Fear of Retaliation in Nursing Home Residents - September's Ombudsman's Report
By Kathleen Heren, Rhode Island's Long-Term Care Ombudsman 8.30.24
Despite federal and state laws protecting a nursing home resident’s rights to voice complaints about abuse and neglect, the fear of retaliation scares many into silence and it has emotional, psychological, and even physical consequences.
The fear of retaliation describes a feeling of vulnerability in which one’s actions may cause retaliation by another. Retaliation refers to the act of revenge by facility staff in
response to a complaint. According to one recent study sponsored by the Long-Term Care Community Coalition (LTCCC) in 2023, over 23% of residents believe that if they file a complaint, they would face severe retaliation from those with a duty to care for them.
Residents' apprehension about possible repercussions is significant due to their dependency on facility staff for basic needs. Worrying about potential retaliation was just as fearsome for some residents as the experience of retaliation itself. Those who felt conflicted about whether or not to report retaliation reported feelings of hopelessness and despair.
The Face of Retaliation
What does retaliation look like? Retaliation can be egregious or subtle, and residents or staff may not recognize many forms.
PSYCHOLOGICAL ABUSE – A facility threatening or attempting to discharge a
resident because they, or their family member, filed a complaint; or a staff
member yelling or cursing at a resident after they were reported to the charge
nurse for failing to provide care.
NEGLECT – A staff person ignoring a resident or intentionally failing to provide care or assistance. Neglect can include unanswered call bells, late meals, ignoring resident requests, and intentionally not providing medication or assistance.
PHYSICAL ABUSE – A staff member hitting, pinching, or being rough with a resident who does not follow directions or complains about something the staff member is doing.
Regardless of the form, retaliation by staff is abuse, whether or not harm was intended. The facility is responsible for protecting residents from abuse and neglect – this includes protecting residents from retaliation. The facility, not the resident or family member, is responsible for preventing retaliation.
Know Your Rights:
The right to be treated with respect and dignity.
The right to exercise rights without interference, coercion, discrimination, or reprisal.
The right to be supported by the facility in the exercise of your rights.
The right to form and participate in a resident or family council.
The right to voice grievances without discrimination or reprisal and without the fear of discrimination or reprisal.
Sometimes, it may be difficult to determine whether staff are retaliating or if a resident’s needs are not being met for another reason, such as understaffing.
Steps to Address Retaliation
However, if retaliation is evident or even suspected, some steps can be taken. If you suspect retaliation, follow the facility’s grievance policy and file a concern with the facility’s Grievance Officer, often the Social Work Director; voice your concerns at a Resident or Family Council meeting where you may find others who share your experience; contact your local Ombudsman for advice and assistance (401-785-3340), and/or file a complaint with the Dept of Health (401-222-5960).
It is not a resident’s responsibility to prevent retaliation, but when residents
hesitate to speak up because of the fear of retaliation, circumstances are unlikely
to change and the problems may continue. It’s scary to speak out, but it is a
resident’s right to be free from abuse and neglect and to have a voice in the way
they are treated and their care is delivered.
Kathleen Heren
Rhode Island State Long-Term Care Ombudsman
Office of the RI State Long-Term Care Ombudsman Program
401-785-3340
As the Rhode Island State Long Term Care Ombudsman, Ms. Heren shares her expertise by providing a monthly guest blog to Connelly Law Offices, Ltd in the Ombudsman's Report. In these blogs, she delves into various issues and topics that she encounters in her role. The insights and opinions expressed in these blogs are solely those of the author(s) and do not necessarily represent the views or opinions of Attorney RJ Connelly III or any of the employees at Connelly Law Offices, Ltd. Please feel free to contact our office with any questions.
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