In South Carolina, there are 195 nursing homes with more than 20,000 licensed beds. Too many times, large chains and corporations pursue of profit at the expense of quality care. Families can feel helpless. Even residents with families who visit often suffer harm. Shareholder Andy Arnold is an experienced nursing home neglect lawyer who has represented more than a 100 of those families in Greenville and throughout the Upstate. He sincerely hopes you never need him. However, if you do, he is prepared to help.

Andy leads Horton Law Firm’s nursing home litigation team. He filed his first nursing home negligence case in 1999. The understaffed nursing home’s repeated failures caused injuries that led to gangrene and the amputation of their mother’s leg. That case was tried in Union County in 2001. The juror delivered the largest jury verdict in Union County history at the time. Since then, Andy Arnold has represented families who had a loved one who suffered from nursing home abuse or nursing home neglect. Horton Law Firm can assemble a team of nursing home neglect lawyers to represent your loved one and seek the justice she deserves.

nursing-home-residents-rightsPreventing Nursing Home Neglect

1. Be informed: Best you can, understand the law: South Carolina Department of Health and Environmental Control (DHEC) regulates nursing homes in South Carolina. For a copy of the most recent DHEC Nursing Home Regulations, click here.  Also, South Carolina has a Bill of Rights for Residents of Long Term Care Facilities.  Each resident or the resident’s legal guardian has the right to participate in planning care and treatment or changes in care and treatment. You should attend as many care plan meetings as you can.  If you are the next of kin, then you have the right to be fully informed in advance about changes in care and treatment that may affect the resident’s well-being.  You have the right to receive from the resident’s physician a complete and current description of the resident’s diagnosis and prognosis in terms that are understandable.

2. Know the Staffing Levels: Understaffing is the root cause of most of the injuries in nursing homes. The law requires certain staffing levels. Federal law requires facilities to post their staffing levels. If you don’t see it, ask where it is posted or ask to be provided with a copy. Federal law also requires a nursing home provide enough staff to provide quality care.  Medicare keeps statistics on staffing and resident outcomes. These stats are based upon self-reporting and may not always be accurate. Use Medicare’s Nursing Home Compare section to see information about a nursing home’s staffing levels, the residents suffer from pressure ulcers, malnutrition and weight loss as well as the results of inspections by DHEC.

2. Visit often but don’t always visit at the same time: The staff needs to see you and know you are watching. Unfortunately, people who work can’t always visit when they want, but you can show up at unexpected times. Sometimes, its the little things.

3. Ask questions: If your resident is lucid, ask her/him questions: How often does she/he see staff members? Did they eat? Did the staff get him/her up? What activities took place that day? Unfortunately, many times the resident is unable to communicate or has a memory that makes the information unreliable. So, ask the staff similar questions. Ask to review the chart. What medications is she/he taking? Why? How did she/he eat? Does he/she have any skin breakdown? Read articles like this and others, and learn other questions to ask.

4. Communicate your concerns: It is important to note that many times the staff at the facility care — or want to care if they only had the time. Corporate decisions many times do not give the staff enough resources and time to do their jobs correctly. And, there is always staff who care. Figure out which one and ask them the questions above but also communicate your concerns. A recent Brown University study showed that better communication improves outcomes. This seems like common sense, but too many times families are afraid or too insecure to register complaints.

5. Contact the Long-Term Care Ombudsman: Long Term Care Ombudsman serves as the
advocate for residents in long term care facilities. They investigate complaints and negotiate on the
residents’ behalf to resolve complaints to the residents’ satisfaction. This is the only program of its kind that is totally devoted to the concerns of facility residents. The Lieutenant Governor’s Office on Aging administers the statewide Long Term Care Ombudsman Program through ten regional offices located throughout the state. There is no charge for services provided by the Ombudsman Program.  Click here for more information.

Nursing Home ResidentsWarning Signs of Nursing Home Neglect

There are tell-tale signs of nursing home abuse and neglect. Knowing what those signs are will help you spot a problem so you can ask questions, complain, demand the care, contact the ombudsman, and attempt to prevent serious harm before it happens.


Accidents happen, but multiple falls in a short time period are an immediate red flag. Nursing homes are required by law to develop care plans to prevent falls. These care plans often times dictate whether a resident needs one person assist with their transfers or two person assist. You should find out the specifics about the plan to prevent falls and broken bones. All too often, the care plan provides for two CNAs to assist with transferring, changing or repositioning but the budget only provides enough staff scheduled for one to that job. When the resident breaks a bone because of insufficient staffing, it is not accident.


These falls and drops usually result in fractures, which can be fatal to the elderly. Seniors’ bones can be more delicate than others, and for this reason the standard of care is higher. It is common sense: Brittle bones require more protection. One risk associated with a broken bone is death, which is a common result of a fractured hip or femur. Bones do not just snap spontaneously. So, someone knows how the fractured occurred. But, many times staff claims not to know the origin then someone is hiding something. Obviously, this is a big warning sign.


Hydration is critical for people of all ages. Failure to properly hydrate residents is a risk factor for serious harm and a sign of neglect. Dehydration leads to other problems, including skin breakdown which leads to pressure ulcers. It can also result in acute or chronic renal failure. The margin for error when caring for the elderly is small. Dehydration is generally found in cases of nursing home abuse and neglect.


Unrelieved pressure causes bedsores (also referred to pressure ulcers). Bedsores usually indicate a failure to properly reposition every two hours as required. Sometimes pressure ulcers indicate a failure to hydrate a resident. Nutrition also plays a role. Many times, staff simply fails to get the resident out of bed. Leaving a resident in one position day and has a very predictable outcome: pressure ulcers. These bedsores are preventable. The normal course is dangerous. Ulcers deepen. Tissue dies and becomes infected. Infection enters the blood stream. Pressure sores are preventable.


Rapid weight loss can be a sign of neglect. If noticeable weight loss occurs, you should ask the staff the cause. You should ask the staff about the plan of care to address weight loss. Is the staff charting weight loss? Show up at mealtime to see whether your resident is getting the assistance she/he needs. Weight loss is a risk factor for skin breakdown and a sign of malnutrition. Sometimes weight loss is unavoidable but sometimes there are interventions that can prevent weight loss.


Andy takes his cases personally; he understands “but for the grace of God” we all face the prospect of being dependent on strangers to care for us. Each case is an opportunity for us to affect change. Each case is a chance to “do unto others.” Change comes by taking a little bit off the bottom line for nursing homes who only care about profits. No single case will change the world, but one by one, each case presents a chance to improve the life of others. Families who fight back can affect the quality of care in nursing care in Greenville and Upstate South Carolina. Their cause is his cause.

For more information visit Greenville Nursing Home Abuse & Neglect Guide.

Contact Andy Arnold at the Horton Law Firm to discuss your nursing home abuse and neglect matter.