1. Healthcare Financing Administration, On-Line Survey, Certification and Reporting Date (March, 1997).
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2. AARP Foundation, Nursing Home Law: Training Module (April 2001).
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3. Comment, AImposing Federal Criminal Liability on Nursing Homes: A Way of Deterring Inadequate Healthcare and Improving the Quality of Care Delivered?@ 43 St. Louis L.J. 653 (1999). Healthcare Financing Administration, On-Line Survey, Certification and Reporting Date (March 1997).
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4. Levit, et al., ANational Health Expenditures@ 18 Healthcare Financing Review 175, 189 (1996).
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5. 68% of nursing facility reimbursement in the United States is from Medicaid. Healthcare Financing Administration, On-Line Survey, Certification and Reporting Date (March, 1997).
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6. This section will focus on civil liability for abuse and neglect rather than criminal liability or regulatory responses. See Comment, AImposng Federal Criminal Liability on Nursing Homes: A Way of Deterring Inadequate Health Care and Improving the Quality of Care Delivered?@ 43 St. Louis L.J. 653 (1999). See also recent cases brought by the government under the False Claims Act, 31 U.S.C. 3279, such as U.S. v. City of Philadelphia, et al., No. 98-4253 (E.D. Pa. 1998). States may also prosecute criminal charges, e.g., People v. Coe, 522 N.E.2d 1039 (N.Y. 1988). See generally Note: AState v. Serelein: Causation and the Criminal Liability of Nursing Home Administrators@ 1986 Wis. L. Rev. 339 (1986).
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7. See '4.02 [1] infra.
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8. The Center for Medicare and Medicaid Services was formerly known as the Health Care Finance Administration.
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9. 42 U.S.C. '1396r(a).
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10. Omnibus Budget Reconciliation Act of 1987, Pub. L. 100-203; 42 U.S.C. '1395i-3 et seq.; 42 U.S.C. '1396r et seq.
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11. 42 U.S.C. '1395i-3(g); 42 U.S.C. '1396r(g).
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12. See Horizon/CMS Healthcare Corp v. Auld, 2000 VIL 1199263, 43 Tex. Sup. Ct. J. 1151 (Tex. 2000).
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13. Survey results can be accessed on the Internet at http://www.medicare.gov/nursing/home.asp.
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14. See, e.g., 10 NYCRR 415.
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15. Health and Human Services Department, Healthcare Administration Fact Sheet, Assuring the Quality of Nursing Home Care (July 21, 1998). Special Committee on Aging, California Nursing Homes: Care Problems Persist Despite Federal and State Oversight (Letter Report, July 27, 1998, GAO/HEHS-98-202).
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16. 42 U.S.C. ''1395i-3(b)(2), 1396r(b)(3); 42 C.F.R. '483.20(d).
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17. 42 C.F.R. '483.75(l).
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18. 42 C.F.R. '483.25(a).
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19. 42 U.S.C. ''1395i-3(b)(6), 1396r(b)(6); 42 C.F.R. '483.40.
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20. 42 U.S.C. ''1395i-3(b)(4)(C), 1396r(b)(4)(C); 42 C.F.R. '483.30.
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21. 42 U.S.C. ''1395i-3(b)(5), 1396r(B)(5), 1396r(e)(2); 42 C.F.R. ''483.75(e), 483.150-483.152.
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22. 42 U.S.C. '1395i-3(f)(2)(B)(iii). The National Academy of Sciences has found that these registries have had a limited effect due to problems with entering and verifying data on the registries. Institute of Medicine, Nursing Staff in Hospitals and Nursing Homes, 183 (1996).
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23. 42 C.F.R. '483.25(i).
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24. 42 C.F.R. '483.25(c).
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25. 42 C.F.R. '483.25(d)(e)(f)(g).
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26. 42 C.F.R. '483.25(j).
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27. 42 C.F.R. '483.25.
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28. 42 C.F.R. '483.25.
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29. 42 U.S.C. ''1395i-3(c)(1)(A)(ii), 1396r(c)(1)(A)(ii), 42 C.R.F. '483.13.
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30. See Office of the Inspector General, Resident Abuse in Nursing Homes: Resolving Physical Abuse Complaints 11, 12 (1990).
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31. See, e.g., N.Y. Pub. Health Law '2803-d(8).
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32. Id. See also Braun and Capezuti, AThe Legal and Medical Aspects of Physical Restraints and Bed Side Rails and Their Relationship to Falls and Fall-Related Injuries in Nursing Homes@ 4 DePaul J. Healthcare L.1(2000); Brooks, ASkilled Nursing Homes Replacing Patient Restraints With Patient Rights@ 45 S.D.L. Rev. 606 (2000). Guttman, et al., Report of the Council on Scientific Affairs: Use of Restraints for Patients in Nursing Homes, 8 Archives Family Med. 101, 105 (1999).
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33. 42 C.F.R. '483.13(a).
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34. 42 C.F.R. '483.25(1).
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35. 42 C.F.R. '483.10(e).
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36. C.F.R. '483.25(i).
    
    See generally, Tideiksaar, Falls in Older Persons: Prevention and Management (Health Professions Press 2d. ed. 1998); Tinehi & Williams, AInjuries Due to Falls, and the Risk of Admission to a Nursing Home@ 337 N.E.J.M. 1279 (1997).
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37. See New York: Yamin v. Baghel, 2001 N.Y. App. Div. LEXIS 6624 (N.Y. App. 2001).
    Missouri: Smith v. Gravois Rest Haven, 662 S.W.2d 880 (Mo. App. 1983).
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38. The Supreme Court has established a four prong test to determine whether a private right of action is created by federal legislation: (1) whether the plaintiff is part of a class intended to benefit from the statute; (2) whether the legislature intended to create a private remedy; (3) whether private right of action would be consistent with the purposes of the legislation; and (4) whether a private right of action would be an inappropriate trespass into an area traditionally relegated to state law. Cort v. Ash, 422 U.S.66 (1975). Under this test, certain courts have recognized a private cause of action under federal nursing home regulations, while others have rejected this assertion.
    
    Recognizing a private cause of action:
    Roberson v. Wood, 464 F.Supp. 983 (E.D. Ill. 1979).
    
    Rejecting a private cause of action:
    Fifth Circuit: Wheat v. Mass, 994 F.2d 273 (5th Cir. 1993).
    Florida: Ayres v. Beaver, 48 F. Supp. 2d 1335 (M.D. Fla. 1999).
    Ohio: Fuzie v. Manor Care Inc., 461 F. Supp. 689 (N.D. Ohio 1977); Nichols v. St. Luke Ctr., 800 F. Supp. 1564 (S.D. Ohio 1992).
    
    See also Edelman, AThe Nursing Home Reform Law: Issues for Litigation@ 24 Clearing House Rev. 545 (1990).
    
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39. 42 U.S.C. '1395i-3(h)(5). See generally Spitzer-Rescik and Krajcinovic, AProtecting the Rights of Nursing Home Residents: How Tort Liability Interacts With Statutory Protections@ 19 Nova L. Rev. 629 (1995).
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40. H.R. Rep. No. 100-391(I), 100th Cong., 1st Sess. 453, 472 (1987).
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41. See, e.g.,
    Alabama: Montgomery Healthcare Facility v. Ballard, 565 So.2d 221 (Ala. 1990) ($2 million dollar punitive damage award against a nursing home for wrongful death from infected bedsores.)
    
    Florida: Beverly Enterprises-Florida v. Spilman, 661 So.2d 867 (Fla. App. 1995) (jury verdict of $720,000 compensatory damages and $2 million dollars in punitive damages affirmed for wrongful death of resident from bedsores). Paton v. Healthcare Facilities v. Campbell, 497 So.2d 1233 (Fla.App. 1986)(appellate court affirmed punitive damage award of $1.7 million dollars for wrongful death caused by infected bedsores).
    
    Georgia: Brogden v. National Healthcare Corp., 103 F. Supp. 1322 (N.D. Ga. 2000); Associated Health Systems, Inc. v. Jones, 366 S.E.2d 147 (Ga.App.1988)(nursing home negligent for assault by another resident).
    
    Illinois: Berlack v. Woodbridge Nursing Home, 671 N.E.2d 768 (Ill.App. 1996)(nursing home liability was found for physically restraining resident for the convenience of the staff). Harris v. Manor Healthcare Corp., 489 n.E.2d 1374 (Ill. 1986)(nursing facility found negligent and punitive damages allowed for decubitus ulcer leading to amputation of resident’s leg).
    
    Louisiana: Roberson v. Provident House, 576 So.2d 992 (La. 1991)(the catheterization of a patient without his consent lead to an award of $25,000 for battery).
    
    Oklahoma: Rodebush v. Oklahoma Nursing Homes, Ltd., 867 P.2d 1241 (Okla. 1993)($1.2 million dollars in punitive damages awarded against nursing home for negligent hiring and supervision of employees who intentionally inflicted physical injury on resident suffering from Alzheimer’s Disease).
    
    Texas: Golden Villa Nursing Home, Inc. v. Smith, 674 S.W.2d 343 (Tex.App. 1984)(nursing home liable for negligent supervision of resident who crossed onto a highway and was hit by a vehicle). See generally Spitzer-Resnick and Kratconovic, AProtecting the Rights of Nursing Home Residents: How Tort Liability Interacts with Statutory Protections@ 19 Nova L. Rev. 629 (1995).
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42. See, e.g., Guidelines of the Joint Commission on Accreditation of Health Care Associations and the American Health Care Association.
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43. See, e.g., Callens v. Jefferson County Nursing Home, 769 So.2d 273 (Ala. 2000).
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44. Olmstead v. Beverly Enterprises-Florida, No.96-1941-CIV-T-17B, 1997 U.S.Dist. Lexis 4059; 10 Fla.L.Weekly Fed.D 652 (M.D.Fla. Mar. 17, 1997)
    
    Georgia: Brogden v. National Healthcare Corp., 103 F. Supp. 1322 (N.D. Ga. 2000); Fisher v. Tombs County Nursing Home, 479 S.E.2d 180 (Ga.App. 1996).
    
    Minnesota: Estate of Reidel v. Lifecare Retirement Communities, Inc., 505 N.W.2d 78 (Minn. App. 1993).
    
    Ohio: Fuzie v. Manor Care Inc., 461 F.Supp.689 (N.D. Ohio 1977).
    See generally Sabetino, ANursing Home Admission Contracts: Undermining Rights the Old Fashioned Way@ Clearing House Rev. 553 (October, 1990).
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45. Arkansas: Ark. Code Ann. '20-10-1209.
    
    California: Cal. Health & Safety '1430; Welfare and Institutions Code ''15600, et seq.
    
    Connecticut: Conn. Gen. Stat. '19a-550(b).
    
    Florida: Fla. Stat. '400.023. See generally, Crotts and Martinez, AThe Nursing Home Residents’ Rights Act - A Good Idea Gone Bad!@ 26 Stetson L. Rev. 599 (1996).
    
    Georgia: Ga. Code Ann. '31-8-136.
    
    Illinois: Ill. Ann. Stat. Ch. 1111/2 P '4153-601-610.
    
    Kentucky: Ky. Rev. Stat. Ann. '216.515(26).
    
    Louisiana: La. Rev. Stat. Ann. '40:2010.9.
    
    Maine: Me. Rev. Stat. Ann. tit. 22, '7948(1).
    
    Missouri: Mo. Ann. Stat. '198.093(3).
    
    New Hampshire: N.H. Rev. Stat. Ann. '151:30.
    
    New Jersey: N.J. Stat. Ann. '30:13-8.
    
    New York: N.Y. Pub. Health Law '2801-d. See generally Gitner, ANursing the Problem: Responding to Patient Abuse in New York State@ 28 Colum. J.L. & Soc. Progs. 559 (1995).
    
    North Carolina: N.C. Gen. Stat. '131E-123.
    
    North Dakota: N.D. Cent. Code '50-10.2-02
    
    Ohio: Ohio Rev. Code Ann. '3721.17(I).
    
    Oklahoma: Okla. Stat. Ann. Tit. 63, '1-1918(G).
    
    Washington: Wash. Rev. Code Ann. '74.34.200.
    
    West Virginia: W.V. Code '16-5C-15(c).
    
    Wisconsin: Wisc. Stat. Ann. '50.10.
    
    District of Columbia: D.C. Code Ann. '3201453.
    See Comment, AThe Defendant Injured Them Once, Don’t Let the Government Do It Again: Information and Answers for Protecting Your Medicaid Plaintiffs in a Tort Settlement@ 75 Tul. L. Rev. 165 (2000).
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46. Florida: McCorkle v. Colonial Care Center, et al., No. 99000815 CI 11 (Fla. Cir., Pinellas Co.) (A jury verdict in the amount of $2.9 million in compensatory and $17 million in punitive damages was awarded on September 27, 2000 for the development of a pressure sore).
    
    Texas: Fuqua v. Horizon C.M.S. Health, No. 98- CV-1098, (N.D. Texas). (On February 14, 2001 the jury awarded a nursing home resident $310 million dollars in punitive damages and $2.71 million dollars in compensatory damages).
    
    See also Arkansas: Sauer v. Advocate Inc., No. CIV-2000-5, (Ark. Cir., Polk Co.) (On June 22, 2001 a jury awarded a nursing home resident $63 million dollars in punitive damages and approximately $15 million dollars in compensatory damages in a course of action sounding in negligence, medical malpractice and breach of contract arising out of allegations of malnutrition and dehydration.
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47. See, e.g., Bourdon and Dubin, AFlorida Long-Term Care: General Liability and Professional Liability Actuarial Analysis,@ Florida Healthcare Association/AON, February 14, 2001 (http://www.protectourparents.com/) (the report noted that the average professional liability cost in Florida is 12 times the average costs of the rest of the country. It also recognized the Astrong increase in frequency and severity@ of claims since the passage of the Nursing Home Reform Act. The report also noted that the three states with the highest per bed liability costs have strong patient rights statutes: Florida, Texas and California. Three months after this report, Florida amended their state statute to limit punitive damages to three times the amount of compensatory damages awarded or one million dollars. See Fla. Stat. '400. The Texas legislature has passed a Long-Term Care Facility Improvement Act, creating a $75 million dollar bond fund to help facilities pay for professional liability insurance coverage (www.capital.state.tx.us/). And, in Louisiana, the House of Representatives and the Senate have passed a bill which would amend the definition of Ahealthcare provider@ to include nursing homes and certified nurse assistants in order to include those potential defendants under current state medical malpractice damage suits and other protections (http://www.legis.state.La.us/)
    
    But see California: Covenant Care Inc. v. The Superior Court of Los Angeles County, No. B145406 and Kane v. The Superior Court of Los Angeles County, No. B145399, Calif. App., 2nd Dist., Div.1, where California State Appeals Court refused to apply the negligence limitations period for asserting a punitive damage claim in a case brought under the state’s Elder Abuse Act.
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48. See Note 45 supra. See also Vignery, Siemon, AInsuring Assisting Living Quality Through the Courts: State Policy Issues Regarding A Consumer Private Right of Action@ Public Policy Institute Research Group of the AARP, (December, 2000).
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49. See Mo. Rev. Stat. '198.093(3); Wills v. Dekalb Area Retirement Center, 530 N.E.2d 1066, 1073 (Ill. App. 1988).
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50. Knowles v. Beverly Enterprises-Florida Inc., No. SC 001910, Fla.Sup. See also Gibson v. Monroe Manor Nursing Home, 756 So.2d 583 (La. App. 2000)(holding that cause of action is heritable).
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51. Arkansas: Ark. Code Ann. '20-10-1209.
    California: Cal. Health & Safety '1430; Welfare and Institutions Code ''15600, et seq.
    Florida: Fla. Stat. '400.023.
    Georgia: Ga. Code Ann. '31-8-136.
    Kentucky: Ky. Rev. Stat. Ann. '216.515(26).
    New Hampshire: N.H. Rev. Stat. Ann. '151:30.
    New Jersey: N.J. Stat. Ann. '30:13-8.
    North Carolina: N.C. Gen. Stat. '131E-123.
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52. Arkansas: Ark. Code Ann. '20-10-1209.
    Connecticut: Conn. Gen. Stat. '19a-550(b).
    Florida: Fla. Stat. '400.023.
    Georgia: Ga. Code Ann. '31-8-136.
    Illinois: Ill. Ann. Stat. Ch. 1111/2 P '4153-601-610.
    Kentucky: Ky. Rev. Stat. Ann. '216.515(26).
    Maine: Me. Rev. Stat. Ann. tit. 22, '7948(1).
    Missouri: Mo. Ann. Stat. '198.093(3).
    New Jersey: N.J. Stat. Ann. '30:13-8.
    New York: N.Y. Pub. Health Law '2801-d
    Ohio: Ohio Rev. Code Ann. '3721.17(I).
    Oklahoma: Okla. Stat. Ann. Tit. 63, '1-1918(G).
    West Virginia: W.V. Code '16-5C-15(c).
    District of Columbia: D.C. Code Ann. '3201453.
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53. North Carolina: N.C. Gen. Stat. '131E-123.
    Wisconsin: Wisc. Stat. Ann. '50.10.
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54. California: Cal. Health & Safety '1430; Welfare and Institutions Code ''15600, et seq.
    Georgia: Ga. Code Ann. '31-8-136.
    Illinois: Ill. Ann. Stat. Ch. 1111/2 P '4153-601-610.
    New Hampshire: N.H. Rev. Stat. Ann. '151:30.
    New York: N.Y. Pub. Health Law '2801-d
    District of Columbia: D.C. Code Ann. '3201453.
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55. New York: N.Y. Pub. Health Law '2801-d
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56. California: Delaney v. Baker, 20 Cal. 4th 23, 971 P.2d 986 (Cal. 1999).
    Illinois: Ill. Ann. Stat. Ch. 1111/2 P '4153-601-610.
    New Hampshire: N.H. Rev. Stat. Ann. '151:30.
    New York: N.Y. Pub. Health Law '2801-d
    Oklahoma: Okla. Stat. Ann. Tit. 63, '1-1918(G).
    West Virginia: W.V. Code '16-5C-15(c).
    District of Columbia: D.C. Code Ann. '3201453.
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57. Kentucky: Ky. Rev. Stat. Ann. '216.515(26).
    Louisiana: La. Rev. Stat. Ann. '40:2010.9.
    Missouri: Mo. Ann. Stat. '198.093(3).
    New Jersey: N.J. Stat. Ann. '30:13-8.
    Ohio: Ohio Rev. Code Ann. '3721.17(I).
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58. Maine: Me. Rev. Stat. Ann. tit. 22, '7948(1).
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59. California: Cal. Health & Safety '1430; Welfare and Institutions Code ''15600, et seq.
    Illinois: Ill. Ann. Stat. Ch. 1111/2 P '4153-601-610.
    New York: N.Y. Pub. Health Law '2801-d
    North Dakota: N.D. Cent. Code '50-10.2-02
    West Virginia: W.V. Code '16-5C-15(c).
    District of Columbia: D.C. Code Ann. '3201453.
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60. New York: N.Y. Pub. Health Law '2801-d
    West Virginia: W.V. Code '16-5C-15(c).
    District of Columbia: D.C. Code Ann. '3201453.
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61. Florida: Fla. Stat. '400.023.
    Illinois: Ill. Ann. Stat. Ch. 1111/2 P '4153-601-610.
    Kentucky: Ky. Rev. Stat. Ann. '216.515(26).
    Louisiana: La. Rev. Stat. Ann. '40:2010.9.
    Maine: Me. Rev. Stat. Ann. tit. 22, '7948(1).
    Missouri: Mo. Ann. Stat. '198.093(3).
    West Virginia: W.V. Code '16-5C-15(c).
    District of Columbia: D.C. Code Ann. '3201453.
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62. Morgan v. Tolland County Healthcare, Inc., 1996 Conn. Super. LEXIS 638.
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63. Begandy v. Richardson, 510 N.Y.S.2d 984 (N.Y.Sup. 1987).
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64. Delaney v. Baker, 20 Cal. 4th 23, 971 P.2d 986 (1999); Mack v. Soung, 95 Cal. Rptr. 2d 830 (Cal. App. 2000).
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65. See, e.g., Hall v. Walter, 969 P.2d 224 (Colo. 1998). Colorado revised statutes '6-1-113.
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66. Karlin v. IVF America, Inc., 93 N.Y.2d 282, 690 N.Y.S.2d 495, 712 N.E.2d 662 (1999). N.Y. Gen. Bus. Law ''349-50. See also Michigan: Nelson v. Ho, 564 N.E.2d 482 (Mich. App. 1997).
    Texas: Sorokolit v. Rhodes, 889 S.W.2d 239 (Tex. 1994).
    Washington: Quimby v. Fine, 724 P.2d 403 (Wash. App. 1986).
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67. Elder v. Fischer, 129 Ohio App.3d 209, 223, 717 N.E.2d 730, 740 (Ohio App. 1998).
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68. See, e.g., California: People v. Casablanca Convalescent Homes, 206 Cal. Rptr. 164 (Cal. App. 1984); Podolsky v. National Medical Enterprises Inc., 58 Cal. Rptr. 2d 89 (Cal. App. 1996).
    See also Swan v. Manor Care of America Inc., No. B.C. 250057 California Superior Court, Los Angelos County, where plaintiffs filed a class action on May 8, 2001 alleging violation of the states unfair competition and false advertising laws by providing substandard care to the states elderly population.
    Illinois: Sullivan’s Wholesale Drug v. Faryl’s Pharmacy Inc., 214 Ill. App. 1073, 573 N.E.2d 1370 (1991); Rohlfing v. Manor Care Inc., 172 F.R.D. 330 (N.D. Ill. 1997).
    Cf. Morgan v. Tolland County Healthcare Inc., 1996 Conn. Super. LEXIS 638 (1996) (granting defendant’s motion to dismiss plaintiff’s count of unfair trade practices where there was a failure to allege that the hospital engaged in unfair methods of competition or unfair or deceptive acts or practices related to a consumer transaction).
    Louisiana: Schenck v. Living Centers-East, Inc., 917 F. Supp. 432 (E.D. La. 1996) (granting defendant’s motion to dismiss plaintiff’s cause of action against a nursing home under the Louisiana Unfair Trade Practices Act due to the fact that Louisiana statute provided no basis to bring a suit by a representative of the deceased nursing home resident and there was no evidence providied of the level of egregious conduct sufficient to support a claim under the statute).
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69. Arizona: Corbin v. Tolleson, 773 P.2d 490 (Ariz. App. 1989).
    Connecticut: Aurigemma v. Arco Petroleum Products Inc., 734 F. Supp. 1025 (D. Conn. 1990).
    Illinois: Arenson v. Whitehall Convalescent & Nursing Home, 164 F.R.D. 659 (N.D. Ill. 1996).
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70. Arizona: Maurer v. Cerkvenik-Anderson Travel, Inc., 890 P.2d 69 (Ariz. App. 1994).
    Connecticut: Sims v. Candela, 711 A.P.2d 778, 45 Conn. Supp. 267 (1998).
    Illinois: Duncavage v. Allen, 497 N.E.2d 433 (Ill. App. 1986).
    Massachusetts: Haddad v. Gonzales, 576 N.E.2d 658 (Mass. 1991).
    Minnesota: Kociemba v. Searle & Company, 680 F. Supp. 1293 (D. Minn. 1988).
    Oklahoma: Fuller v. Sight’N Sound Appliance Centers Inc., 982 P.2d 528 (Ok. App. 1999).
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71. Minority Staff Report of the House Committee on Government Reform, Abuse of Residents is a Major Problem in U.S. Nursing Homes (July 30, 2001).
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72. See '20.02 supra. Previous reports also confirmed occurrences of abuse and neglect in nursing homes. See Office of Inspector General, Department of Health and Human Services, Abuse Complaints of Nursing Home Patients (OEI-06-98-00340) (May, 1999); Minority Staff Report of the House Committee on Government Reform, Nursing Home Conditions in Los Angeles County: Many Homes Fail to Meet Federal Standards for Adequate Care (November 22, 1999); Minority Staff Report of the House Committee on Government Reform, Nursing Home Staffing Levels are Inadequate in Chicago (January 16, 2001); www.house.gov/reform/min/nursinghomes.html.
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