At The Law Offices of John M. McCabe, we understand that placing a loved one in a nursing home is a difficult decision that comes with significant concern for their wellbeing. While most nursing facilities in Raleigh provide adequate care, it's important to understand that there are strict regulations governing what things nursing homes are not allowed to do when caring for residents.
5 Things Nursing Homes Are Not Allowed to Do in Raleigh
Being aware of these prohibited practices can help you protect your loved ones and recognize when their rights have been violated. In this comprehensive guide, we'll explore five critical things nursing homes are not allowed to do in Raleigh and what actions you can take if these violations occur.
1. Nursing Homes Cannot Restrict Residents' Rights
One of the fundamental things nursing homes are not allowed to do is limit or restrict the personal rights of their residents. Under both North Carolina state law and federal regulations through the Nursing Home Reform Act of 1987, nursing home residents retain specific rights that facilities must honor.
What This Means for Residents
Nursing homes in Raleigh cannot:
- Prevent residents from receiving visitors during reasonable hours
- Open residents' mail without permission
- Restrict residents' communication with family, friends, or their legal representatives
- Deny residents the right to participate in their own care planning
- Restrict residents' freedom to voice complaints without fear of retaliation
- Deny residents access to their medical records
- Prevent residents from making personal choices about daily activities, schedules, and healthcare decisions
When nursing homes violate these rights, they may be infringing on residents' civil liberties. This type of violation can lead to emotional distress, social isolation, and deterioration in overall quality of life.
If you suspect that a nursing home is restricting your loved one's rights, documenting these instances and consulting with a nursing home abuse lawyer can help clarify whether these actions constitute a legal violation that requires intervention.
2. Nursing Homes Cannot Provide Substandard Medical Care
Among the most serious things nursing homes are not allowed to do is provide care that falls below established medical standards. Nursing facilities in Raleigh are required to maintain adequate staffing levels and ensure that all staff members are properly trained and qualified to perform their duties.
Common Forms of Substandard Care
Prohibited practices include:
- Failing to administer medications correctly or on schedule
- Neglecting to monitor residents' vital signs and health conditions
- Inadequate response to medical emergencies
- Failure to prevent or properly treat pressure ulcers (bedsores)
- Not providing assistance with basic activities of daily living such as bathing, dressing, and eating
- Neglecting hydration and nutrition needs
- Insufficient pain management
- Failing to implement proper fall prevention measures
Substandard care can lead to serious health complications, unnecessary suffering, and even premature death. If your loved one has experienced a decline in health that appears to result from inadequate care, this may constitute nursing home neglect.
Monitoring your loved one's physical condition during visits and reviewing their medical records can help identify potential issues. If you notice unexplained bruises, rapid weight loss, dehydration, or untreated medical conditions, these could be signs that the nursing home is not meeting its obligation to provide adequate care.
3. Nursing Homes Cannot Use Physical or Chemical Restraints Improperly
Another critical area among things nursing homes are not allowed to do involves the inappropriate use of restraints. Both North Carolina law and federal regulations strictly limit when and how nursing homes may use physical or chemical restraints on residents.
Rules Governing Restraint Use
Nursing homes in Raleigh are prohibited from:
- Using restraints for staff convenience or as a form of punishment
- Implementing restraints without a physician's order
- Maintaining restraints for longer than medically necessary
- Failing to monitor residents while they are restrained
- Using chemical restraints (unnecessary medications, particularly antipsychotics) to control behavior without medical justification
- Not trying less restrictive alternatives before resorting to restraints
- Failing to obtain informed consent when possible
Improper use of restraints can cause physical injuries, psychological trauma, and loss of dignity. It may also lead to complications such as decreased muscle strength, reduced bone mass, and increased risk of pressure ulcers.
If you observe that your loved one appears sedated during visits, shows unexplained bruising on wrists or ankles, or expresses fear about being restrained, these could be warning signs of improper restraint use. A nursing home abuse lawyer can help you determine whether the facility's practices violate regulatory standards and what legal remedies might be available.
4. Nursing Homes Cannot Engage in Financial Exploitation
Financial exploitation represents one of the most concerning things nursing homes are not allowed to do. Residents of nursing facilities are often vulnerable to financial abuse due to cognitive impairments, limited mobility, or dependence on others for assistance with financial matters.
Prohibited Financial Practices
Nursing homes and their staff in Raleigh cannot:
- Access residents' funds without proper authorization
- Coerce residents into making financial decisions that benefit the facility
- Charge for services that were not provided
- Misuse residents' personal funds
- Steal money or valuable possessions from residents
- Force residents to sign over control of their finances
- Add unauthorized charges to residents' bills
- Manipulate residents into changing their wills or adding staff members as beneficiaries
Financial exploitation can devastate a resident's financial security and limit their options for future care. Regularly reviewing your loved one's financial statements, monitoring their bank accounts, and being alert to unexplained transactions can help detect potential financial abuse before significant losses occur.
If you suspect financial exploitation in a nursing home, gathering documentation and consulting with a nursing home abuse lawyer promptly can help protect your loved one's assets and hold the facility accountable for any misconduct.
5. Nursing Homes Cannot Neglect Basic Needs or Create Unsafe Conditions
The final category of things nursing homes are not allowed to do involves neglecting residents' basic needs or maintaining unsafe living conditions. Nursing homes in Raleigh have a legal obligation to provide a clean, safe environment that meets residents' fundamental needs for hygiene, nutrition, and comfort.
Areas of Prohibited Neglect
Nursing facilities cannot:
- Fail to maintain appropriate temperature controls (too hot or too cold)
- Allow unsanitary conditions to persist
- Ignore pest infestations
- Provide inadequate food or water
- Neglect residents' personal hygiene
- Leave residents in soiled clothing or bedding
- Fail to respond to call buttons in a timely manner
- Ignore maintenance issues that create safety hazards
- Have insufficient staffing levels that lead to neglect
Environmental neglect can lead to preventable illnesses, injuries from falls or other accidents, and a diminished quality of life. During visits to your loved one, pay attention to the cleanliness of the facility, the appearance of other residents, response times to requests for assistance, and whether basic needs like hydration and nutrition appear to be met.
If you observe consistent problems in these areas, documenting your concerns and addressing them with the facility's administration should be your first step. If conditions do not improve, consulting with a nursing home abuse lawyer may be necessary to protect your loved one and potentially other residents from ongoing neglect.
What to Do If You Suspect Nursing Home Violations
If you believe that a nursing home is engaging in any of these prohibited practices, there are several steps you can take:
- Document everything: Keep detailed records of any concerning incidents, including dates, times, descriptions, and the names of any staff members involved.
- Report internally: Bring your concerns to the attention of the nursing home's administration and, if applicable, the resident ombudsman.
- File official complaints: Report serious concerns to the North Carolina Department of Health and Human Services, Division of Health Service Regulation, which oversees nursing homes in the state.
- Seek legal guidance: Consult with a nursing home abuse lawyer who understands the specific regulations governing care facilities in Raleigh.
At The Law Offices of John M. McCabe, we have assisted many families in addressing instances where nursing homes have violated these prohibitions. Understanding the things nursing homes are not allowed to do is the first step in protecting your loved ones from potential abuse or neglect.
North Carolina Regulations for Nursing Homes
At The Law Offices of John M. McCabe, we understand that North Carolina maintains specific state-level regulations that work alongside federal standards to define things nursing homes are not allowed to do and protect our vulnerable seniors.
- Licensure requirements: All nursing homes in North Carolina must obtain and maintain a license from the Division of Health Service Regulation, which requires compliance with comprehensive state standards for resident care and facility operations.
- Resident assessment protocols: North Carolina facilities must complete a comprehensive assessment within 14 days of admission, establishing a baseline for detecting changes in condition and ensuring appropriate care planning.
- Adult Care Home Patient's Bill of Rights: State law guarantees nursing home residents specific rights including privacy, dignity, confidentiality, and freedom from abuse, enforcing critical protections against things nursing homes are not allowed to do.
- Physical plant standards: North Carolina regulations specify detailed requirements for facility design, including room size, bathroom accessibility, common areas, and safety features that ensure resident comfort and mobility.
- Administrator qualification requirements: State law requires nursing home administrators to be licensed by the North Carolina State Board of Examiners for Nursing Home Administrators, ensuring facilities have properly qualified leadership.
- Infection control standards: North Carolina mandates specific infection prevention protocols, including requirements for isolation procedures, staff training, and reporting of communicable diseases.
- Dietary service regulations: State regulations require nursing homes to employ or contract with qualified nutrition professionals and provide meals that meet residents' nutritional needs and physician-ordered therapeutic diets.
- Medication administration rules: North Carolina has strict regulations governing medication storage, administration documentation, and staff qualifications for administering medications to prevent dangerous errors.
- Staffing ratio requirements: State regulations establish minimum staffing levels based on resident census and acuity, ensuring facilities maintain adequate personnel to meet resident needs at all times.
- Employee background check mandates: North Carolina requires criminal background checks for all nursing home employees, helping prevent individuals with concerning histories from working with vulnerable residents.
- Complaint investigation procedures: The state maintains a dedicated process for investigating complaints about nursing home conditions, with specific timelines for addressing serious allegations of abuse or neglect.
- Fall prevention protocols: State regulations require nursing homes to implement comprehensive fall prevention programs, including risk assessments, environmental modifications, and staff training.
- Reporting requirements: North Carolina nursing homes must report incidents of suspected abuse, neglect, or exploitation to both the Department of Social Services and the Division of Health Service Regulation within 24 hours.
- Disaster preparedness mandates: Facilities must maintain comprehensive emergency plans addressing various scenarios including natural disasters, power outages, and other emergencies that could endanger residents.
- Quality improvement standards: North Carolina requires nursing homes to maintain active quality assurance and performance improvement programs that regularly evaluate and enhance care practices.
Federal Regulations for Nursing Homes
At The Law Offices of John M. McCabe, we recognize that federal regulations establish critical baselines for care that help prevent things nursing homes are not allowed to do and protect vulnerable residents.
- Nursing Home Reform Act (OBRA '87): This landmark legislation established comprehensive standards for nursing home care, requiring facilities to provide services that maintain the highest practicable physical, mental, and psychosocial well-being of each resident.
- Resident rights protections: Federal law guarantees nursing home residents specific rights including privacy, dignity, self-determination, and freedom from abuse, neglect, and inappropriate restraint use.
- Staffing requirements: Nursing homes must maintain sufficient staff with appropriate training to provide necessary care, including 24-hour licensed nursing services and a registered nurse at least 8 consecutive hours per day.
- Care planning procedures: Facilities must develop comprehensive care plans for each resident within 7 days of admission, with regular assessments and updates to address changing needs.
- Medication management standards: Nursing homes must ensure accurate administration of medications, proper documentation, and regular reviews to prevent adverse drug events and inappropriate use.
- Dietary services regulations: Facilities must provide each resident with a nourishing, well-balanced diet that meets individual nutritional and special dietary needs.
- Quality of life standards: Federal regulations require nursing homes to maintain an environment that promotes dignity, comfort, and quality of life, supporting residents' physical and mental health.
- Infection control protocols: Nursing homes must establish and maintain infection prevention and control programs designed to provide a safe environment and prevent disease transmission.
- Physical environment safety: Facilities must comply with Life Safety Code requirements and maintain comfortable temperatures, adequate lighting, housekeeping, and maintenance to ensure resident safety.
- Abuse and neglect prohibitions: Federal law strictly forbids things nursing homes are not allowed to do, including physical, verbal, sexual, or mental abuse, involuntary seclusion, and neglect of any resident.
- Complaint investigation procedures: CMS requires state survey agencies to promptly investigate complaints about nursing home conditions, with specific timeframes for addressing serious allegations.
- Transfer and discharge limitations: Nursing homes cannot transfer or discharge residents unless specific criteria are met, including proper notice and documentation of necessity.
- Resident assessment requirements: Facilities must conduct comprehensive, standardized assessments of each resident's functional capacity using the Resident Assessment Instrument (RAI).
- Financial protections: Regulations prohibit nursing homes from requesting or requiring residents to waive rights to Medicare or Medicaid benefits or from charging for services covered by these programs.
- Survey and enforcement mechanisms: Regular inspections, complaint investigations, and enforcement remedies including civil monetary penalties help ensure compliance with federal standards.
How a Nursing Home Abuse Lawyer Can Protect Your Rights and Safety
At The Law Offices of John M. McCabe, we understand that discovering your loved one has experienced abuse or neglect in a nursing home can be devastating and confusing.
- Legal evaluation of your case: A nursing home abuse lawyer assesses the specifics of your situation to determine if things nursing homes are not allowed to do have occurred and if you have grounds for a legal claim.
- Investigation of abuse allegations: Our attorneys thoroughly investigate nursing home violations by gathering medical records, interviewing witnesses, and consulting with healthcare professionals to build a comprehensive understanding of what happened.
- Documentation of evidence: We meticulously document all evidence of nursing home neglect or abuse, including photographs of injuries, medication records, facility conditions, and staff-to-resident ratios that may have contributed to the situation.
- Identification of liable parties: A nursing home abuse lawyer identifies all potentially responsible parties, which may include individual staff members, administrators, the facility ownership, or corporate entities that failed to maintain proper standards.
- Understanding of complex regulations: We navigate the intricate web of federal and North Carolina regulations governing nursing homes to identify specific violations that strengthen your case.
- Calculation of damages: Your attorney accurately calculates all potential damages, including medical expenses, pain and suffering, emotional distress, and in the most serious cases, wrongful death compensation.
- Filing of necessary legal documents: We handle all required paperwork within strict legal deadlines, ensuring your claim is properly filed and processed through the appropriate channels.
- Communication with insurance companies: A nursing home abuse lawyer manages all communications with insurance representatives, protecting you from tactics designed to minimize your claim or shift blame.
- Negotiation of fair settlements: Our attorneys leverage our knowledge of similar cases and settlement ranges to negotiate vigorously for compensation that truly reflects the harm your loved one experienced.
- Litigation representation: If a fair settlement cannot be reached, we provide strong courtroom representation, presenting your case persuasively to judges and juries.
- Access to industry knowledge: We draw upon our extensive understanding of common nursing home practices, staffing issues, and industry standards to identify when things nursing homes are not allowed to do have occurred.
- Protection from retaliation: Your attorney helps shield your loved one from potential retaliation while they remain in the facility by taking appropriate legal precautions and monitoring care closely.
- Coordination with regulatory agencies: We work with state and federal oversight agencies to report violations, trigger inspections, and ensure problematic facilities face appropriate regulatory consequences.
- Emotional support and guidance: Beyond legal representation, a nursing home abuse lawyer provides compassionate guidance through a challenging emotional process, helping you understand each step of the legal journey.
- Prevention of future abuse: By holding negligent facilities accountable, your legal action helps prevent similar abuses from happening to other vulnerable residents in the future.
Protect Your Loved Ones Today
If you suspect your family member has experienced things nursing homes are not allowed to do, don't wait to take action. The Law Offices of John M. McCabe is ready to help you understand your legal options and fight for the dignity, safety, and justice your loved one deserves. Contact us today for a confidential consultation.
