Family decision guides
Plain-English answers to the questions families ask us most. Written by the team at Solomon & Relihan, drawing on 50+ years of nursing-home litigation experience.
How to read a CMS deficiency
Surveyors grade every citation by scope and severity using letters A–L. Levels G and above mean residents were actually harmed. J–L means immediate jeopardy — the most serious category. Match the F-tag number against 42 CFR Part 483 to see exactly which federal rule the facility broke.
- A–C: No actual harm, minimal potential
- D–F: Potential for minimal harm
- G–I: Actual harm to residents
- J–L: Immediate Jeopardy — danger of serious injury or death
Questions to ask on a facility tour
Use these to compare what staff say with what the data shows. If answers conflict with CMS records, ask why.
- What is your current nurse-to-resident ratio on day, evening, and night shifts?
- What was your most recent nursing turnover percentage?
- How many residents currently have pressure injuries? How did each one develop?
- How quickly do you transfer to the hospital when a resident’s condition changes?
- May I see your last state survey results in writing?
- Who owns this facility — and what other facilities does the owner operate?
Warning signs of nursing-home neglect
If a loved one is already in care, these signs warrant immediate attention — and often a formal complaint.
- Unexplained bruises, fractures, or pressure injuries (bedsores)
- Sudden weight loss, dehydration, or untreated infections
- Falls without documented investigation
- Soiled clothing or bedding; foul odor
- Withdrawal, fear of staff, or unusual sedation
- Medication errors or missed doses
We Wrote the Book On Nursing Home Abuse & Neglect
Our book, The Nursing Home Survival Guide: Getting Better Care in Arizona’s Nursing Homes, co-authored by Martin J. Solomon and Danielle R. Solomon, is a comprehensive resource designed to educate and empower you.
Your rights under federal and AZ law
Nursing-home residents are protected by OBRA-87 (42 CFR Part 483) and Arizona’s nursing-care-institution rules (A.A.C. Title 9, Chapter 10, Article 9).
- Right to be free of physical or chemical restraints not required for medical treatment
- Right to a written care plan reviewed quarterly with you involved
- Right to privacy, dignity, and a grievance process
- Right to refuse a transfer or discharge except in specific circumstances
- Right to file complaints with AZDHS without retaliation
What to do if something goes wrong
Take immediate steps to protect your loved one and preserve evidence.
- Document everything — photos, dates, names of staff, written observations
- Request the complete medical record in writing (the facility must provide it)
- Notify the Director of Nursing and Administrator in writing
- File a complaint with AZDHS (azcarecheck.azdhs.gov) — they must investigate
- Call Adult Protective Services if abuse is suspected: 1-877-767-2385
- Consult a nursing-home abuse attorney — Solomon & Relihan offers free consultations
Need to talk with a lawyer?
If you suspect abuse or neglect, Solomon & Relihan offers free, confidential consultations. We only get paid if we win your case.
