nursing home



Leitner Varughese Warywoda is a premier New York City law firm representing victims of nursing home abuse and negligence. 


The decision to entrust a loved one into the care of a nursing home can be one of the most difficult choices with which a family is ever confronted. When entering into this sacred trust with a nursing home, you expect that your loved one will be properly cared for with dignity and respect. Unfortunately, negligence and outright abuse in nursing homes is far too common. Although many state and federal regulations, such as the New York State Public Health Law, have been established to protect nursing home residents, gross violations occur every single day tragically compromising the health, well-being, and dignity of some of our society's most vulnerable members. 


Brett Leitner and Justin Varughese are among New York’s  most recognized and respected leaders in the area of nursing home abuse & negligence litigation. Both in and out of the courtroom, our attorneys work tirelessly to create an environment where negligence and abuse will not be tolerated. Having recovered millions of dollars in nursing home verdicts and settlements for injured residents and their families, Leitner Varughese Warywoda will provide a voice for your loved one that cannot be ignored.



Nursing home abuse and neglect comes in many different forms.  Some of the signs, symptoms, and injuries that come as a result of abuse and neglect are:


  • Bed Sores or Pressure Sores (also known as “decubitus ulcers” or “pressure ulcers”)

  • Falls resulting in fractures or other serious injury

  • Infection or Sepsis

  • Head injuries

  • Injuries of unknown origin

  • Malnutrition or Dehydration

  • Medication Errors

  • Choking

  • Clogged Breathing Tubes

  • Physical or Sexual Assault or Abuse

  • Physical or Chemical Restraints

  • Burns

  • Alzheimer's and other dementias

  • Assaults by staff





The most important thing you can do for your loved one in a nursing home to keep them safe and healthy is to watch closely for signs of abuse.  This can best be accomplished by visiting frequently, at different times of day, and engaging in regular dialogue with the nursing home staff including doctors, nurses, and aides.  Some signs to watch out for include:


  • Rapid weight loss

  • Falls

  • Development of a bed sore

  • Unexplained bruises or other injuries

  • Sudden agitation

  • Emotional withdrawal

  • The substitution of heavy medication or sedatives for supervision

  • The inability of a caretaker to sufficiently explain the resident’s condition



According to the New York State Department of Health, nursing home residents have the right to:

  • dignity, respect and a comfortable living environment

  • quality of care and treatment without discrimination

  • freedom of choice to make your own, independent decisions

  • be informed in writing about services and fees before you enter the nursing home

  • the safeguard of your property and money

  • appeal a transfer or discharge with the New York State Department of Health

  • privacy in communications and the treatment and care of personal needs/belongings

  • choose your own schedule, activities and other preferences that are important to you

  • receive visitors of your choosing at the time of your choosing

  • an easy-to-use and responsive complaint procedure

  • be free from abuse including verbal, sexual, mental and physical abuse

  • be free from restraints

  • exercise all of your rights without fear of reprisal

  • participate in the established resident council at the facility

  • access and inspect records pertaining to your care



Rules and regulations exist governing a New York State nursing home's duties and obligations with regard to producing copies of a nursing home resident's medical and nursing records.

Section 18(2) of the New York Public Health Law (PHL) states that, upon written request, a health care provider shall provide an opportunity, within ten days, for a patient to inspect the patient’s information concerning or relating to the examination or treatment of the patient.


Section 18(1)(b) defines “Health care provider” or “provider” as a “health care facility” or a “health care practitioner” as defined by this subdivision.


Section 18(1) (c) defines “Health care facility” or “facility” as a “hospital as defined in article twenty-eight of this chapter”


Section 2801 defines “Hospital” as “a facility or institution engaged principally in providing services by or under the supervision of a physician or, in the case of a dental clinic or dental dispensary, of a dentist, or, in the case of a midwifery birth center, of a midwife, for the prevention, diagnosis or treatment of human disease, pain, injury, deformity or physical condition, including, but not limited to, a general hospital, public health center, diagnostic center, treatment center, dental clinic, dental dispensary, rehabilitation center other than a facility used solely for vocational rehabilitation, nursing home … .”


In addition to Section 18(2) of the New York Public Health Law (PHL), 10 NYCRR 415.3(c)(iv) mandates that the facility provide the requesting party with the right “to inspect all records including clinical records, pertaining to himself or herself within 24 hours after oral or written request to the facility” and, in addition, to purchase copies with 48 hours of the request. 


Moreover, 42 CFR 483.10(g) additionally requires that the facility must provide the records within 24 hours of the request.


Finally, the Rules and Regulations of the Board of Regents concerning professional conduct clearly require your compliance with such request.  For your reference, the specific regulation referred to [Chapter 1, Board of Regents, Sec. 2(a)(6)] states:


 “Unprofessional conduct shall also include … upon a patient’s written request, failing to make available to a patient … copies of the record required by paragraph 3 of this sub-division (i.e. office records) and copies of the reports, test records, evaluations of x-rays relating to the patient which are in possession or under the control of the licensee.”

Failure to comply with State law and with the Board of Regents Rules and Regulations may be considered misconduct under New York Education Law Sec. 6509.  


Examples of portions of the patient’s medical records that may be requested include, but are not limited to, nurse's notes, physician’s orders, medication/treatment administration records (i.e. MARs/TARs), CNA (certified nursing aide) accountability records, Minimum Data Sets (MDS), care plans, risk assessments, discharge notes, transfer records, patient review instruments (PRI), x-ray interpretation, photographs, lab results, physical therapy records, occupational therapy records, social service records, wound sheets, pressure ulcer tracking forms, etc.  


In addition, there are explicit rules which prohibit a New York State nursing home from retaliating and/or discriminating against a resident in response to the filing of an action against the nursing home, specifically by way of a Public Health Law § 2801-d action.




It is essential that family members of loved ones residing in nursing homes pay careful attention to the following signs and symptoms, which may be evidence that your loved one is being neglected or abused in a nursing home.  In order to obtain the best care possible, family members should be vigilant and act as advocates for their loved ones.  Paying careful attention to potential signs of nursing home neglect is extraordinarily important in maintaining a safe environment for your loved one in a nursing home.




From our perspective based on handling hundreds of nursing home abuse and neglect lawsuits, in the vast majority of cases, a nursing home resident who is adequately cared for should not develop bedsores.  Also known as "decubitus ulcers" or "pressure sores, this skin breakdown results from unrelieved pressure, friction, humidity, and poor nutrition, and most often occurs in residents left unattended for extended periods of time without repositioning and relieving pressure.  Bedsores can start small and develop into cavernous holes in the body, with muscles, tendons, and bones being exposed.  These gaping sores can result in unbearable pain and shock to the body, and can lead to deadly infections.




When a nursing home resident is allegedly "found" with an injury and the nursing home has no excuse or explanation for the cause, this is a sign of possibly abuse or neglect.  The nursing home is required by law to report any such injuries of unknown origin to the Department of Health as soon as possible.  The nursing home also should investigate the cause of these unexplained injuries.




Lack of adequate nutrition and hydration is a sign that a nursing home resident is possibly being neglected or abused.  Weight loss can be a direct result of dehydration, serious illness, poor food taste and quality, or a lack of ability to feed one's self.




Nursing homes must develop a written plan of care to lessen the risk of those residents who are at risk for falling.  Falls are one of the leading causes of death in the elderly.  Unfortunately, many nursing homes fail to have sufficient staff, and in fact have inadequate staff, leading to a lack of supervision and resident falling.


Remember, by law, nursing homes must ensure that residents' rights are protected under state and federal law.  If you believe that your loved ones' rights in a nursing home have been violated, it is essential that you contact a skilled nursing home attorney today.


Nursing homes have a duty to recognize residents that are fall risks in order to identify interventions to prevent the resident from falling, and to minimize complications and injuries from falls that do take place.


Residents should be assessed for their risk of falls upon admission, quarterly, annually and with change of condition such as by using a Fall Assessment Form.  The resident's score should be used to determine the resident's risk of falling and to assist with development of care plans.


Some interventions that may be used with residents who are at lower risk of falling include:


  • orient resident  to their surroundings and assigned staff

  • check lighting is adequate for safe environment

  • non-slip footwear

  • call bell within reach

  • light cord within reach

  • personal  care items within reach

  • bed at lowest position and wheels locked

  • room clear of environmental  hazards (cords,  furniture, etc.)

  • ambulate resident as frequently as appropriate


Residents that are at moderate risk for falling may also be given these interventions:


  • Every two hour comfort and toileting rounds (this may include positioning, offering snacks, ensuring warmth, ambulating, etc.

  • consult with MD or consultant pharmacist (evaluate side effects of medications

  • personal bed or chair alarm

  • seat belt

  • therapy evaluation  or re-evaluation

  • other consults


High risk may include these interventions:


  • move resident closer to nursing station as available

  • all other suggested interventions previously not implemented

  • bedside mat on floor

  • more frequent observation· (every 1 hour) for toileting and comfort rounds




  • Personal  clip alarm applied/ repositioned    

  • Bed alarm added / checked / strip changed ·    

  • Seat belt applied (Velcro / Clip)    

  • Medications  reviewed with physician    

  • Physician notified of complaint of weakness / dizziness    

  • Low bed    

  • Padded mat at bedside    

  • Added to toileting schedule    

  • Non-skid socks applied    

  • Slippers / shoes applied    

  • Physical  therapy evaluation/ re-evaluation    

  • Occupational therapy evaluation / re-evaluation    

  • Orthostatic blood pressure check    

  • Floor checked for spills    

  • Wires, cords, moved from area    

  • Eye exam ordered    

  • Call bell checked    

  • Resident reminded to call for assistance    

  • Resident reminded to use walker / wheelchair    

  • Walker / Wheelchair repositioned within reach    

  • Commode  at bedside    



A pressure ulcer, also known as a decubitus ulcer or bed sore, is any lesion caused by unrelieved pressure that results in damage to underlying tissue.  There are several other factors other than pressure that may contribute to the development of ulcers, including moisture, friction, shear immobility, sensory loss and certain underlying medical conditions.


The national Pressure Ulcer Advisory Panel (NPUAP) bed sore classification system defines six different stages:

 - Stage I and Deep Tissue Injury (DTI) display intact skin

 - Stage II, III, and IV are graded by the depth of the wound

 - Unstageable pressure wounds are those in which the base of the wound cannot be seen due to being covered by necrotic tissue


The most common areas of the body where bed sores develop are those areas subjected to pressure, including bony prominences and those areas covered by orthopedic devices or straps.  Areas of the body which are subject to often unrelieved pressure include the back of the head, the buttocks, the sacrum, the hips, and the heels.


A Stage I pressure ulcer does not show skin breakage but appears as an area of non-blanchable erythema.  A Stage I wound may be difficult to identity in darkly pigmented persons when relying only on skin color changes.


Stage II pressure ulcers are superficial skin breaks into the dermis layer only or clear blisters.  if there is necrotic tissue or slough or if the blister is blood-filled, it is not Stage II.


A Stage III pressure ulcer is a full-thickness skin break into subcutaneous tissue but does not permeate into the muscle or bone.  A Stage II wound can have undermining or slough.


A Stage IV pressure ulcer penetrates through skin to deeper tissues with bone showing in the base of the ulcer bed.  Undermining and tunneling and necrotic tissue may be present in Stage IV ulcers.

If you believe that a loved one may be the victim of nursing home neglect or abuse, you should take action quickly and contact us online or call Leitner Varughese PLLC at 855 LV FIRM NY or (631) 240-4390 to set up a free consultation with an experienced New York injury lawyer.



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