Do Care Facilities Adjust Their Care for Patients with Worsening Conditions?

Families do their best to care for loved ones suffering from debilitating injuries and illness, but sometimes patients require specialized medical assistance. Unfortunately, age-related conditions seldom improve and often result in deteriorating health. A loved one’s welfare may depend on the protection and services offered by skilled nursing facilities. Even so, you might spend months selecting the right nursing or rehabilitation home for your parent before waiting for a bed to open.

Many families wonder whether nursing facilities can or will provide care for their loved one’s worsening medical conditions. The answer often depends on the nature of the patient’s admission, the care home’s ability to offer advanced services, and the specific laws protecting patients in that jurisdiction.

Most Common Conditions Resulting in Admissions to Care Facilities

Patients often transition to long-term care when their condition requires around-the-clock medical services or safety monitoring.

Vulnerable adults and elderly citizens struggling with the following conditions often need in-patient medical services:

• Traumatic brain injuries – Unfortunately, severe head injuries often result in permanent mental, physical, and emotional disabilities. Patients might suffer from constant seizures, confusion, or even enter a coma. Such conditions could require life-support.
• Falls and broken hips – These injuries often leave patients immobilized, but treatment options are typically limited to pain management. Elderly Americans often need in-patient care, including physical therapy and prescription pain medication, after suffering from a broken hip.
• Dementia – The confusion associated with dementia and related mental health conditions, such as Alzheimer’s, typically necessitates 24-hour monitoring to ensure a patient’s health and safety. Regrettably, these conditions usually worsen over time and require more advanced medical treatment and nursing services.
• Diabetes – From blindness to amputations, diabetes takes a toll on a patient’s health. This incurable condition often worsens when patients do not receive proper nursing care.
• Incontinence – Deteriorating bowel health and urinary tract infections may result in unsanitary conditions necessitating specialized nursing and medical care
• Heart attacks and strokes – These life-changing medical events often result in traumatic brain injuries and the inability to live independently
• Parkinson’s disease and mobility disorders – Many genetic and nervous system disorders affect patients’ ability to move, leading to substantial fall risks. Patients often require regular physical therapy and assistance with daily activities such as dressing, eating, and bathing. These conditions deteriorate with age, often requiring an increased level of nursing care.

Most of these conditions result in permanent disabilities that naturally worsen over time. One disorder may also cause a debilitating injury when patients do not receive proper care. For example, a nursing home resident admitted with Parkinson’s disease may fall and break a hip due to negligent supervision. Likewise, a patient with diabetes often develops blood clots, blindness, and mental health disorders when left bedridden.

Consider speaking with a nursing home abuse and neglect lawyer if your loved one’s condition rapidly worsens after admission or secondary illnesses develop.

Reviewing Patient-Caregiver Contracts and Admissions Documents

Due to the cost of and demand for long-term care, facilities accepting Medicare, Medicaid, and private insurance frequently operate at capacity. Families and patients often have limited options when it comes to selecting a nursing and rehabilitation home. Typically, local social service workers and medical professionals analyze patients’ conditions and match them with facilities equipped to provide the necessary care. Patients without substantial assets might remain in the hospital while awaiting the first available bed in a designated care and rehabilitation home.

Once a bed becomes available, the facility reviews the patient’s medical records and may offer skilled nursing services. The patient (or legal guardian) and the care home must typically agree to any subsequent caregiver relationship in writing.

These admission contracts often identify the patient’s primary medical condition, set the scope of care, outline available services, and explain applicable policies and procedures. In most cases, the contract dictates the level of care. Nursing homes might refuse to provide long-term support for medical needs associated with conditions outside the agreement’s scope.

Some contracts address these situations directly by listing additional services available upon request and associated price increases. In such cases, the nursing team or an independent physician might examine the patient, file a report, and automatically trigger treatment provisions for worsening conditions. However, administrators might invoke the care contract to force the transfer or removal of a patient from a designated facility.

Families should request that a local elder care lawyer reviews any admissions documents to determine whether to appeal a denial of services, prepare for a transfer, or otherwise demand additional treatment for patients with deteriorating health conditions.

Understanding Patients’ Rights as Their Health Deteriorates

The right nursing facilities should provide suitable medical treatment and support services that allow your loved ones to live their best lives.

However, not every facility has the resources and certifications necessary to treat new or worsening conditions.

Families need to distinguish between facilities that:

• Cannot provide for a loved one’s medical needs
• Caused worsening conditions through negligence
• Simply refused to make reasonable care adjustments

Appealing a Forced Transfer or Discharge

Receiving a notice of discharge or transfer does not excuse a care home’s failure to provide life-sustaining services, transfer a patient to a hospital, or reasonably accommodate a resident’s immediate medical needs. Before requesting a transfer, skilled nursing facilities must typically inform families of a patients’ worsening health and reasonably accommodate the patient’s changing needs.

These medical adjustments could include:

If the facility agreed in the admission contract to provide medical care for a specific condition, it must typically adjust its services as that condition worsens. Most states require nursing homes and assisted living facilities to take all reasonable steps to ensure patient welfare before initiating discharge and transfer procedures. As such, care homes must usually provide medical evidence of new or worsening conditions and explain why they cannot reasonably adjust their patient’s care plans.

Families typically have the right to appeal any forced transfer or removal to a local health agency, request an independent medical examination, and demand facilities continue to care for patients during the appellate process.

Demanding Care Adjustments

Families often return home shocked after visiting loved ones in long-term care facilities. They might smell urine while in their loved one’s room, find their loved one in pain, or notice a drastic shift in the resident’s lucidity. These changes might occur naturally from age-related degeneration, but they also might indicate abuse. In either case, nursing homes cannot neglect patients by failing to identify worsening conditions and taking the appropriate action. Legal guardians might demand a new medical assessment and request that care homes implement suggested changes.

A medical neglect attorney might review the admission’s contract, demand resident’s medical records, and explain the patient’s rights to nursing facilities. Legal advocates could draft a detailed letter demanding the care home adjust a patient’s treatment plan according to acceptable medical standards. Failure to do so might result in medical malpractice, healthcare fraud, negligence, and breach of contract claims against the nursing home.

Transferring a Patient and Seeking Financial Reimbursements

Your loved one’s health and comfort come first, which often means finding the patient an alternative care facility when a nursing home refuses to provide essential services. Families might also pay private caregivers to monitor and advocate for the patient’s needs with nurses. Once a patient’s condition stabilizes, a local lawyer might help families recover out-of-pocket costs for these additional services from a negligent care home.

Consider requesting an independent assessment of the patient’s medical condition and asking long-term care facilities to make any recommended adjustments before taking legal action. Judges often consider whether families made a reasonable effort to hold care homes to their contract before pursuing alternatives. A nursing home lawyer can help you do this.

Cases When Care Homes May Decline to Adjust Treatment Plans

Assisted living complexes often reserve the right to discharge residents who develop severe medical conditions, such as dementia, if they pose a danger to other occupants. Nursing facilities might also limit available services in the admission contract. Most care homes refuse to treat worsening conditions if a doctor certifies that the patient needs services the facility does not provide.

For example, a nursing home may not offer end-of-life (hospice) care or have a dedicated dementia unit. For the most part, families may not force facilities to render services they do not already provide. They might, however, hold nursing homes accountable for causing or contributing to a worsening condition.

Distinguishing Natural Degenerative Conditions from Medical Neglect

When a loved one first enters a long-term care facility, families should speak with doctors about a condition’s natural progression. For example, dementia patients advance through multiple stages of the disorder despite receiving quality care. You should consider the disorder’s stage at admission and compare that to the patient’s current condition. If a loved one’s health deteriorated more quickly than expected while receiving specialized care, this could indicate medical neglect.

Legal guardians may request a patient’s medical records and discuss them with a lawyer. A legal professional could submit these records to qualified independent geriatricians and nurses for review. Independent medical studies often involve collecting records from before the admission and comparing them to current healthcare reports. Medical experts might help families distinguish between malpractice and a naturally occurring degeneration or identify potential signs of medical neglect. The same professionals might also draft recommended treatment plans and help support care adjustment requests.

Filing a Medical Malpractice or Wrongful Death Lawsuit Against a Negligent Nursing Facility

Unfortunately, patients can suffer from abuse and neglect at the hands of overworked and untrained staff members.

The top complaints associated with skilled nursing facilities in the United States include:

• Failing to respond to patient needs
• Untrained or limited medical staff
• Lack of sufficient nutrition and proper supervision
• Insufficient physical therapy, resulting in bedsores, bowel issues, and amputations
• Limited social interaction and mentally stimulating activities
• Lack of dedicated time with doctors
• Battery, verbal abuse, and sexual assault
• Overmedication
• Failing to sanitize and clean the facility’s living quarters
• Failing to address incontinence

These factors frequently contribute to worsening conditions and form the basis of medical malpractice, negligence, and wrongful death lawsuits. Patients, legal guardians, or estate representatives may work with a local law firm to file a medical malpractice action against a negligent care home. Generally, the patient’s representative must show that nursing staff failed in their legal duties to the resident by neglecting to provide necessary services or rendering subpar medical care.

Injured plaintiffs and their families might file medical negligence lawsuits against licensed nurses, doctors, physician’s assistants, and care homes. If the patient was abused or neglected by unlicensed professionals, such as administrators or nurse’s aids, an attorney might include claims for general negligence, battery, and emotional distress. These legal complaints might also include breach of contract actions if a nursing home failed to provide promised services under an admission agreement. A nursing home attorney might include all relevant claims against multiple defendants in a single lawsuit.

Retaining an Attorney and Recovering Compensation for Medical Neglect

Patients or their families might recover money for any direct and indirect damages associated with viable nursing home malpractice claims. An insurance settlement or financial recovery could include compensation for the patient’s medical bills, hospital costs, medical advocates, pain, suffering, mental anguish, loss of enjoyment of life, and funeral costs.

Most medical negligence and nursing home lawyers accept cases on a contingency fee basis, without charging any upfront costs or consultation fees. Instead, nursing home lawyers generally take a percentage of any eventual financial recovery (often around 33 percent) and reimburse themselves for any associated litigation expenses. Most firms also provide specialized patient advocacy, medical record review, and insurance appeal services.

Consider confidentially discussing your concerns about a loved one’s worsening medical condition with a local legal advocate.