When you or a loved one suffer a serious injury at a nursing home in New Jersey, you will likely focus on the nursing staff for being at fault. The nurses at the home are the ones who regularly treat you and with whom you have the most contact. However the person who is ultimately responsible to make major decisions about your care at the home is normally your attending doctor. Under the Nursing Home Reform Act §483.30 each nursing home resident must remain under the care of a physician. Likewise a physician, physician assistant, nurse practitioner, or clinical nurse specialist must provide orders for the resident’s immediate care and needs.
Do Nursing Homes Need To Hire Doctors To Administer Medical Care to Patients?
In fact under §483.30(a) the nursing home must ensure that your medical care is supervised by a physician – what is called an attending physician or doctor. If your attending physician is unavailable then the home must make sure another doctor can step in and supervise you. The attending physician must also review a nursing home resident’s plan of care during each time the physician sees a resident, and sign and date all orders with the exception of influenza and pneumococcal vaccines.
An attending physician must also see a nursing home resident at least once every 30 days for the first three months a resident is there under §483.30(c), and at least once every 60 days thereafter. Given a resident’s condition these visits could be more frequent. These physician visits must be made by the physician personally – so the attending physician cannot just send a resident or certified nursing practitioner to examine you and report back to him or her. There are some tasks the attending physician can delegate to a physician assistant, nurse practitioner, etc. though. However that medical care provider must be under the supervision of the attending physician.
When Are Doctors Notified About The Health or Medical Changes of Nursing Home Residents?
As the above statutes and regulations show then, a nursing home must make sure that you are being cared for by a doctor, and that attending physician must stay on top of your care. Because the attending doctor is not ever present at the nursing home, they do rely on the nursing staff to report updates about you or your loved one’s physical condition. Under §483.10(g)(14) a nursing home must immediately inform the resident, their physician, and the resident’s representatives when there is:
• An accident involving the resident which results in injury and has the potential for requiring physician intervention;
• A significant change in the resident’s physical, mental, or psychosocial status (that is a deterioration in health, mental, or psychosocial status in either life-threatening conditions or clinical complications);
• A need to alter treatment significantly such as stopping treatment because of bad reactions to it, or starting a new form of treatment;
• A decision to transfer or discharge your family from the nursing home.
Therefore, if the nursing staff does not report a significant change in your physical condition to the attending physician and serious harm results, it is likely the fault will lie on the nursing staff. However if the nursing staff does timely report a significant change in your physical condition to the attending physician, and that physician does not order or give the care you need to treat the significant change in your physical condition, the attending can be at fault for any harm that comes to you. Likewise an attending physician has to make sure to follow up on their orders. They cannot just make an order for your care and assume it was carried through. For example if that physician orders your lab results, and those lab results are never sent to that physician, it is on that physician to follow up with the nursing home about those lab results.
Whether or not your attending physician at a nursing home is at fault for any injuries caused to you depends on a thorough review of the records and consultation with other medical experts. The Thistle Law Firm is experienced at handling claims against nursing homes. If you or a loved one was harmed at a nursing home the attorneys at the Thistle Law Firm are here to take your call and discuss your legal options at 215-568-6800.