Traction Law Group, North Palm Beach, FL (2026)

09/03/2026

One of the most productive things you can do for your loved one's care in a nursing home, long-term care facility, or rehab setting costs absolutely nothing. Show up, and get to know the people caring for them.

Know who actually decides. If your loved one is having problems and you are advocating for change at that facility, remember that the aide on the floor usually is not the person making decisions about staffing levels or budgets. Administration sets staffing and budgets. The charge nurse runs the shift. The aide provides the daily care. The person you see most is rarely the person who decides.

In many cases, the frontline staff are working harder than anybody, with too many residents and too little support. Treat them like the professionals they are.

Two questions worth asking. Ask how their shift is going. Ask what they have noticed. These are the people who see your loved one every single day.

When staff know you, and know that you respect the work they do, they may share helpful day-to-day context about your loved one's routine, mood, comfort, preferences, and functioning. Those are details that do not always make it into a clinical chart, but they can help you understand how your loved one is really doing.

When you visit. Sit down with your loved one. Ask open-ended questions rather than yes-or-no ones. Notice changes in mood, appetite, weight, mobility, and hygiene, and pay attention to how clean and comfortable the room is.

Be specific. If you do have concerns, raise them early and be specific about what you observed. There is a real difference between "she seems off" and "she has skipped lunch three days this week." Specifics get written down. Talk to the nurse or care team and ask what the plan is.

Having familiarity with the staff can help get small problems addressed before they turn into bigger ones. Regular family involvement helps you stay informed and spot changes in your loved one's condition or care sooner.

That said, every resident deserves safe, respectful, and attentive care, whether their family is able to visit often or not. Presence is a tool families can use. It is not a condition of good care, and no facility should treat it as one.

At Traction Law Group, we share practical information to help families protect their loved ones in long-term care. Be sure to give us a follow.

This is general information, not legal or medical advice.

More from Traction Law Group:
BedsoreGuide.com — a guide to bedsores and pressure injuries: the stages, the warning signs, and what to do if a loved one has one. https://bedsoreguide.com
NursingHomeComplaint.org — how to file a nursing home complaint, with state-by-state steps, Adult Protective Services contacts, and ombudsman directories. https://nursinghomecomplaint.org

09/01/2026

You have a loved one in a nursing home. Maybe you checked the ratings. Maybe you visited. Maybe the facility told you they are prepared for emergencies.

Here is a question most families never think to ask. What happens when the power goes out?

In April 2026, the HHS Office of Inspector General published an audit titled "Most Nursing Homes Throughout the United States Do Not Have Adequate or Reliable Emergency Power Systems." Auditors identified emergency power system deficiencies at 72 of the 100 sampled nursing homes they reviewed, with a total of 119 deficiencies among those 72 homes.

Based on that sample, OIG estimated that about 10,983 nursing homes nationwide, roughly 73%, have inadequate or unreliable emergency power systems. The estimated breakdown includes 53% with inadequate generator maintenance, 39% with generators that do not supply enough power to essential areas, and 10% running generators that are 40 years old or older. OIG attributed these problems to inadequate nursing home resources and frequent management and staff turnover.

Why this matters. A power failure at a nursing home is not just about the lights. It can affect air conditioning and heat, elevators, oxygen and medical equipment, food storage, medication storage, and a resident's ability to call for help and get it quickly. OIG concluded that these deficiencies put residents at increased risk of injury or death during a power failure.

The audit cites what that has looked like in practice. After Hurricane Irma in September 2017, twelve nursing home residents in Florida died from extreme heat when their facility lost power and had no working emergency power to cool the building. During Hurricane Ida in August 2021, seven nursing home residents in Louisiana died in unsafe and unsanitary conditions after homes evacuated residents into an overcrowded warehouse. During Winter Storm Uri, 118 nursing homes in Texas lost power.

What to ask. Federal rules require nursing homes to have an alternate source of energy to maintain safe temperatures and to support food storage, emergency lighting, fire protection, and sewage disposal, or to evacuate residents. Facilities with generators are required to perform weekly maintenance checks.

Ask the nursing home directly: When was your generator last tested, and can I see the maintenance records? What areas and which pieces of equipment does it actually power? How long can it operate on the fuel kept on site? What is your evacuation plan if the generator fails?

These estimates are nationwide figures derived from a 100-facility sample. They do not tell you anything about one specific building. That is exactly why the questions above matter, and why the answers should come from the facility in writing.

Your loved one should not have to wait for a hurricane, tornado, blizzard, or heat wave to find out whether the facility was prepared.

This is general information, not legal or medical advice.

Source: HHS Office of Inspector General, Most Nursing Homes Throughout the United States Do Not Have Adequate or Reliable Emergency Power Systems (A-02-23-01022), April 2026: https://oig.hhs.gov/reports/all/2026/most-nursing-homes-throughout-the-united-states-do-not-have-adequate-or-reliable-emergency-power-systems/

More from Traction Law Group:
🔹 BedsoreGuide.com — a guide to bedsores and pressure injuries: the stages, the warning signs, and what to do if a loved one has one. https://bedsoreguide.com
🔹 NursingHomeComplaint.org — how to file a nursing home complaint, with state-by-state steps, Adult Protective Services contacts, and ombudsman directories. https://nursinghomecomplaint.org

08/30/2026

Before you trust a nursing home with someone you love, you can read its federal inspection report for free.

ProPublica's Nursing Home Inspect is a free public tool built on federal CMS inspection data, covering more than 15,000 nursing homes, over 90,000 inspection reports, and nearly 400,000 deficiencies. It is updated every month.

How to search it. Type a home's name, city, or state into the search box and it autocompletes as you go. You can also search for words inside the inspection reports themselves, things like "pressure ulcer" or "fall," to see exactly where those words appear in inspectors' own narratives. The Advanced Report Search supports exact phrases and Boolean searches when you want to zero in on a specific concern.

What a facility page shows you. Open any home's page and you get its full deficiency history: inspector narratives describing each failure, any fines and whether they were paid, staffing levels, and ownership changes in the past twelve months. You can also compare homes, or entire states, by serious deficiencies and average fines.

The severity scale. Every deficiency gets a severity rating from A to L. Ratings J, K, and L mean "immediate jeopardy," the government's term for a real risk of serious injury or death. Those three letters are worth knowing on sight, because they are the most serious classification the inspection system has.

One thing of note. Almost every home has some deficiencies on record. The point is to compare, not to panic. Reports only show problems inspectors found, never the whole picture. Look up any home and always visit in person before you decide.

The tool: https://projects.propublica.org/nursing-homes/
ProPublica's how-to article: https://www.propublica.org/article/how-to-use-updated-nursing-home-inspect
Medicare Care Compare: https://www.medicare.gov/care-compare/

More free guides from Traction Law Group:
🔹 NursingHomeComplaint.org — how to file a nursing home complaint, with state-by-state steps, Adult Protective Services contacts, and ombudsman directories. https://nursinghomecomplaint.org
🔹 BedsoreGuide.com — a guide to bedsores and pressure injuries: the stages, the warning signs, and what to do if a loved one has one. https://bedsoreguide.com

Educational content only. Not legal advice. Nursing Home Inspect is a ProPublica project; we are not affiliated with ProPublica. See the full disclaimer at the end of the video.

08/28/2026

Think a nursing home may be violating your loved one's rights? You are not powerless. Swipe through for the steps you can take.

The path runs in order, and it starts inside the building. Talk with the staff member directly involved. If that does not work, move up: supervisor, department head, administrator, then the facility owner or board. Raise it at the next care-plan meeting, or request a special one. Then use the facility's formal grievance process.

That last step has teeth people do not realize. Every nursing facility is required to have a grievance process, and you must receive a written response telling you what was investigated, what was found, whether the complaint was confirmed, and what the facility did or will do about it. Ask for a copy of the grievance policy. Keep copies of everything.

If internal steps are not working, two outside programs can help. Your Long-Term Care Ombudsman advocates for residents and helps resolve concerns. Your State Survey Agency oversees nursing homes and investigates complaints, and you can file anonymously if you prefer.

There is also strength in numbers. Join a resident or family council, or help start one if the facility does not have one.

Federal law requires nursing homes to provide quality, person-centered care and the services each resident needs to reach their highest level of well-being. If care falls short, you have the right to raise concerns and to be heard.

These steps come from the National Consumer Voice for Quality Long-Term Care. Search any program with your state's name to find local contacts.

Document what you observe, ask questions, and seek help early.

More resources in our bio: BedsoreGuide, a guide to bedsores and pressure injuries, and NursingHomeComplaint, how to file a nursing home complaint and where to report.

This is general information, not legal or medical advice.

08/27/2026

You have a loved one in a nursing home. You look up the facility online, see its staffing information, and think there must be enough nurses there to take care of your mom or dad.

Then your loved one waits too long for help. Maybe they are not being turned often enough. Maybe they are not cleaned when they need to be. Maybe they fall, develop a pressure injury, or are left waiting because staff are not available to help with a transfer.

And now you are in a difficult spot. Your loved one lives there. Moving to another nursing home can be hard, since beds are limited and coverage can be complicated. You do not want to make things worse for the person you are trying to protect.

Here is why it is worth looking beyond the online staffing information.

Nursing homes are required to electronically submit staffing information to CMS through the Payroll-Based Journal, including the number of hours each direct care staff member was paid to deliver services for each day worked. In June 2026, the HHS Office of Inspector General published an audit of whether the registered nurse hours reported for March 2024 were supported in accordance with federal requirements.

For 45 of 100 sampled items, nursing homes reported a net of 748.5 hours that were not supported. For 2 of 100 sampled items, nursing homes reported 336 hours that could not be verified, because the nursing homes did not provide supporting documentation.

Based on those sample results, OIG estimated for its sampling frame that for March 2024, nursing homes reported approximately 938,000 hours, about 5 percent, for approximately 53,000 registered nurses, about 42 percent, that were not supported in accordance with federal requirements.

Read the title of that audit, because it is the finding: CMS's processes were not effective in ensuring the accuracy of staffing information reported in the Payroll-Based Journal. This is a conclusion about federal oversight of the data, not a conclusion that facilities were deliberately misreporting. OIG made four recommendations to CMS. CMS concurred with two, did not concur with one, and did not indicate a position on the fourth. All four remain open and unimplemented.

A few things this does not mean. It does not mean every nursing home reports staffing inaccurately. It does not mean a specific facility's numbers are wrong. And it covers registered nurse hours in one month's sampling frame, so it should not be stretched to every staffing category or every date.

What it does mean is that a staffing rating or a public staffing figure is a starting point, not the whole answer about staffing on the shift your loved one actually experienced.

So ask. Ask what staffing looks like on your loved one's actual shift. Ask about evenings, weekends, and overnight. Ask how many nurses and aides are on the unit, how often agency staff are used, and how quickly residents get help after pressing the call button.

Because if your loved one was hurt, the question is not just what the website said. The question is whether enough trained staff were there when your loved one needed help.

This is general information, not legal or medical advice.

Sources: HHS Office of Inspector General, A-09-24-02005, issued June 17, 2026: https://oig.hhs.gov/reports/all/2026/cmss-processes-were-not-effective-in-ensuring-the-accuracy-of-staffing-information-reported-in-the-payroll-based-journal/ · CMS Payroll Based Journal Daily Nurse Staffing dataset: https://data.cms.gov/quality-of-care/payroll-based-journal-daily-nurse-staffing · Medicare Care Compare: https://www.medicare.gov/care-compare/

More from Traction Law Group:
🔹 BedsoreGuide.com — a guide to bedsores and pressure injuries: the stages, the warning signs, and what to do if a loved one has one. https://bedsoreguide.com
🔹 NursingHomeComplaint.org — how to file a nursing home complaint, with state-by-state steps, Adult Protective Services contacts, and ombudsman directories. https://nursinghomecomplaint.org

08/25/2026

Four patients went in for routine joint replacement surgery at Ascension Saint Thomas Midtown in Nashville, Tennessee. They were supposed to receive an anesthetic. Instead, the hospital says they received potassium phosphate.

According to Ascension Saint Thomas, the error occurred on August 14, 2026, inside the pharmacy at its Midtown hospital. The four patients were supposed to receive mepivacaine, an anesthetic medication. The hospital says they instead received potassium phosphate, that all four experienced adverse health reactions and received immediate medical care, and that a comprehensive review confirmed no other patients were affected. Hospital leadership says it self-reported the incident to state regulators the same day it was identified.

One family has told local news that their 72-year-old loved one went in for a routine knee replacement and woke up unable to move from the sternum down. That is the family's account. The state investigation remains ongoing, and no findings have been publicly issued.

Ascension Saint Thomas says it has since implemented several safeguards: high-alert medications are now stored in separate, distinctly marked locations; any spinal medication scan alert must now trigger a hard stop resolved through independent verification; and spinal medication workflows now require a second trained pharmacist to perform final visual and physical checks. The hospital says it continues to work with state and federal officials and has engaged independent third-party quality experts to review its plans.

Those details matter, because medication safety is not about hoping someone catches a mistake. It requires systems built to catch mistakes before a drug reaches a patient.

Those are the same questions families should be asking in nursing homes. Medication errors are not limited to handing the wrong pill to the wrong resident. They can begin with an incorrect order, pharmacy dispensing, packaging, medication reconciliation after a hospital transfer, administration, documentation, or monitoring afterward. Federal nursing home regulations at 42 CFR 483.45 require facilities to ensure that residents are free of any significant medication errors and that medication error rates are not five percent or greater.

If a loved one suddenly becomes confused, excessively sleepy, falls, bleeds, has abnormal blood sugar, or declines rapidly after a medication change, do not assume it is simply part of aging. Ask what changed. Ask what medication was ordered, what was actually administered, who verified it, what the records show, and what monitoring occurred after the change.

Medication safety is not a slogan. It is a system responsibility.

At Traction Law Group we share information about keeping your loved ones safe in long-term care. Be sure to give us a follow.

This is general information, not legal or medical advice. It describes publicly reported statements by Ascension Saint Thomas and publicly reported accounts from an affected family. The investigation is ongoing and nothing here should be read as a finding of fault.

Sources: FOX 17 News (August 21, 2026): https://fox17.com/news/local/nashville-hospital-ascension-saint-thomas-admits-pharmacy-error-tennessee-woman-left-paralyzed · WSMV4: https://www.wsmv.com/2026/08/19/alleged-drug-mix-up-ascension-saint-thomas-nashville-leaves-72-year-old-woman-paralyzed-family-says/ · 42 C.F.R. § 483.45: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-B/section-483.45 · HHS OIG antipsychotic report (March 2026): https://oig.hhs.gov/reports/all/2026/nursing-homes-inappropriate-use-of-antipsychotic-drugs-poses-a-risk-to-residents/

More from Traction Law Group:
BedsoreGuide.com — a guide to bedsores and pressure injuries: the stages, the warning signs, and what to do if a loved one has one. https://bedsoreguide.com
NursingHomeComplaint.org — how to file a nursing home complaint, with state-by-state steps, Adult Protective Services contacts, and ombudsman directories. https://nursinghomecomplaint.org

08/23/2026

CMS is sending nursing homes about $883 million more next year. The question is whether it goes to the facility's bottom line or whether it puts more staff on the floor.

On July 29, 2026, CMS finalized a 2.4% Medicare payment update for skilled nursing facilities for fiscal year 2027, based on a 3.3% market basket reduced by a 0.9% productivity adjustment. CMS estimates that comes to $882.74 million in additional aggregate Medicare payments to skilled nursing facilities.

Worth knowing alongside that number: CMS also estimates a $203.6 million reduction in FY 2027 under the Skilled Nursing Facility Value-Based Purchasing Program for certain facilities, and CMS notes those adjustments are not folded into the payment rate estimate above. Some of the increase is already being clawed back from facilities that underperform.

At the same time, CMS is running a national Nursing Home Staffing Campaign. In CMS's own words, nursing home staffing has a significant impact on the quality of care residents receive, and feedback from both nursing home staff and residents consistently highlights staffing as their primary concern.

As part of that campaign, CMS has announced financial incentives for nurses. Qualified RNs and LPNs will be able to receive up to $40,000 for loan repayment and a $10,000 stipend in return for working three years in a qualifying nursing home or state inspection agency. Note the timing. These incentives are not open for applications yet. CMS is standing up the administrators who will distribute the funds, and says it will provide links to apply once the program is running.

So here is the question families should be asking. When a nursing home receives more money, does that become more aides and nurses on the floor, or does it simply increase the company's margin?

This is where families should ask about the facility's nursing hours per resident day, its staff turnover, and whether there are enough people working evenings, weekends, and overnight shifts. Those first two are not just good questions. Total Nursing Hours per Resident Day and Total Nursing Staff Turnover are measures CMS uses in the SNF Value-Based Purchasing Program, so Medicare is already scoring facilities on exactly what you are asking about. You can look both up on Medicare's Care Compare.

When someone develops a pressure wound, misses meals, or waits too long for help, the issue is not abstract. It comes down to whether enough trained staff were on the floor when that resident needed them.

At Traction Law Group we share information about the state of long-term care in America and how to keep your loved ones safe in these facilities. Be sure to give us a follow.

This is general information, not legal or medical advice.

Sources: CMS, FY 2027 SNF PPS Final Rule (CMS-1843-F), July 29, 2026: https://www.cms.gov/newsroom/fact-sheets/fiscal-year-2027-skilled-nursing-facility-prospective-payment-system-final-rule-cms-1843-f · CMS Nursing Home Staffing Campaign: https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/cms-nursing-home-staffing-campaign · CMS Nursing Home Careers: https://www.cms.gov/priorities/nursing-home-careers/overview · SNF Value-Based Purchasing measures: https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing/measures · Medicare Care Compare: https://www.medicare.gov/care-compare/

More from Traction Law Group:
🔹 BedsoreGuide.com — a guide to bedsores and pressure injuries: the stages, the warning signs, and what to do if a loved one has one. https://bedsoreguide.com
🔹 NursingHomeComplaint.org — how to file a nursing home complaint, with state-by-state steps, Adult Protective Services contacts, and ombudsman directories. https://nursinghomecomplaint.org

08/22/2026

64% of Texas nursing homes were cited for putting residents in immediate jeopardy, and almost nobody knows what that phrase actually means.

Here it is. When an inspector finds that a home failed a care requirement, that is called a deficiency. Deficiencies are rated A through L based on how widespread and how severe the problem is. J, K, and L are the worst three. Those mean immediate jeopardy, the government's term for a situation placing residents at risk of serious injury, harm, impairment, or even death.

Those three ratings account for about 2% of all deficiencies in the entire country. Two percent. That is what makes a figure like 64% of facilities so striking.

According to the latest July 2026 data from ProPublica, these are the percentages of homes in the eight worst states where inspectors found at least one of these deficiencies in the last three years. Texas at 64%, the District of Columbia at 59%, Delaware at 52%, Rhode Island at 51%, and New Mexico at 49%. Kansas, West Virginia, and South Carolina came in at 44% each.

Before anyone says Texas is simply a big state, the comparison holds up. Texas has 1,177 nursing homes and 2,300 serious deficiencies. California has nearly the same number of facilities, 1,165, and 387 serious deficiencies. Same number of homes, roughly six times the immediate jeopardy citations. Looked at another way, serious findings make up about 7% of all deficiencies cited in Texas, against roughly 2% nationally.

Two notes on reading these numbers fairly. Cited during an inspection is not the same as proof that a specific named resident was injured, though it is the most serious classification the system has. And the states on this list vary enormously in size. Texas has 1,177 homes, while the District of Columbia has 17, so a single facility moves a small jurisdiction's percentage far more than it moves Texas's. The raw counts are the honest way to compare across very different states.

Here is the part that matters, because we do not bring this up to scare you. ProPublica's Nursing Home Inspect tool is a great place to get information on the state of long-term care where you live, and you can look up individual nursing home statistics.

Let us know your thoughts.

At Traction Law Group we share information on keeping loved ones safe in long-term care. Be sure to give us a follow.

This is general information, not legal or medical advice.

Sources: ProPublica, Nursing Home Inspect, State-by-State Breakdown, data as of July 2026: https://projects.propublica.org/nursing-homes/summary · ProPublica Nursing Home Inspect (search individual facilities): https://projects.propublica.org/nursing-homes/ · Medicare Care Compare: https://www.medicare.gov/care-compare/

More from Traction Law Group:
🔹 BedsoreGuide.com — a guide to bedsores and pressure injuries: the stages, the warning signs, and what to do if a loved one has one. https://bedsoreguide.com
🔹 NursingHomeComplaint.org — how to file a nursing home complaint, with state-by-state steps, Adult Protective Services contacts, and ombudsman directories. https://nursinghomecomplaint.org

08/20/2026

See this shiny trophy? It is about to appear on nursing home profiles on Medicare's Care Compare website, and it is not what most families will assume it is.

Starting September 8, 2026, CMS is implementing a Risk-Based Survey process nationwide. Nursing homes CMS identifies as higher performing receive a modified standard survey: fewer surveyors, a smaller sample of residents reviewed, and roughly half the onsite time of a traditional inspection. CMS estimates about 12% of nursing homes qualify, 1,560 of 14,682 nationwide. Those facilities get a high-performing facility icon, a gold trophy, on their Care Compare profile beginning September 30, 2026.

The qualifying criteria are real performance measures. A facility needs a five-star overall rating, at least a three-star staffing rating, no citations for actual harm, immediate jeopardy, or substandard quality of care in the last survey cycle, no staffing waivers, and no change in ownership since the last standard survey.

Here is the part families do not know. CMS says the reason for the change is money. In its own memorandum, CMS states that the federal budget for nursing home surveys has not been increased since 2015, and that during that period there has been over a 20% increase in state survey agencies' obligation to conduct complaint surveys. CMS says these constraints have severely hindered states' ability to hire surveyors, prevented complaint investigations where residents are at risk, and created a backlog of nursing homes that have not received their required standard survey.

Resident advocates have pushed back hard. The National Consumer Voice for Quality Long-Term Care opposes the system and says that by placing an icon on Care Compare, CMS is misleading residents and families, since consumers will likely read the trophy as a mark of excellence when it means the facility qualifies for a program created to address survey funding shortfalls. The Long-Term Care Community Coalition is urging CMS to withdraw the policy entirely, warning that abuse, neglect, psychosocial well-being, and quality of life cannot be reliably identified through quality measures or administrative data alone, and require thorough on-site observation and resident interviews. Those are precisely the activities a shortened survey reduces.

Quality can also change quickly. Staffing shortages, management turnover, and financial pressure can change a building in months, while the icon stays on the profile until the facility is no longer eligible.

Would this trophy increase your trust in your mother's nursing home if you saw it on their Care Compare profile? Let us know in the comments.

At Traction Law Group we share information on keeping loved ones safe in long-term care. Be sure to give us a follow.

This is general information, not legal advice.

Sources: CMS, QSO-26-14-NH (July 16, 2026):https://www.cms.gov/files/document/qso-26-14-nh-original-release-2026-07-16.pdf · LTCCC Senior Care Policy Brief: https://nursinghome411.org/policybrief-jul31-2026/ · National Consumer Voice statement: https://theconsumervoice.org/news/cms-announces-plans-to-reduce-oversight-of-some-nursing-homes-through-risk-based-survey-system/ · Medicare Care Compare: https://www.medicare.gov/care-compare/

More from Traction Law Group:
🔹 BedsoreGuide.com — a guide to bedsores and pressure injuries: the stages, the warning signs, and what to do if a loved one has one. https://bedsoreguide.com
🔹 NursingHomeComplaint.org — how to file a nursing home complaint, with state-by-state steps, Adult Protective Services contacts, and ombudsman directories. https://nursinghomecomplaint.org

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