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 loved ones due to neglect and abuse in nursing homes. Over the past 25 years, I have handled hundreds of cases involving wrongful death claims stemming from substandard care in Arizona’s long-term care facilities.
My work has involved litigating against nursing home operators for failures in staffing, oversight, and basic resident protections, resulting in preventable injuries, infections, and deaths. I have seen firsthand the devastating human cost of systemic failures in our elder care system, and I appreciate the Committee’s recent hearing on July 30, 2025, where Lori Smetanka of the National Consumer Voice for Quality Long- Term Care highlighted many of these critical issues.
Her testimony underscores the national crisis, and I aim to provide an Arizona-specific perspective informed by my legal experience and the families I represent.
The Alarming Scope of Nursing Home Abuse and Neglect in Arizona
Arizona, like the nation, is grappling with a rapidly aging population. By 2024, nearly one in five Arizonans was aged 65 or older, totaling approximately 1.4 million seniors. This demographic shift has amplified the risks of elder abuse and neglect, particularly in nursing homes where vulnerable individuals—often with cognitive impairments or physical dependencies—rely on facilities for their daily needs. Recent data shows a concerning rise in elder abuse cases, with over 5,000 allegations of abuse in assisted living facilities and nursing homes in 2024, including more than 3,000 in Maricopa County alone.
More than 85% of these cases involved victims with hearing, vision, and physical difficulties, and nearly 70% had cognitive or mental impairments, making them especially susceptible to harm. Arizona’s per capita rate of elder abuse exceeds the national average, and under-reporting remains a significant barrier to the actual rate.
This increase mirrors what I observe in my practice: families coming forward after discovering bedsores, dehydration, falls, or unexplained injuries that point to chronic neglect. Nationally, as noted in Ms. Smetanka’s testimony, abuse deficiencies in nursing homes more than doubled from 2013 to 2017, with deficiencies increasing in severity.
In Arizona, this translates to tangible failures—36% of the state’s 142 CMS-registered nursing homes
(52 facilities) hold a 1-star or 2-star quality rating, indicating persistent underperformance in care standards. Facilities have been cited for resident-on-resident assaults, failure to prevent pressure sores, falls, over-medication for staff convenience and inadequate investigations of abuse allegations.
Understaffing is a root cause I encounter repeatedly. Overworked staff cannot provide the individualized care required, leading to avoidable tragedies. As Ms. Smetanka referenced, nursing care hours have declined despite rising resident needs, and high turnover—often exceeding 60%—doubles the risk of abuse.
In Arizona, about 25% of nursing homes have been found responsible for abuse or neglect, exacerbating these issues. Corporate owners obtain increased dollars from Medicare by seeking high acuity patients requiring intensive nursing care while diverting millions of Medicare dollars to related companies that are intended for patient care.
Cases from My Practice: Human Stories Behind the Statistics
In my representation of families, I’ve witnessed patterns that align with the under-reporting and systemic gaps described by Ms. Smetanka.
For instance, I handled a case involving an 82-year-old woman with dementia in a Phoenix-area nursing home. She suffered severe dehydration and sepsis due to neglected infection and hydration protocols, leading to her death. Our investigation revealed chronic understaffing due to diversion of funds from nursing. The family only learned the full extent through litigation.
Another case involved a 75-year-old man in a Phoenix facility who endured repeated falls due to a lack of supervision. In a final fall he suffered a head injury leading to his death. These are not isolated incidents; they reflect broader failures in oversight, where facilities prioritize profits over care.
As Ms. Smetanka noted, related-party transactions hide up to 68% of profits, diverting funds from direct resident services. In Arizona, this contributes to a high turnover of staff and tragic patient outcomes.
Recommendations for Federal Action
Based on my experience litigating these cases, I urge the Committee to prioritize the following reforms to protect Arizona’s seniors and align with Ms. Smetanka’s calls for action:
- Enforce Stronger Nursing Home Standards: Mandate minimum staffing levels based on resident acuity, with penalties for non-compliance. CMS should receive increased funding for surveys and audits of Medicare cost reports to curb fraud and ensure funds go to care, not hidden profits. Arizona’s high rate of low-rated facilities demands federal intervention to remove chronic violators from Special Focus lists more swiftly.
- Enhance Legal Accountability and Reporting: Strengthen mandatory reporting laws with protections against retaliation for staff whistleblowers. Invest in free legal aid for victims and families to pursue civil claims, ensuring facilities face meaningful consequences for neglect leading to death.
Conclusion
The crisis of elder abuse and neglect in Arizona’s nursing homes is a moral and legal imperative we should no longer ignore. The families I represent seek justice not just for their loved ones, but to prevent future tragedies. I implore the Committee to act decisively—boost funding and enforce accountability—to ensure every senior lives with dignity and safety. Thank you for considering this testimony. I am available for any questions or further discussion.
Respectfully submitted,
Martin J. Solomon, Attorney at Law