Approximately eight (8) months ago we moved my mother from another state to a local nursing home, so she would be close to my family. Since she has been in the nursing home, I am not aware that any physician has examined or seen my mother during this time frame. I believe my mother's overall condition is worsening and I am concerned that she needs to have a physician look at her. Should a physician have seen my mother by this time and who should I talk to regarding this matter?

Each resident of a nursing home must remain under the care of a physician. The nursing home facility must ensure that the medical care and other health care of each resident is supervised by a physician and that another physician supervise the medical care and health care of residents when an attending physician is unavailable. A resident must be seen by a physician at least once every thirty (30) days for the first ninety (90) days after admission, and at least once every sixty (60) days thereafter. Your mother should have been seen by a physician and should be under a physician's care. You should immediately contact the Administrator of the nursing facility to ensure that a physician examines your mother and your mother comes under a physician's care. If you are not happy with the explanation you receive, or if your mother is not examined, you should report the matter to the Texas Department of Human Services, which is the investigative agency that investigates nursing home complaints. There are numerous state and federal laws that govern the rights of nursing home residents. If you have any questions regarding the rights of nursing home residents or the duties of the nursing home staff, please feel free to contact our office.

My mother resides in a local nursing home. She has regularly received pain medications for the constant pain she experiences. When I recently went to visit her, she was in a lot of pain and told me she had not been given her pain medication at all that day. When I asked the staff why my mother had not been given any pain medication, they said they were trying to wean her off the pain medication. I contacted my mother's physician, who was not aware that they had discontinued her pain medication. He had not issued any orders to try to wean her off of the medication. He was very upset that the nursing home staff had not given her her medication per his orders. Can the nursing home staff make a decision to stop medication on its own or must a resident's physician be contacted?

Under the circumstances you described, the nursing staff must contact the physician to make any changes in medication dosage, amounts or times prescribed. Obviously, if the medication is given and there is an adverse side effect, the nursing home staff will not continue its usage until a physician is notified. In any event, the physician should make the decision to discontinue or change the medication. I would complain to the administrator and director of nursing regarding this change in your mother's medication. If you are not satisfied with the response that you receive, you should report the matter to the Texas Department of Human Services, which is the investigative agency that investigates nursing home complaints. There are numerous state and federal laws that govern the rights of nursing home residents. If you have any questions regarding the rights of nursing home residents or the duties of the nursing home staff, please feel free to contact our office.

My mother and father reside in a local nursing home. I have always been concerned about the care they receive while residents in a nursing home. Recently, I have heard that the Texas Legislature is considering Legislation regarding nursing homes and nursing home residents. Will the considered Legislation affect my parents' rights while residing in a nursing home?

The Senate has approved a Bill and the House has tentatively passed a Bill that is aimed at protecting nursing home residents from neglect, abuse and mismanagement. As currently prepared, it sets up minimum care standards in several areas including nutrition, medication administration, record keeping and general treatment. It is aimed primarily at providing protection for residents and providing enforcement procedures against facilities that do not provide adequate care to residents. I strongly urge anyone who has a family member or friend residing in a nursing home to contact their House Representative and Senator in support of these Bills to ensure residents are adequately protected. If you have any questions regarding the rights of nursing home residents or the duties of the nursing home staff, please feel free to contact our office.

My father resides in a local nursing home. On my last visit, I saw several bruises on my father's arms that appeared as if someone had grabbed him. I reported this to the aide on duty and she said she would investigate and get back with me. As I have not heard anything, what should I do to find out how my father received these bruises?

You should immediately contact the Administrator and Director of Nursing to meet with you and examine and discuss these bruises with you. You may also wish to have the medical director present or have your father examined by his physician. You need to have some explanation as to the cause of the bruises. If you fail to get a response or are not happy with the response you receive , you should contact the Texas Department of Human Services, which is the investigative agency that investigates nursing home complaints. There are numerous state and federal laws that govern the rights of nursing home residents. If you have any questions regarding the rights of nursing home residents or the duties of the nursing home staff, please feel free to contact our office.

My mother is a resident of a local nursing home. She is diabetic and this fact is well known to the nursing home staff. The nurses aide was clipping her fingernails and toenails and they clipped the skin on one of her toes. Apparently my mother bled for quite sometime and now the nail has become infected. We were not made aware of this until we bought my mother some new shoes and went to try them on and then learned the incident had happened a month before. We contacted my mother's physician and he was not made aware of the injury or the infection. Should we or the doctor have been made aware of this injury and the infection?

Yes. First of all, the nursing care facility must ensure that the resident's environment remains as free of accident hazards as possible and each residents receives adequate supervision and assistance to prevent injry. Obviously, care should have been taken to ensure the skin was not clipped when they were clipping her nails to prevent an injury. Further, any significant adverse changes in your mother's condition needs to be promptly reported to the attending physician and to the responsible party. The facility must immediately inform the physician and a legal representative or the family member when there has been an accident involving the resident which results in injury and has potential for requiring physician intervention. In this case, the family and the physician should have been notified of the injury, and certainly should have been notified of the infection so that it could be properly treated. If there are any other questions regarding the rights of nursing home residents and the duties of the nursing home staff, please feel free to contact our office.

My grandmother resides in a local nursing home and is unable to feed herself. She is fed in her room. Due to an apparent shortage of staff or their busy schedule, my grandmother's food is brought to her but by the time an aide is able to feed her, the food is usually cold. We have asked the nurses aide if we could show up at her feeding times, and when they bring the food, if we could feed her so that she would not have to eat her food cold. The nurses aides informed us that we were not allowed to do that and that they would get to her as soon as they could. Do we have the right to feed our grandmother at meal times?

The nursing facility must ensure that the nutritional needs of each resident are met, and that the meals are served promptly and timely and it is not allowed to get cold. As long as you and other family members are not bringing foods that would be harmful to your grandmother's nutritional needs, or is against her physician's orders you should be able to feed your grandmother. Specifically, if the food is prepared by the nursing home, and complies with your grandmother's physicians orders regarding her nutritional needs, there is absolutely no reason why you cannot feed your grandmother. I would discuss this matter with the Director of Nursing and the Administrator as soon as possible. Make sure they are aware of the situation where your grandmother is receiving her food cold and see that this situation is remedied as soon as possible. If there are any other questions regarding the rights of nursing home residents and the duties of the nursing home staff, please feel free to contact our office.

My mother has been residing in a local nursing home for several months. Years ago, my father passed away and my mother married a man to whom the rest of the family was never very close. Since my mother has been in the nursing home, her husband has moved out of state, and we have no idea where he is currently residing. He has had no contact with my mother. We have made several requests to the nursing home about the care of my mother regarding her nutritional needs, and physical therapy and have discussed her needs with her physician. The nursing home staff will not listen to our requests as they have told us that my mother's husband is the responsible party and he is the only one to whom they can respond. What can we do in this situation?

The nursing facility has a responsibility to ensure that each residents nutritional needs, physical needs, health and well being is being properly and adequately met. As the nursing home staff is aware, you are her family. If your requests are not outside your mother's physician's recommendations for her health and care, they should take into consideration your requests even if the family members are not considered the responsible party. I would discuss this matter with the Director of Nursing and the Administrator of the nursing home. If you are not satisfied with the response, you should either consider placing your mother in a different nursing home, that will understand the situation and will agree to respond to a loving, caring family, or you could consider guardianship proceedings through a Probate Court to obtain the rights to act on your mother's behalf. If there are any other questions regarding the rights of nursing home residents and the duties of the nursing home staff, please feel free to contact our office.

My mother has been residing in a local nursing home for over a year. We were recently notified by the nursing home that they have not been paid by Medicare for her stay for the last few months and that we have to move my mother out of the nursing home within a week. What are our rights regarding payment of the nursing home's bill and how much notice must we be given before the nursing home can discharge my mother?

The nursing facility must permit each resident to remain in the facility and must not transfer or discharge the resident from the facility unless the resident or the legal responsible party has failed, after reasonable and appropriate notice, to pay for the stay at the facility. Further, under the facts you have stated, before the facility can transfer or discharge your mother, they must notify your mother and the responsible party or family representative about the transfer in writing and give at least thirty (30) days notice before the resident is transferred or discharged. I would immediately contact the Administrator of the nursing home facility and find out the reasons why the nursing home facility has not been paid. Also, request that you have the full thirty (30) days as required by law to have your mother transferred, if the payment dispute cannot be resolved during that time frame. If there are any other questions regarding the rights of nursing home residents and the duties of the nursing home staff, please feel free to contact our office.