The federal skilled nursing facility (SNF) Quality of Care standard is contained in 42 CFR §483.25 Quality of Care. “Each resident must receive, and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.”
The comprehensive assessment is defined in 42 CFR §483.20(b) (1) as the Resident Assessment Instrument (RAI); commonly referred to as the Minimum Data Set (MDS) (see Long-Term Care Facility Resident Assessment Instrument User’s Manual, published by CMS). The federal SNF staffing standard is contained in 42 CFR §483.30 Nursing Services. “The facility must have sufficient nursing staff to provide nursing and related services to obtain or maintain the highest practicable physical, mental and psychosocial well-being of each resident as determined by resident assessments and individual plans of care.”
The Center for Medicare and Medicaid Services (CMS) suggests appropriate levels of staffing based on reported acuity of residents. These suggestions are based on information provided by the facility for reimbursement.
The Medicare and Medicaid system reimburses skilled nursing facility providers based on a prospective payment system. Each Medicare and Medicaid resident is uniquely assessed using a Minimum Data Set (MDS) assessment. The assessment information can be translated into a Resource Utilization Group (RUG) category. There are currently sixty-six different RUG categories.
Each RUG score will translate to an amount of time CMS expects to be provided to each assessed resident based upon the resources necessary to provide for those needs. For each Medicare resident, the RUG provides the nursing home with a different daily per diem reimbursement.
The Centers for Medicare and Medicaid Services (CMS) publishes expected staffing levels for each SNF based on the MDSs (RUGs) submitted to CMS for payment. CMS publishes the reported staffing levels and the expected staffing levels as part of their “Five Star Rating” system. Each RUG category requires certain hours per patient per day (HPPD) for RNs, LPNs, and CNAs. This system applies to all residents, no matter their pay source.
Sadly, many NYC nursing homes report their residents as “high acuity” for payment from Medicare, but staff below Medicare’s expected staffing.
Frequently Asked Questions about a New York City Nursing Home Neglect Lawsuit
How Do I Know if my Nursing Home was Understaffed?
This is not a determination that you need to make. Our NYC nursing home abuse lawyers will analyze the available census data and compare it to any available Medicare or Medicaid cost reports. We can aid in the investigation of what happened to your loved one in the NYC nursing home, and, whether the injuries arose out of understaffed nurses.
Can I Win a Claim against a Nursing Home for a Slip and Fall Accident?
Perhaps. A nursing home is liable for a slip and fall accident if the accident was caused by its own negligence or by the negligence of one of its employees. As long as you can trace the accident to negligence (failure to keep floors dry, for example), you can win.
How Can I Find Out If My Mother Is Being Improperly Medicated?
If you are worried that your mother is being improperly medicated or over-medicated, take the following actions:
- Obtain your mother’s medical records (you may need her signature, a durable power of attorney, or legal guardianship to do this);
- Discuss the matter with the nursing home administration or staff; and
- Contact a New York nursing home abuse lawyer to investigate on your mother’s behalf.
Remember, you can sue the nursing home itself for improper acts or omissions by its staff.
What Are Some Examples of Nursing Home Abuse?
The following are just a few of the many different possible examples:
- Improper restraints (including chemical restraints such as excessive medication)
- Threats, name-calling, and other forms of verbal abuse
- Deliberately or negligently withholding needed care (refusing to let the resident take a shower as punishment, for example)
- Failure to prevent abuse by visitors or by other patients
My Father Was Injured in an Assault by Another Resident. Can I Claim against the Nursing Home?
Yes, you can, and you can win if you are able to show that the assault was the result of the nursing home’s understaffing or negligent security.
What if Another Company or Individual Negligently Hurt my Loved One While in the Nursing Home?
Special healthcare providers and independent contractors are given access to nursing home patients by the nursing home. New York law holds that, if these third party providers injure a nursing home resident while in the facility, the nursing home can still be held liable. Nursing homes have a non-delegable duty to keep residents safe. This means they cannot wash their hands of this responsibility, simply because a third party was allowed to provide care in their nursing home.
Some examples of potential third party tortfeasors inside a nursing home include:
- physical therapists
- agency nurses; and
- outside wound care teams
If a third party is given access to your loved one in the nursing home, and subsequently harms them, the nursing home is likely responsible under New York law.
Who Can I Sue in a Nursing Home Abuse Lawsuit?
You can sue the nursing home itself and, depending on the circumstances, you can also sue:
- Nursing home administrators;
- Nursing home staff;
- Nurses;
- Nurse’s aids;
- Doctors; and
- Other health care providers.
You cannot generally sue the nursing home for the negligence of a doctor. In cases such as that, you may need to file a medical malpractice lawsuit.
In any case, there is usually a good chance that you will be able to settle the claim out of court. Most nursing home negligence claims resolve before trial.
Large NYC Area Nursing Homes
NEW GOUVERNEUR HOSPITAL S N F
227 MADISON STREET
NEW YORK, NY 10002
(212) 441-5023
VILLAGE CARE REHABILITATION AND NURSING CENTER
214 W HOUSTON STREET
NEW YORK, NY 10014
(212) 337-9400
NEW YORK, NY 10002
(212) 673-8500
BROOKLYN, NY 11201
(718) 858-6400
COBBLE HILL HEALTH CENTER INC
BROOKLYN, NY 11201
(718) 855-6789
HOPKINS CENTER FOR REHABILITATION AND HEALTHCARE
BROOKLYN, NY 11217
(718) 694-6700
HOBOKEN UNIVERSITY MEDICAL CENTER TCU
HOBOKEN, NJ 07030
(201) 418-1000
ALARIS HEALTH AT HAMILTON PARK
JERSEY CITY, NJ 07302
(201) 653-8800
OXFORD NURSING HOME
BROOKLYN, NY 11217
(718) 638-0360
BEDFORD CENTER FOR NURSING AND REHABILITATION
BROOKLYN, NY 11249
(718) 858-6200
NEW CARLTON REHAB AND NURSING CENTER, L L C
BROOKLYN, NY 11238
(718) 789-6262
CONCORD NURSING AND REHABILITATION CENTER
BROOKLYN, NY 11216
(718) 636-7500
DOWNTOWN BROOKLYN NURSING & REHABILITATION CENTER
BROOKLYN, NY 11238
(718) 636-1000
MANHATTANVIEW NURSING HOME
UNION CITY, NJ 07087
(201) 325-8400
MORNINGSIDE NURSING AND REHABILITATION CENTER
BRONX, NY 10461
(718) 409-8200
PELHAM PARKWAY NURSING CTR & REHAB FACILITY L L C
BRONX, NY 10469
(718) 798-8600
MORRIS PARK NURSING HOME
BRONX, NY 10469
(718) 231-4300
BRONX GARDENS REHABILITATION AND NURSING CENTER
BRONX, NY 10457
(718) 960-3910
EGER HEALTH CARE AND REHABILITATION CENTER
STATEN ISLAND, NY 10306
(718) 979-1800
SEA VIEW HOSPITAL REHABILITATION CENTER AND HOME
STATEN ISLAND, NY 10314
(718) 317-3000
CLOVE LAKES HEALTH CARE AND REHAB CENTER, INC
STATEN ISLAND, NY 10314
(718) 289-7900
RIVERDALE NURSING HOME
641 WEST 230TH ST
(718) 796-4800
THE CITADEL REHAB AND NURSING CENTER AT KINGSBRIDGE
BRONX, NY 10463
(718) 796-8100
HOLLISWOOD CTR FOR REHABILITATION AND HEALTHCARE
HOLLIS, NY 11423
(718) 740-3500
WESTCHESTER CENTER FOR REHABILITATION & NURSING
MOUNT VERNON, NY 10550
(914) 699-1600
BRIDGE VIEW NURSING HOME
WHITESTONE, NY 11357
(718) 961-1212
DR SUSAN SMITH MCKINNEY NURSING AND REHAB CENTER
BROOKLYN, NY 11203
(718) 245-7000
Get Your Free NYC Nursing Home Neglect Attorney Consultation
Want to discuss the potential merits of an injury or wrongful death lawsuit against a New York City nursing home? Our NYC nursing home abuse lawyers provide free case consultations.
Call us now at 646-969-5855 or send in a submission through our website by completing the form below.
We are available to speak with you and advise you on your options in the wake of a family tragedy inside a long term care facility. Do not let the cycle of elder abuse and neglect go unreported. Take a stand and speak with our NYC nursing home abuse attorneys today.