffing shortages
Adequate staffing lowers the risk of health issues such as bedsores, infections, and emergency room visits. To assess staffing levels, ask about the facility’s nurse-to-resident and aide-to-resident ratios and response times for call lights. Also, ask if the facility has a protocol in place if a nurse or aide calls out sick.
Frequent staff turnover
High turnover among nursing aides in nursing homes is a major red flag, and they often reach over 100% each year. This turnover means many staff members won’t be there long enough to truly understand residents’ day-to-day needs. Certified nursing aides handle most of the hands-on care, so consistent staffing is key to providing quality care that’s responsive to each resident’s well-being.
Beyond turnover rates, ask about:
- Availability of nursing care overnight
- Emergency procedures and protocols
- On-site medical staff, like a doctor
While turnover doesn’t always mean a facility is short-staffed, it can disrupt the continuity of care. Long-term caregivers build familiarity with residents’ routines, moods, and physical needs. However, frequent staff changes increase the risk of miscommunication and missed details in care.
Lack of social activities for residents
When visiting a nursing home, look closely at the social activities offered to residents. Social engagement isn’t just a nice perk; it supports residents’ mental and physical well-being. Lack of social activities can lead to isolation and loneliness, which can increase the risk of dementia. Here are some things to consider:
- Are residents up and active by mid-morning, joining in on scheduled activities?
- What activities are available? Look for everything from arts and crafts to clubs and gentle exercise options.
- Do residents dine together in the common area, enjoying shared mealtimes?
- Do residents feel comfortable interacting with staff, asking questions, or socializing when appropriate?
- Is there a safe, inviting outdoor space where residents can spend time, ideally in a secure and welcoming neighborhood?
State inspection and complaint records
State agencies responsible for licensing and certifying nursing homes conduct annual inspections to ensure facilities meet strict federal and state standards. These inspections verify that residents receive quality care and address complaints made by residents, family members, or third-party advocates.
Sadly, some residents experience neglect or abuse in lower-quality facilities. Abuse can show up as withheld food, missed medications, or denied access to healthcare. Watch for signs such as broken eyeglasses, disruptions in medication, unexplained bruising, or thumb-sucking. Harsh treatment from staff, belittling, or physical intimidation are also major red flags.
Lack of resident alertness
When visiting a nursing home, take note if any of the residents seem unresponsive. This can indicate the facility may be overusing antipsychotic medications (e.g., Haldol or Seroquel) to manage behaviors that staff find challenging, particularly for residents with dementia or Alzheimer’s.
While these medications may sometimes be necessary to ensure safety, misuse can significantly reduce a resident’s communication abilities and lead to a decline in their mental and physical health.
During your tour, ask the staff how they manage challenging behaviors and if psychiatric evaluations are conducted before using medications. Inquire about their approach to residents who may become aggressive to understand if they resort to physical or chemical restraints as a first response.
Cleanliness of residential rooms
When touring a nursing home, pay close attention to the cleanliness of resident rooms. Clean spaces are important for stopping the spread of germs and bacteria.
Look for signs of poor sanitation, such as overflowing trash cans, food trays left out long after meals, unmade beds or dirty linens, and personal items scattered on the floor. Nursing homes should take pride in maintaining fresh, orderly spaces. If the place doesn’t meet your standards now, consider looking elsewhere.
Is the facility meeting residents’ dietary needs?
While no one expects gourmet dining in a nursing home, residents should receive healthy, well-balanced meals that meet their nutritional needs. Beyond basic preferences, a quality nursing home will cater to specific dietary needs, including:
- Low-sodium options
- Lactose-free alternatives
- Gluten-free meals
- Allergen-friendly dishes, like avoiding tree nuts
- Acid reflux-friendly choices, free from common trigger foods
Unappealing food or meals that don’t align with dietary needs signal a red flag, often leading to poor nutrition and unhealthy weight loss in residents.
Watch for evasive or dismissive staff
You deserve open, respectful communication when discussing your loved one’s care. Everyone on the care team should prioritize your loved one’s well-being and value your input. But if you get dismissive answers or rude behavior, take it as a warning sign and consider exploring other options. If the staff seems evasive or dismissive, it’s time to dig deeper.
Try asking direct questions such as:
- Has there been any change in my loved one’s care plan recently?
- Have you noticed any signs of discomfort or pain?
- What activities keep them engaged when I can’t visit?
- I’ve noticed a specific behavior—do you have any concerns about it?
“No lift” policies
Many nursing homes have started adopting “no-lift” policies. This means that staff won’t physically move residents who have fallen. Instead, they call 911 and wait for emergency responders to do the lifting. This policy is designed to prevent back injuries for staff and reduce liability, but it raises serious concerns about quality care.
For example, it can lead to:
- Delays in getting help for fallen residents
- Increased demand on local emergency services
- Erosion of trust between residents and caregivers
If you’re considering a facility for a loved one, ask about their fall prevention and response strategies, such as:
- Fall prevention measures: Does the facility use bed alarms or other monitoring devices?
- Staff training for falls: Are staff trained to safely assist residents who’ve fallen?
- Regular rounding schedules: Is staff frequently checking on residents to catch any falls quickly?
- Equipment for transfers: Does the facility have Hoyer lifts or other transfer equipment to handle difficult moves?
Our Chicago law firm is here to help
If you suspect your loved one is being harmed in a Chicago-area nursing home, trust your instincts and don’t wait to take action. The nursing home negligence attorneys at Ferrell Young, LLC in Chicago know how distressing it is to see a family member suffer in a place you trusted with their care. Our experienced legal team will take swift action to investigate your case, build a solid claim, and fight for the compensation and accountability your family deserves.
When nursing homes fail to provide the dignity and safety every resident deserves, we step in. We have a proven track record of holding these facilities accountable and reaching positive outcomes for our clients. Don’t let your loved one suffer anymore. Contact us for a free consultation, and let us work together to protect your family’s rights.
“Thank you Ferrell Young LLC for working so diligently on my case. Everyone I came in contact with was exceptionally friendly and responsive and made such a stressful time in my life more at ease. I can’t thank you all enough!!” – Kirby B.