## Nursing home abuse and neglect in Hawaii Older adults in nursing homes and assisted-living facilities are among the most vulnerable to neglect, mistreatment, and outright abuse. Hawaii families have multiple paths to seek accountability — civil litigation, regulatory complaints, criminal referrals. ### Hawaii framework - **State regulator:** Hawaii Department of Health — Office of Health Care Assurance - **Statute of limitations on injury claims:** 2 years ## Common types of nursing-home harm **Physical abuse:** - Hitting, slapping, pushing - Improper restraint use - Force-feeding - Pinching, twisting, rough handling **Neglect:** - **Bedsores / pressure ulcers** — the classic indicator of inadequate care - Dehydration / malnutrition - Falls — often from understaffing - Medication errors - Failure to treat infections - Poor hygiene - Wandering / elopement - Inadequate supervision **Sexual abuse:** - Resident-on-resident abuse (often unreported) - Staff abuse (rare but devastating) **Financial exploitation:** - Theft from rooms - Identity theft - Manipulation into changing wills, deeds, beneficiary designations - Unauthorized credit-card use **Emotional / psychological abuse:** - Isolation, threats, humiliation, intimidation - Withholding visits with family ## Federal regulations apply Nursing homes that accept Medicare or Medicaid are subject to extensive federal regulations: - **Federal Nursing Home Reform Act (1987)** — codified resident rights - **CMS regulations** — staffing, training, care planning, dignity - **Resident Bill of Rights** — applicable in every certified facility - **Annual surveys** — facilities inspected; deficiencies on public record - **Five-Star Quality Rating System** — published on Care Compare ## Common causes of harm - **Understaffing** — chronic across the industry; staff-to-resident ratios drive most neglect - **Inadequate training** - **High turnover** - **Cost-cutting** — corporate ownership often prioritizes profit over care - **Inadequate background checks** - **Poor incident reporting** - **Inadequate facility maintenance** - **Inappropriate use of psychotropic medications** as chemical restraints ## Warning signs to watch for - **Bedsores** — particularly Stage 3 and 4 - **Unexplained bruises, cuts, or injuries** - **Sudden weight loss or dehydration** - **Withdrawal, fear, agitation in resident's behavior** - **Soiled clothing / bed linen** - **Bedrooms that smell of urine** - **Staff that won't leave you alone with the resident** - **Sudden financial transactions** by the resident - **Untreated medical conditions** — infections, pain - **Frequent staff turnover** ## Who can be liable - **The facility / corporate owner** - **Individual staff members** — particularly for criminal abuse - **Parent companies / management companies** — corporate veil-piercing - **Doctors and nurse practitioners** — for medical-malpractice elements - **Pharmacy / equipment vendors** — for products supplied Many nursing homes are owned by complex corporate structures designed to limit liability — discovery into ownership is critical. ## Damages - **Medical expenses** for ongoing care from injuries - **Pain and suffering** - **Mental anguish** - **Permanent impairment / disfigurement** - **Wrongful death** in fatal cases - **Punitive damages** for malicious or reckless conduct - **Statutory damages and attorney's fees** in elder-abuse statute states (CA, IL, others) ## Filing complaints Multiple complaint paths run in parallel: - **State licensing agency** (above) - **Long-Term Care Ombudsman** — every state has one; advocates for residents - **Adult Protective Services** for individual abuse - **State Attorney General Medicaid Fraud Control Unit** - **Local police / district attorney** for criminal acts - **CMS** for federally certified facilities ## Forced arbitration Most nursing-home admission contracts include **mandatory arbitration clauses** — which can prevent jury trials and limit damages. Recent federal rule (2019) and state-level reforms have begun limiting these. Don't sign one if you can refuse — and if you must, fight enforceability later. ## What you should do If you suspect abuse or neglect in Hawaii: photograph injuries (date-stamped), document everything in writing, request medical records (you have a right to them), file complaints with both state regulator AND local APS / law enforcement, and contact a nursing-home / elder-abuse attorney. Many Hawaii attorneys specialize in this area; most offer free consultations and work on contingency. --- *This guide is general information about Hawaii law as of early 2026 and is not legal advice. Nursing-home cases involve federal regulations, state law, contracts, and forensic medical issues. Talk to a licensed Hawaii attorney about your specific case.*