The outlook isn’t rosy for Texas’ senior citizens when it comes to quality of care in our state’s nursing homes and long-term care facilities.

Studies by groups such as AARP, respected publications which include U.S. News & World Report, and government healthcare agencies like Medicare show that throughout the U.S., nursing home/senior care facilities’ health-standard violations are declining. But Texas’ numbers are going in the wrong direction – up, way up!

According to The Dallas Morning News, citations for deficiencies in Texas facilities rose by 20% between 2010 and 2014; and severe infractions increased by 3% over that same period – while severe violations at nursing homes across the country declined by 16%.

This pattern of poor care in Texas nursing homes has consistently placed the state at or near the bottom of authoritative quality rankings, including:

  • 2014 & 2015 – Families for Better Care, a nonprofit advocating better nursing home care, 51st (including Washington D.C.)+++++
  • 2017 & 2018 – 45th in U.S. News & World Report
  • AARP’s 2018 Long-term Care Scorecard – 35th

And in 2018, ProPublica’s updated (June 2018) nursing home database ranks Texas worst in:

  • Number of total federal and state health standard violations by state inspectors
  • Number of major violations
  • Total amount of all fines assessed – a whopping $21,208,734

Overall, Texas ranked at or near the bottom in all but one of the seven ProPublica-rated categories.

Elder Abuse is Still Common in Care Centers throughout the U.S.

Each year it’s estimated that 5,000,000 older Americans are abused, neglected, or exploited, according to The Administration for Community Living, part of the U.S. Department of Health and Human Services. And experts strongly suspect that for every case of elder abuse or neglect which is reported, as many as 23 go unreported.

One appalling example which occurred in 2017 comes to us by way of KXAN television in Austin. The Texas Department of Aging and Disability Services (DADS) told the station about its investigation which uncovered a shocking video, recorded at a local nursing home and loaded to social media. It showed a patient whose hand was covered with feces, getting her nose tickled with a feather held by a nurse’s aide, who merrily watched the woman reaching to scratch her face with her feces-covered hand.

Texas certainly seems to have plenty of laws that govern nursing home care. But the state still has – at best – a checkered history of challenges in effectively overseeing the care of its elderly citizens. In early 2017, the AARP-published report, “Intolerable Care,” blasted DADS, calling its regulatory system “toothless” because it allows bad actors to regularly hurt their elderly clients. “Texas nursing home quality is shamefully poor,” the story reads. “As a result of this intolerable care, many residents of Texas nursing homes face unnecessary health and safety risks.”

Know the Signs of Nursing Home Abuse & Elder Neglect

Although nursing home abuse is not always obvious, there are some warning signs that that can give you clues when it’s happening to your loved one. Sadly, as we have already disclosed, many such cases go unreported because:

  • Your family member may be afraid to tell someone.
  • He or she might be (or feel) threatened by the abuser.
  • They may accept the abuse and think it’s normal.
  • Your relative might even be unaware that what they’re experiencing is abuse.
  • They can’t communicate with you because of physical or mental limitations.
  • Maybe they are shamed by the abuser to feel they deserve to be punished.
  • Or they just might not want to burden you with their problems.

In addition to physical abuse — such as slapping, shaking, or worse things, like the Austin example earlier in this story — nursing home neglect can also include a resident’s basic needs not being met. A prime example includes failure to give proper medication, and in some cases, unnecessary use of antipsychotic medications.

According to the FDA, this abuse kills an estimated 15,000 nursing home patients every year. Of all the drugs used as chemical restraints, antipsychotics are the most widespread and may be the most dangerous. One investigative report by a Dallas TV station revealed that some nursing homes were caught overmedicating residents with antipsychotics just so the facilities wouldn’t have to hire more staff members.

Other forms of nursing home abuse involve failure to care for wounds, to provide nutritious meals, and to assist with patients’ personal hygiene.

Elder care residents who are unreasonably restrained or subjected to sexual assault are also victims of abuse. Mental abuse (patients being humiliated, insulted, or threatened) can be just as damaging. And yet, with no evidence to support such claims, they are difficult to prove. This also includes refusal to let a patient make personal decisions like eating, getting out of bed, or handling their money.

You should be concerned if your nursing home relative has:

  • Unexplained bruises, cuts, burns, sprains, or fractures
  • Bedsores
  • Rapid weight gain or loss
  • Sudden changes in behavior, especially regarding money
  • Been kept in an over-medicated state or suffered because their pain was not managed effectively
  • Lost possessions
  • Abruptly changed legal papers such as a will or financial documents.

Other indications may come from abusive doctors, nurses or staff members themselves:

  • They don’t keep you and other family members informed about your relative’s status, or they give evasive or non-specific answers to direct questions about your family member.
  • They cannot satisfactorily explain the marks or bruises on your loved one.
  • You or your relative’s visiting friends are discouraged from seeing your relative.
  • There are delays in allowing you to see your loved one.
  • You are dissuaded from being alone with your family member.

So What Can You (and Your Elderly Family Member) Do?

The first thing is to do your homework going in. There’s a lot of good rating information for individual facilities. In addition to the ProPublica Scorecard link we shared above, two other reliable resources are:

And as you tour prospective nursing homes, notice the cleanliness of the facility, the number of staff relative to residents, and the overall mood of the residents. You might want to arrive around meal time so you can ask if you and your relative can eat in the cafeteria. Offer to pay. Aside from your impression of the meal; How it is received by others? Spend time lingering in front of residents’ open doors and see how they are.  Strike up a short conversation with them. Ask them questions.

In other words, take the time to observe, observe, observe. And after your family member has moved in, occasionally stop by unannounced to see your family member. Call it your own little “snap inspection.”

And if you suspect something is wrong, Texas now allows you to install a hidden camera in your relative’s nursing home. These are commonly referred to as “granny cams.” There are some rules you must follow, but if you reach that point of necessity, talk to a nursing home abuse attorney so you won’t run afoul of the law. If your granny cam confirms your suspicions, you will certainly have a more in-depth conversation with your chosen lawyer.

The legal team at Terry Bryant Accident & Injury Law have years of experience in holding negligent nursing homes accountable. If you suspect that your loved one has been abused or neglected, you should know that there are legal options available. We offer free consultations to help you better understand the next steps.