What can I do to make the nursing home where my friend lives improve safety and cleanliness?

Friends and family of nursing home residents can advocate for improvements, starting with management and proceeding, if necessary, to the state’s ombudsman or a lawyer.

Question: I have an elderly friend who lives in a nursing home in our town. I visit her weekly and I've noticed that the place is not very clean—sometimes her bed linens are not changed for weeks. And, I've also noticed that there is no smoke alarm in her room. Can I do anything to make the nursing home improve conditions?

Answer: You can do something, and it is good that you are monitoring your friend's situation. Many elders are not so lucky as to have an advocate for them. Fortunately, state and federal law may help you help her.

Talk to Management

Begin with the simplest method--consider approaching management and airing your concerns. This approach works best when you suspect that the problem lies with one or two workers, and is not systemic. Management may respond to your concerns. If they don't, you can escalate your approach, as explained below.

Federal Nursing Home Reform Act

You did not say whether the nursing home in question is a private home or one receiving public funds. If the nursing home where your friend lives receives Medicare or Medicaid funding, it is governed by the standards set in the Nursing Home Reform Act ("NHRA").(42 U.S.C. § 1396g.)The NHRA requires that homes receiving federal monies provide for the physical and mental well-being of residents.

The lack of smoke alarms is likely a violation of state law and perhaps city or county ordinance. In addition, the federal Fire Safety Requirements for Long Term Care Facilities, Automatic Sprinkler Systems requires that Medicare- and Medicaid-certified nursing homes install sprinkler systems throughout the facilities.

Ombudsman Program

In order to address concerns about conditions in the home, you can contact an ombudsman set up under the "Older Americans Act." Under the Act, every state must designate an ombudsman to receive and investigate reports of deficiencies at nursing homes within its borders. To find the ombudsman for your state, visit the National Long-Term Care Ombudsman Resource Center.

State Laws

In addition to the federal law, state elder abuse and nursing home abuse laws may provide your friend with the right to take action (through a representative, if she is too infirm to do it herself). Many states, such as California, Florida, New Jersey, and others, have laws that give elders or their representatives the right to file lawsuits when nursing home conditions cause them harm.

See a Lawyer

As you can see, a number of state and federal laws (and even local ordinances) may come into play when a nursing home is in poor condition. A lawyer with experience in elder law in your area can help you sort through the regulations and figure out how to help your friend.

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