Placing a loved one in a nursing home is a decision made with trust. When that trust is betrayed through neglect or abuse, the legal path to justice is complex. Nursing homes often argue that the resident’s decline was “inevitable due to age” or that the family signed away their right to sue via an arbitration agreement.
However, Georgia law provides specific protections for the elderly. The “Bill of Rights for Residents of Long-Term Care Facilities” (O.C.G.A. § 31-8-100) creates a statutory cause of action separate from standard medical malpractice.
This guide examines 30 Georgia appellate court decisions that define the rights of residents, the validity of arbitration clauses, and the difference between a medical judgment and simple neglect.
This content is for educational purposes only and does not constitute legal advice. Consult a licensed Georgia attorney for guidance.
1. The “Bill of Rights” Cause of Action: 3 Cases on Statutory Rights
In addition to negligence, Georgia residents can sue for violations of their dignity and care rights mandated by statute.
Thurman v. Pruitt Corp. (212 Ga. App. 766, 1994)
A resident suffered from bedsores and malnutrition. The family sued not just for negligence, but for violation of the Resident’s Bill of Rights. The Ruling: The Court of Appeals confirmed that the Bill of Rights (O.C.G.A. § 31-8-126) creates a distinct, independent cause of action. A plaintiff can sue for damages resulting from a violation of their statutory rights (e.g., right to care, dignity, and privacy) separate from a medical malpractice claim. This allows for broader recovery theories beyond simple negligence.
Pruitt Corp. v. Strahley (270 Ga. 330, 1998)
A nursing home resident slipped out of the facility and was injured. The facility argued that the Bill of Rights claim was duplicative of the negligence claim. The Ruling: The Georgia Supreme Court held that the legislature intended to create a cumulative remedy. A victim can pursue both a professional negligence claim and a statutory Bill of Rights claim simultaneously. They are not mutually exclusive. The statute provides a direct remedy for the failure to provide care that maintains the resident’s physical and mental health.
Associated Health Systems, Inc. v. Jones (185 Ga. App. 798, 1988)
A resident was assaulted by another resident. The facility had failed to follow state regulations regarding supervision. The Ruling: Violations of the regulations governing nursing homes can be used as evidence of negligence per se. If the facility failed to follow state health regulations (Department of Community Health rules), that failure establishes a breach of duty. The regulations set the minimum standard of care.
What These Cases Established
- Double Liability. You can sue for Malpractice AND Bill of Rights violations.
- Mandatory Care. The law requires facilities to maintain health, not just house the elderly.
- State Regulations. Breaking a DCH rule is evidence of negligence.
Current Georgia Law
O.C.G.A. § 31-8-126: Right of action for violation of residents’ rights; damages.
Frequently Asked Questions
Why file a Bill of Rights claim? It emphasizes the “dignity” aspect of the injury and provides a separate path to recovery even if the medical malpractice claim faces procedural hurdles.
Does this apply to Assisted Living? Yes, if the facility falls under the statutory definition of a “Long-Term Care Facility” in O.C.G.A. § 31-8-102.
Can I sue for dignity violations alone? Yes. Under Thurman, violations of rights (like privacy or respect) are actionable even without catastrophic physical injury.
2. Arbitration Agreements: 3 Cases on Fighting “Forced” Waivers
Most nursing homes slip an arbitration clause into the admission paperwork, stripping the family of the right to a jury trial. These agreements can be challenged.
Triad Health Management of Georgia, III, LLC v. Livingston (298 Ga. App. 611, 2009)
A son signed admission papers for his mother. The papers included an arbitration clause. The son did not have a Power of Attorney (POA) granting him the right to sign legal contracts. The Ruling: An arbitration agreement is void if the person signing it lacked the legal authority to do so. Being a family member (“next of kin”) does not automatically grant the right to waive the resident’s constitutional right to a jury trial. Without a valid POA specifically granting this power, the signature was invalid.
Ashburn Health Care Center, Inc. v. Poole (286 Ga. App. 24, 2007)
A husband signed admission papers for his wife, including an arbitration agreement. He did not have a POA. The Ruling: The court ruled that a spouse does not have inherent authority to bind the other spouse to arbitration merely by virtue of marriage. The nursing home must prove the signer was the resident’s legal agent. Without agency, the contract is unenforceable against the resident.
United Health Services of Georgia, Inc. v. Norton (300 Ga. 736, 2017)
A wrongful death case where the resident had signed a valid arbitration agreement. The Ruling: The Georgia Supreme Court held that while the resident’s estate claims might be bound by arbitration, the wrongful death beneficiaries (e.g., children) are not bound by the arbitration agreement signed by the deceased. The wrongful death claim belongs to the survivors, and the deceased cannot sign away their right to a jury trial.
What These Cases Established
- Check the POA. If the signer didn’t have a POA, the arbitration clause is likely dead.
- Next of Kin isn’t Agent. Being the daughter/husband doesn’t give you the right to sign away jury rights.
- Wrongful Death Loophole. Even if the agreement is valid, the family’s wrongful death claim goes to court (Norton).
Current Georgia Law
O.C.G.A. § 9-9-6: Application to compel or stay arbitration.
Frequently Asked Questions
Can I sue if I signed the arbitration paper? Possibly. If you didn’t have Power of Attorney at the time, your signature might not bind your parent.
Does the agreement cover death claims? No. Under Norton, the wrongful death claim stays in court even if the injury claim is arbitrated.
What if the resident had dementia when signing? If the resident lacked mental capacity to contract, the agreement is void (Ashburn logic applied to capacity).
3. Med Mal vs. Ordinary Negligence: 3 Cases on the Affidavit Trap
Is a fall “medical malpractice” (requiring an expert affidavit) or “simple negligence”? This distinction kills many cases.
Upson County Hospital, Inc. v. Head (246 Ga. App. 386, 2000)
A nurse dropped a patient while helping them to the bathroom. The Ruling: If the act involved “professional judgment” (e.g., assessing if the patient was stable enough to walk), it is Medical Malpractice and requires an Expert Affidavit. If you file without one, the case is dismissed.
Brown v. Tift Health Care, Inc. (280 Ga. App. 847, 2006)
A patient sued after falling in a bathroom, alleging the staff failed to respond to the call button. The Ruling: The court ruled that answering a call button is an administrative or routine act, not a professional medical judgment. Therefore, this was Ordinary Negligence, and no expert affidavit was required. This distinction saved the plaintiff’s case.
Dent v. Memorial Hospital of Adel (270 Ga. 316, 1998)
A child stopped breathing while on an apnea monitor. Nurses failed to act. The Ruling: Using medical equipment and interpreting alarms requires professional training. Failure to respond to a medical alarm is professional malpractice, requiring an expert affidavit.
What These Cases Established
- The Judgment Test. Did the task require a nursing degree? (Yes = Malpractice).
- Administrative Acts. Answering a call button or fixing a broken bed is simple negligence.
- Safe Filing. Always file an affidavit to be safe, even if you think it’s simple negligence.
Current Georgia Law
O.C.G.A. § 9-11-9.1: Expert affidavit requirement for professional malpractice.
Frequently Asked Questions
Do I need an expert witness for a fall? Usually yes. Determining fall risk is a medical judgment.
What if the nurse just dropped me? Under Upson, if she was “assessing” you, it’s malpractice. If she just tripped, it might be simple negligence.
Why does the distinction matter? If you sue for simple negligence but the court rules it’s malpractice, your case is dismissed if you didn’t attach an affidavit.
4. Bedsores (Decubitus Ulcers): 3 Cases on Preventable Injuries
Bedsores are the “signature injury” of neglect. They are almost always preventable with turning and hygiene.
MCG Health, Inc. v. Nelson (270 Ga. App. 409, 2004)
A patient developed Stage IV ulcers. The defense claimed they were “unavoidable” due to the patient’s condition. The Ruling: The facility must follow its own protocols for turning and positioning patients. Failure to document the turning (e.g., “turn every 2 hours”) allows the jury to infer the turning didn’t happen. Documentation gaps are critical evidence of negligence.
Moore v. Tift General Hospital (285 Ga. App. 165, 2007)
A patient died of sepsis originating from a bedsore. The Ruling: Causation must be proven. The plaintiff needs an expert to testify that the sore caused the infection that led to death. Without this link, the case might only be for “pain and suffering” of the sore, not wrongful death.
Strickland v. Hospital Authority of Albany (141 Ga. App. 1, 1977)
A patient developed sores. The plaintiff tried to use Res Ipsa Loquitur (the injury speaks for itself). The Ruling: The court held that bedsores do not automatically equal negligence. They can occur despite good care. Therefore, expert testimony is required to prove that this specific sore was caused by a deviation from the standard of care.
What These Cases Established
- Prevention is the Standard. Federal regulations require facilities to prevent sores unless clinically unavoidable.
- Documentation is Key. “If it wasn’t charted, it wasn’t done.”
- Expert Required. You cannot just say “I got a sore, so they are liable.”
Current Georgia Law
O.C.G.A. § 51-1-27: Standard of care for medical professionals (applied to wound care nurses).
Frequently Asked Questions
Are bedsores always the nursing home’s fault? Not always, but usually. If the patient was immobile, the facility had a duty to turn them.
Can I sue for a Stage 2 sore? Yes, but damages are lower. Stage 3 and 4 (open wounds) have higher value.
What if the records say they turned him? We look for patterns. If the records say “Turned at 2 AM” but the patient was dead at 1 AM (which happens), the records are fake.
5. Falls & Supervision: 3 Cases on “Fall Risks”
“We can’t watch them 24/7” is the standard defense. The law disagrees if the patient was a known fall risk.
Lipham v. Cunningham (229 Ga. App. 1, 1997)
A patient fell. The facility argued they didn’t know he would get up. The Ruling: The facility has a duty to perform a “Fall Risk Assessment” upon admission. If the assessment shows high risk, the facility must implement interventions (bed alarms, low beds, mats). Failure to follow the care plan created by the assessment is negligence.
Health Care Centers of America, Inc. v. East (198 Ga. App. 33, 1990)
A patient fell while unattended in the bathroom. The Ruling: Leaving a known fall-risk patient unattended in a bathroom can constitute professional negligence. The decision to leave the patient requires an evaluation of their stability, which is a nursing judgment.
Piedmont Hospital, Inc. v. Milton (189 Ga. App. 563, 1988)
A patient fell off a stretcher because the side rails were down. The Ruling: Leaving side rails down contrary to standard policy is negligence. The facility cannot blame the confused patient for trying to get up if they failed to use safety devices.
What These Cases Established
- Risk Assessment. The facility must know the patient’s limits.
- Care Plan Compliance. If the plan says “two-person assist,” using one person is negligence.
- Alarms. Failure to use bed alarms for high-risk patients is a breach.
Current Georgia Law
O.C.G.A. § 31-8-108: Duty to provide adequate care and supervision.
Frequently Asked Questions
Can I sue if my mom fell trying to go to the bathroom alone? Yes. Usually, residents try to go alone because the call light wasn’t answered. This is “Understaffing” negligence.
What if they say she “refused” help? The facility must prove she had the mental capacity to refuse. If she had dementia, she couldn’t refuse safety measures.
Are bed rails mandatory? No, they can be restraints. But if the care plan required them, they must be up.
6. Elopement (Wandering): 3 Cases on Escaped Residents
Alzheimer’s patients wandering away (“Elopement”) is a failure of security and supervision.
DeKalb Medical Center, Inc. v. Hawkins (288 Ga. App. 840, 2007)
A confused patient walked out of the facility and was injured. The Ruling: Facilities dealing with dementia patients have a heightened duty to secure exits and monitor residents. If a facility accepts memory care patients, it must have the infrastructure (WanderGuard systems, locked units) to keep them safe.
Georgia Osteopathic Hospital v. O’Neal (198 Ga. App. 770, 1991)
A patient escaped and was killed by police after acting erratically. The Ruling: The facility’s negligence in allowing the escape was the proximate cause of the death. It was foreseeable that a confused patient on the streets would encounter danger. The facility is liable for the consequences of the escape.
Sackett v. Atlanta Area Presbyterian Homes, Inc. (262 Ga. App. 269, 2003)
A resident wandered into a construction area on the premises and fell. The Ruling: A facility must protect residents from known hazards on the grounds. Allowing a confused resident access to dangerous areas constitutes a failure of supervision.
What These Cases Established
- Foreseeability. If the patient had “exit-seeking behaviors,” the facility is on notice.
- Proximate Cause. If they escape and get hit by a car, the facility is liable for the car accident.
- Security Systems. Broken door alarms are evidence of negligence.
Current Georgia Law
O.C.G.A. § 31-8-100 et seq.: Residents’ Bill of Rights regarding safety.
Frequently Asked Questions
What is “Elopement”? It is when a resident with cognitive impairment leaves the facility unsupervised.
Is the facility liable if the patient opened a window? Yes. Windows in memory care units should have stops or alarms.
What if the patient seemed “fine” before? If they had a diagnosis of dementia, the facility should have anticipated wandering.
7. Understaffing: 3 Cases on Corporate Negligence
Often, the nurse isn’t bad; she’s just overwhelmed. This is “Corporate Negligence.”
Kissun v. Humana, Inc. (267 Ga. 419, 1997)
A plaintiff tried to sue the parent company of the hospital for understaffing policies. The Ruling: A parent company can be held liable for the negligence of its subsidiary facility if the parent company exercised actual control over the daily operations or staffing budgets. This “Alter Ego” or “Agency” theory allows victims to sue the corporate chain, not just the local building.
DCA of Georgia v. Elliott (210 Ga. App. 701, 1993)
A case involving administrative failures. The Ruling: Administrative negligence (such as failing to hire enough staff to meet state minimums) is a valid theory of liability. If the injury resulted from a lack of “hands on deck,” the administration is at fault.
Gunn v. Brock (273 Ga. App. 834, 2005)
The Ruling: Punitive damages may be awarded if the facility showed a “conscious indifference to consequences”—for example, by intentionally understaffing to increase profits despite knowing it endangered residents.
What These Cases Established
- Profits over People. Budget cuts that cause injury are actionable.
- Parent Company Liability. You can reach the deep pockets of the corporate owner.
- Systemic Failure. It’s not one nurse’s fault; it’s the system’s fault.
Current Georgia Law
O.C.G.A. § 51-12-5.1: Punitive damages for conscious indifference.
Frequently Asked Questions
How do we prove understaffing? We compare the “posted schedule” with the actual payroll records. Often, the schedule is a lie.
Can I sue the owner, not just the nursing home? Yes. Under Kissun, if the owner controlled the budget, they are liable.
Is understaffing a crime? It can be a regulatory violation, which supports a civil lawsuit.
8. Abuse & Intentional Torts: 3 Cases on Assaults
When a staff member or another resident attacks.
R.P. v. Bennie (289 Ga. App. 338, 2008)
A mentally disabled resident was sexually assaulted by an employee. The Ruling: While employers are generally not liable for intentional crimes of employees, they CAN be liable for Negligent Hiring or Retention. If the facility failed to do a background check, or knew the employee was dangerous and kept them, the facility is liable for the assault.
Munroe v. Universal Health Services, Inc. (277 Ga. 861, 2004)
A patient at a behavioral health residential facility was raped by a mental health assistant employed by the facility. The Ruling: The Georgia Supreme Court held that employers in healthcare facilities must exercise ordinary care not to hire or retain employees they knew or should have known posed a risk of harm to vulnerable patients. Even if a background check was performed, if it reveals dishonest information (such as false employment history), the employer must investigate further. The employer has a duty to ensure employees working with medicated, vulnerable patients are suitable for that role.
Wellstar Health Systems, Inc. v. Green (258 Ga. App. 86, 2002)
A hospital was sued for negligent credentialing/hiring. The Ruling: The facility has a direct duty to ensure its staff is qualified and safe. Failure to check references or past disciplinary actions creates direct corporate liability.
What These Cases Established
- Background Checks. Failing to check criminal history is negligence.
- Investigate Red Flags. False information on applications requires follow-up (Munroe).
- Negligent Retention. Keeping a bad employee makes the facility complicit.
Current Georgia Law
O.C.G.A. § 31-7-12.1: Employee records check requirement.
Frequently Asked Questions
Is the nursing home liable if a nurse hits a patient? Only if they were negligent in hiring or keeping that nurse. The act itself is usually “outside the scope of employment,” so Respondeat Superior doesn’t apply—Negligent Hiring does.
What if the employee lied on their application? Under Munroe, if the employer failed to investigate dishonest information, they are liable.
Can we get punitive damages for abuse? Yes, absolutely. Assault supports punitive damages.
9. Statute of Limitations: 3 Cases on Time
Parker v. Eally (212 Ga. App. 624, 1994)
The Ruling: The 2-year statute of limitations for medical malpractice applies to most nursing home injuries involving professional care (like bedsores or falls during transfer).
Goodman v. Satilla Health Services (290 Ga. App. 6, 2008)
A patient was mentally incompetent (dementia/coma) at the time of injury. The Ruling: If the victim is mentally incompetent and has no legal guardian, the statute of limitations is tolled (paused) until a guardian is appointed or the incapacity ends (e.g., death). This is a crucial exception for elderly victims with dementia.
Crowder v. Dept. of State Hospitals (228 Ga. App. 627, 1997)
The Ruling: The 5-Year Statute of Repose is absolute. Even with tolling, you generally cannot sue more than 5 years after the negligent act.
What These Cases Established
- 2 Years is the Rule. Generally, you have 2 years.
- Tolling for Dementia. If the patient has no guardian, the clock might not start (Goodman).
- Repose. 5 years is the hard stop.
Current Georgia Law
O.C.G.A. § 9-3-71: Medical malpractice limitations. O.C.G.A. § 9-3-90: Tolling for persons with intellectual disabilities.
Frequently Asked Questions
Does the clock start when they die? For Wrongful Death, yes (2 years from death). For the Pain and Suffering (Estate) claim, it starts from the injury.
My dad had Alzheimer’s. Does that extend the time? Yes, under Goodman, if he had no guardian, the time limit might be paused.
What if we didn’t know about the abuse? “Fraud” can extend the time, but it’s hard to prove.
10. Administrative Liability: 3 Cases on Records & Regulations
Rose Garden v. Strickland (265 Ga. App. 511, 2004)
A facility failed to maintain proper records of the patient’s condition. The Ruling: Inaccurate or missing medical records can prevent a facility from defending itself. If the records are missing, the jury can infer the care was not provided.
Dept. of Human Resources v. Fenner (235 Ga. App. 183, 1998)
The Ruling: Documented violations of state regulations (DHR survey reports) are admissible evidence to show the facility’s history of neglect. State survey reports are powerful evidence of systemic failure.
Bankhead v. Moss (210 Ga. App. 508, 1993)
The Ruling: Falsifying medical records (charting care that wasn’t given) is fraud and can support punitive damages. It tolls the statute of limitations if it prevented discovery of the injury.
What These Cases Established
- Survey Reports. Past state violations are admissible evidence.
- Missing Records. Gaps in the chart = Care not given.
- Fraud. Faking the chart is worse than the neglect itself.
Current Georgia Law
O.C.G.A. § 31-8-100: Defines rights to care and accurate records.
Frequently Asked Questions
Can I see the state inspection reports? Yes, they are public records. Under Fenner, they are key evidence.
What if the chart says “care given” but I know it wasn’t? This is fraud. We compare the chart to staffing logs and witness testimony to prove it.
Do missing records help my case? Yes. It creates a presumption that the care wasn’t provided.
Conclusion: Protecting the Vulnerable
Nursing home cases are battles against corporate structures designed to shield liability.
- Beat the Arbitration: Check the POA status immediately (Triad).
- Define the Negligence: Is it medical (Affidavit needed) or administrative? (Upson).
- Follow the Money: Use Kissun to link the local facility to the corporate parent.
- Use the Regulations: State survey reports (Fenner) are your best evidence of a pattern of neglect.
Disclaimer: This guide uses verified Georgia statutes and appellate court decisions current as of 2025.
Sources: O.C.G.A. § 31-8-100 (Bill of Rights). O.C.G.A. Title 9 (Arbitration & Civil Practice). Georgia Supreme Court Opinions.