“It was going to happen anyway.”
That is the defense in nearly every one of these cases. A resident develops a pressure wound, falls, becomes dehydrated, or loses the ability to walk, and the facility explains that this is what happens to frail, elderly people. Sometimes that is true. Very often the records say something else entirely.
A pressure wound that progresses from a surface abrasion to a Stage 4 injury reaching bone did not happen in a day. It happened over weeks, in a facility that sold the family a written care plan promising repositioning, toileting on a schedule, bathing, and skin monitoring, and then did not staff to deliver it.
What we look for
- The admission assessment and care plan, and whether the care actually delivered matched what was sold
- Staffing records against census, shift by shift
- Wound documentation, and any gap between the facility's charting and what the hospital found on transfer
- Prior citations and survey deficiencies at the same facility
These matters may be governed by a state's medical malpractice act, which can require an expert certificate before the case can even be served, and can cap damages. That is a reason to move early, not a reason not to call.
How neglect claims differ in D.C., Maryland, and Virginia
In all three jurisdictions, a claim against a nursing facility can be treated as a medical malpractice claim, with special steps that must be completed before or soon after suit is filed. The steps are different in each place.
- D.C. “Healthcare provider” in D.C.'s malpractice statute expressly includes nursing facilities and long-term care facilities (D.C. Code § 16-2801(2)). Anyone who intends to sue a healthcare provider for medical malpractice must give the provider written notice at least 90 days before filing (D.C. Code § 16-2802(a)). That notice has to be built into the timeline from the start.
- Maryland. The Health Care Malpractice Claims Act covers “related institutions,” which include nursing facilities, and assisted living programs (Md. Code, Cts. & Jud. Proc. § 3-2A-01(f)(1); Md. Code, Health-Gen. § 19-301(l), (o)). A covered claim is filed first with the Health Care Alternative Dispute Resolution Office, and it is dismissed unless a certificate of a qualified expert is filed within 90 days (Md. Code, Cts. & Jud. Proc. § 3-2A-04(a), (b)(1)). The Act also has its own cap on noneconomic damages (§ 3-2A-09).
- Virginia. The Virginia Medical Malpractice Act names nursing homes as health care providers, and defines their professional services to include staffing, personal hygiene, hydration, nutrition, fall assessments and interventions, and patient monitoring (Va. Code § 8.01-581.1). When the plaintiff asks for service of the complaint, the plaintiff certifies that a qualified expert has signed a written opinion supporting the claim, unless the negligence is within a jury's common knowledge (Va. Code § 8.01-20.1). For an assisted living facility, whether the Act applies depends on how the facility is licensed and who delivered the care.
Deadlines and damages rules also differ, and a resident's death adds wrongful death and survival claims. See our pages on wrongful death, Maryland wrongful death claims, and Virginia wrongful death claims.
Frequently asked questions
What are the warning signs of nursing home neglect?
Pressure wounds, repeated falls, dehydration, sudden weight loss, poor hygiene, and a loss of mobility the family cannot explain are common signs. A gap between what the facility tells the family and what the hospital finds on transfer is another. Write down dates and take photographs when you can.
Is a bedsore always a sign of neglect?
Not always, but a pressure wound that progresses to a deep Stage 4 injury usually develops over weeks. Whether it reflects neglect depends on the care plan, the repositioning and skin checks actually performed, and staffing. Those records usually answer the question.
Is a nursing home neglect claim a medical malpractice claim?
Often, yes, and that brings special procedures. D.C.'s malpractice statute covers nursing and long-term care facilities and requires 90 days' written notice before suit (D.C. Code §§ 16-2801, 16-2802). Maryland's Health Care Malpractice Claims Act covers nursing facilities and assisted living programs and requires a certificate of a qualified expert within 90 days (Md. Code, Cts. & Jud. Proc. §§ 3-2A-01, 3-2A-04). Virginia's Medical Malpractice Act covers nursing homes and requires an expert certification when service is requested (Va. Code §§ 8.01-581.1, 8.01-20.1).
How do you prove a facility was understaffed?
By comparing staffing records against the number of residents, shift by shift, and against the care the residents' care plans required. Survey reports and prior deficiency citations at the same facility can show the problem was known. Much of this comes through the records request and discovery once a case is filed.
What if my parent died from neglect?
The family may have wrongful death and survival claims in addition to the neglect claim. Who may bring them, and what damages are available, differ among D.C., Maryland, and Virginia, so talk with a lawyer before the deadlines run.
Related reading
- Nursing home neglect in Washington, D.C.: warning signs and your rights
- Assisted living neglect in Maryland: the regulatory gap
- Bedsores at a Virginia assisted living facility: a wrongful death verdict upheld
- Wrongful death cases in D.C., Maryland, and Virginia
- DMV Injury Guide: preserving documents and records
- DMV Injury Guide: what your case is worth
Talk to a DMV injury lawyer today
D.C. requires 90 days' written notice before suit, and Maryland requires an expert certificate within 90 days of filing. Call early so those steps do not crowd the filing deadline.
Posey Lebowitz PLLC · 3221 M Street NW, Washington, DC 20007
Call (202) 524-0123 or request a free consultation. No fee unless we win your injury case.
More than $32 million recovered.
Plus more than $22 million in other assets.
Across more than 250 matters, in the District of Columbia, Maryland, and Virginia.
These case results are examples of matters handled by Posey Lebowitz PLLC. The outcome of any case depends on the specific facts and legal circumstances of that case. These results do not guarantee or predict a similar result in any future matter. Amounts shown are gross recoveries before attorney's fees, case expenses, and medical liens. Asset values are stated as of 2026 and will change.
Responsible attorneys: Ryan C. Posey and Jacob M. Lebowitz. Posey Lebowitz PLLC, 3221 M Street NW, Washington, DC 20007.