Solomon is a legal analyst and legal editor.
We live in a society where the bad news cycle runs nonstop in the media. In practice, this means we often become so inundated with bad news content that when there is a trend we should be aware of, it can get lost in the noise.
With more people caring for a person dependent upon them, whether a child, elderly individual, or someone with a disability, there is an upward trend in abuse and neglect. Neglecting the care of a dependent person can constitute a serious criminal offense known as “negligent care of a dependent person.”
What is “Negligent Care”?
The legal concept of negligent care of a dependent person is defined in state statutes, such as Pennsylvania’s 18 Pa. C.S. § 2713, which criminalizes the neglect of a “care-dependent person” by a caretaker. A “care-dependent person” is any adult who, due to physical or cognitive disability or impairment, requires assistance to meet their needs for food, shelter, clothing, personal care, or healthcare. A “caretaker” is any person who has an obligation or legal responsibility for providing any kind of care to the dependent individual, including family members, healthcare providers, nursing home employees, or other designated caregivers; the “care” doesn’t always have to be medical care.
Under Pennsylvania law, a caretaker commits the offense of neglect if they “intentionally, knowingly or recklessly” cause “bodily injury, serious bodily injury or death by failing to provide treatment, care, goods or services necessary to preserve the health, safety or welfare of the care-dependent person…” This could include failing to provide basic necessities, ignoring or concealing harmful conditions or environmental factors, using improper physical or chemical restraints, or isolating the dependent person in a way that results in bodily harm.
Pennsylvania expanded the scope of this offense in 2018 through Act 53, which added a new provision criminalizing a caretaker who “intentionally, knowingly or recklessly endangers the welfare of a care-dependent person for whom he is responsible by failing to provide treatment, care, goods or services necessary to preserve the health, safety or welfare of the care-dependent person.” This broadened the law to cover neglect that does not necessarily result in physical injury but still jeopardizes the dependent person’s well-being.
Other states have laws similar to Pennsylvania’s “Neglect of Care-Dependent Person” statute. For example, in California, Penal Code Section 368 criminalizes elder abuse, including neglect of a dependent adult. In New York, Penal Law Section 260.32 criminalizes endangering the welfare of a vulnerable elderly person or an incompetent or physically disabled person. The legal specifics vary by state.
High-Profile Cases
In Pennsylvania, one high-profile case was that of Christann Gainey, a Philadelphia nurse who, in 2022, pleaded guilty to neglect of a care-dependent person and tampering with records. Her patient, Herbert R. McMaster, Sr., 84, was “left in the lobby of the facility and died hours after suffering a fall and serious head injury.” McMaster, Sr., was the father of H.R. McMaster, a national security adviser under former President Trump.
Another notable case is that of former Pennsylvania nurse Heather Pressdee, who, according to prosecutors, confessed to “harming, with the intent to kill” 19 people at different rehabilitation centers where she worked. These charges followed previous charges against Pressdee for allegedly killing patients in her care through lethal doses of insulin. In sum, the charges against her included: “two counts of first-degree murder, 17 counts of attempted murder and 19 counts of neglect of a care-dependent person, in connection with the 19 patients she allegedly mistreated.”
While these high-profile, tragic cases underscore the importance of proper training, supervision, and accountability for those entrusted with the care of vulnerable individuals — both for nurses and all other caretakers — what we don’t see are the ongoing cases that rarely hit the news cycle.
Ken Fulginiti, JD, and Sarah Dooley, JD, run Fulginiti Law, a Philadelphia firm with a focus on negligent care litigation. Fulginiti has a current case in which he just deposed (for an ensuing civil lawsuit) a person convicted of three counts of negligent care, one count for each of his clients who was sexually abused at a nursing home.
Fulginiti told me he has seen a marked upward trend over the past decade in negligent care cases, with a spike during the COVID pandemic that has persisted.
“Fortunately, laws such as Pennsylvania’s Act 53 have widened the definition of ‘neglect’ to encompass behaviors that could jeopardize a dependent’s welfare, even if they don’t cause physical harm. Some of these victims cannot communicate and are the most vulnerable members of our society, relying upon others for proper care so they can maintain their dignity and health. This legislation is significant for safeguarding individuals, as it expands the understanding of what constitutes neglect.”
Imbalance of Power
Part of what makes these cases so challenging is the massive power imbalance between the parties. In previous cases, Fulginiti has heard defense counsel argue, “How are you going to prove your case? Your client has dementia.”
As Fulginiti explains, “Asking a lawyer how they’re going to prove a case since their client has dementia ignores the reality that these victims of abuse feel what is happening to them. Being a victim of abuse and being unable to communicate effectively exacerbates the harm. An abuse victim unable to communicate can only internalize what happened to them — they generally can’t seek the help they need.”
Negligent care of a dependent person is one of those areas at the intersection of law and healthcare that doesn’t get enough attention because of how often it’s swept under the rug — and how deeply uncomfortable it is. Yet, when we reflect on the urgency of addressing negligent care, we need to remember that at the heart of each legal definition, statute, and court case are real people — individuals who, despite their vulnerabilities, deserve to live with dignity, respect, and the assurance of proper care. This applies whether they are being treated in a long term care facility, a hospital, or simply at home by a family member.
The conversation about negligent care of dependent persons challenges us to look beyond the noise of the daily news cycle and focus on the pressing issues that can no longer afford to be lost in the shuffle. It is a call to action for healthcare professionals, lawmakers, caregivers, families, and society at large to recommit to the protection and care of the most vulnerable among us, ensuring that their health, safety, and welfare are not just protected by law but enshrined in cultural practice. Only then can we hope to build a society that truly cares for all its members, regardless of their dependency status.
Aron Solomon, JD, is the chief strategy officer for Amplify, a legal marketing and media agency. He has taught entrepreneurship at McGill University and the University of Pennsylvania, and was elected to Fastcase 50, recognizing the top 50 legal innovators in the world. Solomon is a Pulitzer Prize-nominated writer.
Disclosures
Amplify does legal marketing for Fulginiti Law.
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