Solomon & Relihan Has Been Fighting for Arizona Families
for More Than 50 Years
We Wrote the Book on Nursing Home Abuse and Neglect
This book draws from our decades as nursing home abuse lawyers to help you navigate the challenges of long-term care, spot warning signs, and hold facilities accountable. We’ve included some key resources and insights below.
Chapter 1: Understanding the Industry – Problems in Nursing Home Care
The nursing home sector often prioritizes profits over people, especially in for-profit facilities owned by private equity [PE] firms. Business models lead to understaffing, inadequate care, and higher risks for residents. For instance, facilities receive more federal funding for sicker residents but instead of hiring more staff to meet these needs, they cut labor costs to maximize profits. As a result, there is a 10% higher mortality rate in PE-owned homes compared to others, as they are often among the worst-staffed nursing homes.
Why do corporate owners contribute to neglect?
Large corporate owners often focus on maximizing profit instead of prioritizing resident care. This can lead to chronic understaffing, high turnover, and staff burnout. Some owners use complex corporate structures with multiple holding companies and LLCs to make it difficult to determine who is truly responsible. This lack of accountability creates an environment where residents are more likely to experience abuse — physical, emotional, or sexual — and neglect such as poor hygiene, isolation, and unsafe living conditions. This structure also makes it more difficult to hold those who are responsible for poor care accountable.
How does understaffing affect care?
When there are not enough staff members residents wait longer for help, mistakes happen more often, and infections spread more easily. The consequences can be severe. Studies show that nursing homes owned by private equity firms have 11 percent more preventable emergency room visits and nearly 9 percent more preventable hospitalizations compared to other facilities.
What other red flags should families watch for?
Beyond corporate ownership and staffing levels, be alert for:
- Signs of abuse or neglect, including unexplained injuries, poor hygiene, or emotional withdrawal.
- Isolation and loneliness due to lack of social interaction.
- Financial exploitation, such as theft or manipulation.
- Limited autonomy over daily routines.
- Outdated or inadequate facilities that compromise safety or comfort.
Why is staff turnover a problem?
High turnover means residents are constantly cared for by new and unfamiliar staff. This disrupts continuity of care, increases the likelihood of mistakes, and prevents strong relationships from forming between residents and caregivers.
How can Arizona families check a facility’s track record?
Chapter 2: Choosing a "Better" Option – How to Identify the Right Care for Your Loved One
Selecting the right nursing home starts with a clear understanding of your loved one’s medical needs, personal preferences, and daily support requirements. It also requires in-person visits and careful review of objective data. It’s important to focus on staffing ratios, cleanliness, safety, and whether the facility offers specialized services such as physical therapy, dementia care, or palliative support.
What tools help evaluate nursing homes?
Several public resources can help you compare facilities.
- AZNursingHomeCompare.com provides federal Medicare data, allowing you to see past violations, staffing levels, and quality measures.
- Medicare’s Nursing Home Compare rates facilities nationwide based on health inspections, staffing levels, and quality of care.
- ProPublica’s Nursing Home Inspect provides details on infractions, fines, and inspection histories for more than 90,000 U.S. nursing homes.
These tools are most effective when paired with personal visits to observe how staff interact with residents and how quickly needs are addressed.
Informed decisions prioritize dignity and safety, helping families feel more confident in their choices.
What types of care should I look for?
A quality nursing home should provide:
- Skilled nursing care: 24-hour medical oversight from both registered nurses and licensed practical nurses.
- Medical care: Physician or nurse practitioner management of medications, chronic illnesses, and ongoing treatments.
- Therapy services: Physical, occupational, and speech therapy for recovery and maintenance of function.
- Activities of daily living (ADLs): Assistance with bathing, dressing, eating, toileting, and mobility.
- Specialized units: Dementia units with secure environments, palliative care for symptom management, and hospice services for end-of-life comfort.
- For bed-bound or chair-bound residents, ensure frequent repositioning, skin checks, and proper nutrition to prevent bedsores.
- For residents with dysphagia, confirm that modified diets and thickened liquids are available to reduce choking and aspiration risks.
What red flags should families avoid?
Be cautious of:
- Staffing levels below 4.0 hours of direct care per resident per day.
- Low inspection ratings or a history of unresolved violations.
- Facilities that smell of urine, appear unkempt, or have inattentive staff.
- Inconsistent answers from staff about care procedures.
Visit at different times, including evenings and weekends, to see how the facility operates when management is not as visible.
Arizona-specific tip:
Arizona law requires licensed staffing levels for nursing homes. You can verify compliance through ADHS surveys, available on AZNursingHomeCompare.com. Our printed book includes QR codes for quick access to these resources.
Chapter 3: How to Advocate for a Loved One in a Nursing Home
Advocacy starts the day your loved one enters the facility and continues throughout their stay. You have the right to be involved in every aspect of their care and to expect open communication from the facility.
What rights do nursing home residents have?
Under federal OBRA regulations and Arizona law, residents are entitled to dignity, privacy, safety, and participation in their own care decisions. Before admission, you have the right to visit the facility, ask about services and costs, and receive clear explanations. After admission, residents have the right to see their records, participate in activities, refuse treatment, and be free from abuse or unnecessary restraints.
Avoid signing pre-dispute arbitration clauses. These limit your legal options if serious problems arise.
How do I participate in care planning?
Attend interdisciplinary care plan meetings with nurses, physicians, therapists, and dietitians. These meetings review your loved one’s condition, medications, therapy goals, and dietary needs. Monitor:
- Nurses’ notes for changes in condition.
- Physician orders to confirm treatments are appropriate.
- Dietary sheets to track nutrition and hydration.
- Medication administration records for accuracy.
Watch for signs like unintended weight loss or medication changes without explanation.
What if I see problems?
Document concerns in writing, including dates, times, and witnesses. Escalate issues to the facility administrator. Federal law protects the formation of resident and family councils, and facilities cannot retaliate against participants. These groups can be a powerful way to address systemic problems.
Who are the key staff members to know?
- Administrator: Oversees operations and staffing.
- Director of Nursing (DON): Manages nursing staff and care quality.
- Certified Nursing Assistants (CNAs): Provide most daily hands-on care.
- Therapists: Physical, occupational, and speech therapists address mobility, self-care, and communication needs.
If you live far away, consider hiring a nurse advocate to regularly check on your loved one and the medical care they are receiving and report back.
What is a nursing home family group and why should I join or start one?
A nursing home family group is an organized gathering of residents’ families and friends who work together to improve care and address concerns. Federal law requires facilities to support these groups, provide meeting space, and respond to their recommendations without retaliation. Joining or starting a family group gives you a stronger voice, helps identify common problems, and creates a network of support for both residents and their families.
Arizona-specific tip:
The Area Agency on Aging helpline at (602) 264-HELP is available 24 hours a day to connect you with resources and answer questions. Our book also includes sample advance directive forms and other resources that may be helpful.
Chapter 4: Recognizing Signs of Abuse and Neglect in the Nursing Home
Neglect and abuse can take many forms and often result from chronic understaffing or a profit-first approach to operations.
What are the most common signs of neglect?
- Unexplained injuries like bruises, burns, or fractures.
- Poor hygiene or unchanged clothing and bedding.
- Sudden weight loss, dehydration, or malnutrition.
- Unsanitary rooms or foul odors.
- Pressure ulcers (bedsores) ranging from early redness to deep wounds exposing bone.
What types of abuse should I watch for?
- Physical: Hitting, rough handling, or unnecessary restraints.
- Emotional: Isolation, verbal insults, or intimidation.
- Chemical: Overmedicating residents to make them easier to manage.
How do falls and injuries happen?
Falls often result from hazards like wet floors, poor lighting, insufficient staffing, or inadequate supervision. Missing or broken assistive devices and inaccessible call buttons increase the risk.
How should I report concerns?
- For emergencies, call 911.
- For suspected abuse or neglect, contact Arizona Adult Protective Services at 1-877-SOS-ADULT or the Arizona Department of Health Services at (602) 364-2536.
- Document with photos, notes, and witness statements.
Arizona-specific tip:
SpeakUpAZ.org allows you to report suspected abuse anonymously. Our full resource list includes state and federal agencies as well as the Attorney General’s Task Force Against Senior Abuse.
Chapter 5: How to Advocate for a Loved One in a Nursing Home
Both federal and Arizona laws provide protections for residents, but it is up to families to ensure these rights are respected.
What are the key federal protections?
Under the Omnibus Budget Reconciliation Act (OBRA), residents have the right to quality care, dignity, and self-determination. Facilities must maintain adequate staffing, meet safety standards, and follow each resident’s care plan.
What does Arizona law add?
Arizona requires facilities to be licensed by ADHS, maintain safe conditions, and address complaints. State law also enforces the Arizona Adult Protective Services Act (APSA), which requires reporting suspected abuse of vulnerable adults.
How do I verify licenses or report violations?
- Nurses: Verify through the Arizona State Board of Nursing.
- Physicians: Check with the Arizona Medical Board or Osteopathic Board.
- Administrators: File complaints with the Arizona Board of Nursing Care Institution Administrators.
What are resident rights in detail?
These include access to records, protection of property, control over daily routines, and the ability to voice grievances without retaliation.
Chapter 6: Using the Justice System to Improve Nursing Home Care
Legal action can protect your loved one and prompt systemic changes that benefit all residents.
What is the purpose of civil lawsuits?
Lawsuits hold facilities accountable for harm caused by neglect or abuse. They can compensate victims for medical costs, pain, suffering, and wrongful death, while also deterring similar behavior in the future.
What types of damages are available?
- Compensatory damages: Cover actual losses, such as medical expenses and emotional distress.
- Punitive damages: Punish egregious misconduct and deter future violations.
When should families consider legal action?
If your loved one is harmed due to neglect, abuse, or unsafe conditions, consult an attorney experienced in nursing home cases. In Arizona, our firm has used litigation to improve staffing and care standards across the state.
The Nursing Home Survival Guide is your toolkit for protecting loved ones. The book contains step-by-step instructions, forms, and real-world examples that go beyond what we can share here. Together, we can safeguard vulnerable residents and improve the standard of elder care in Arizona.
If you suspect abuse, neglect, or a violation of resident rights, call Solomon & Relihan at (602) 387-3000
Meet Your Guides
The Nursing Home Survival Guide is your comprehensive resource for navigating nursing home care and elder abuse cases. My name is Martin Solomon and for over 50 years, I’ve been an attorney in Arizona, standing up for the rights of vulnerable adults. My daughter Danielle practices alongside me and together we’ve created these resources to help guide you on your journey. We know no nursing home is perfect but, with these resources and its companion site, AZNursingHomeCompare.com, we support families like yours during difficult times.
Our practice is built on a commitment to making information accessible and actionable. We know that choosing a nursing home can be overwhelming, and we aim to provide the tools you need to make confident, informed decisions. Our resources are meant to empower you to advocate effectively, challenge substandard care, and safeguard your loved ones.
We’re here to help. Whether you need legal assistance or simply want guidance from trusted nursing home abuse lawyers, we invite you to explore our tools and connect with our team.
Together, we can create a safer, more respectful environment for vulnerable adults.
WHAT WE DONursing Home Abuse and Neglect Resources
Dehydration in a Nursing Home May Be a Sign of Neglect or Malpractice
Families shouldn’t have to guess whether a loved one is getting enough to drink. In Arizona nursing homes, staff must assess hydration risk, offer sufficient fluids, and respond quickly when warning signs appear. When they don’t and a resident is harmed, that isn’t just “neglect,” it can be medical malpractice. Dehydration doesn’t just “happen.” It’s...
How to Recognize Medical Malpractice in a Nursing Home
When you place a loved one in a nursing home, assisted living facility, or group home, you trust the staff and medical providers to provide competent and compassionate care. You expect them to meet daily needs, monitor changes in health, and follow medical orders. Too often, however, those expectations are not met. Lapses in medical...
Nursing Home Abuse Statistics in Arizona: Key Data and Trends for 2025
Arizona’s senior population has continued to expand, reaching approximately 1.4 million residents aged 65 and older as of 2024 and representing about 19% of the state’s total population. Projections indicate this group will grow by over 40% by 2030, significantly increasing demand on nursing homes and long-term care facilities. Recent data shows a concerning rise...
Martin J. Solomon Submits Written Testimony to Congress Regarding Arizona’s Nursing Home Abuse and Neglect Crisis
Chairman Scott, Ranking Member Gillibrand, and distinguished Members of the Committee, Thank you for the opportunity to submit this written testimony to the U.S. Senate Special Committee on Aging. My name is Martin J. Solomon, and I am an attorney based in Phoenix, Arizona, whose practice is exclusively devoted to representing families who have lost...
Nursing Home Abuse & Neglect
Nursing Home Injuries
Hospice Abuse and Neglect
Elder Abuse
Group Home Abuse and Neglect
Wrongful Death In Care Facilities
We’re With You, Every Step of the Way
Solomon & Relihan is with you every step of the way. With more than 50 years of experience and more than a 95% success rate in fighting nursing home neglect and abuse, we’re the right team to help you and your family. Remember, you only pay if we succeed.
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