Carma Henson: Holding Nursing Homes Accountable
“Nursing homes are getting away with murder. I will scream it to the top of my lungs,” said Carma Henson, who handles nursing home abuse cases at Raleigh-based personal injury firm Henson Fuerst. She has focused her practice on these cases for more than 15 years. “I am determined to hold nursing homes accountable, one case at a time. Bad care is so rampant, and it happens so often that there are many more cases of horrible care and horrible outcomes than lawyers in North Carolina to handle it all.”
“The elderly are so vulnerable to being abused or neglected or ignored when they are admitted into these facilities,” said Henson. “These cases are near and dear to my heart. Our young and our elderly are the most vulnerable in our society and need the most protection. I want to make these facilities safer, and to hold them accountable when they are not.”
The National Center on Elder Abuse reported that approximately 1 in 10 nursing home residents in the United States experience some form of abuse.
Our young and our elderly are the most vulnerable in our society and need the most protection. I want to make these facilities safer, and to hold them accountable when they are not.”
Passion for Fighting
“Families are in a predicament. A family member is placed in a long-term care facility because they need around-the-clock care that their family cannot provide at home. They have to trust the nursing homes to do what they are being paid well to do,” said Henson. “That doesn’t happen when they are understaffed. Residents get abused, neglected, and die because nursing homes value their pocketbooks over people’s lives. Corporate greed trumps residents’ needs. And people die as a result.”
Henson said her passion for fighting nursing home abuse came from personal experience. “While I was in law school, my family and I helplessly watched my grandfather who was in a nursing home. We often felt helpless, not knowing our resources and what we could do to ensure he got the best of care, aside from constantly being at his side.”
Henson’s parents are Lumbee Indians from Robeson County. She grew up in Garner where she faced struggles not because of her heritage but because of economics. “My parents grew up in families with meager means, but they both had a mindset that pushed them to persevere to provide a better life for their children.”
Henson and her twin brother, J.D., were the first in her immediate family to attend college.
“My motivation and strength to persevere and not shy away from difficult and complicated battles against large corporations stems from constant motivation from my mom, who was a single mom. She always had a goal that probably seemed unachievable to others, but she knew through sheer will and hard work she would achieve her goals. I learned that by observing how she lived her life. I always told her she was the ‘wind beneath my wings,’ like the Bette Midler song,” said Henson.
Heads in Beds
The CDC reported in 2020 that there were 15,300 nursing homes in the United States. For-profit companies owned 70% of them. These facilities make most of their money from Medicare and Medicaid reimbursements.
“Nursing homes make money based on what they call ‘heads in beds’ – how many residents are in that facility,” explained Henson. “They make more money [from Medicare and Medicaid] if they have residents with higher or more acute needs because they can charge more to care for those residents. But if they have a resident who has a G tube and none of the staff know how to change out or clean the G tube, then you’ve got a problem. But guess what, they take these high-acuity residents anyway because that’s where the big money comes in the door. The money, money, money.”
Not all nursing homes operate unsafely. There are some good facilities, which usually only accept private pay or are owned by nonprofits, such as those affiliated with churches.
The cases that come to Henson’s door are typically families who suspect their loved one died in a nursing home because of abuse and neglect.
“The families work hard with me. It’s a team effort. It’s a good feeling to say to the family, ‘We did it. We got justice for your mother.’ And we can bring them some accountability and closure,” said Henson. “If I get the sense that the family is just money-hungry, those aren’t the cases we want to pursue. Our clients are the folks who want accountability, and who want to make a difference for someone else’s parents who are still in those facilities, so they don’t have to suffer from the same injustices.”
Corporate Greed
Henson said abuse is almost always a function of nursing home operators prioritizing money over life. “Corporate greed over patient needs. They do not budget enough for staff, which is their number one expense. [The staff] are overworked, and they’re underpaid, so the good nurses don’t want to work there,” explained Henson. “It’s simple. A facility can’t provide good care if there are not enough staff. However, these bad actors ignore that because understaffing leads to higher profits for nursing homes.”
A recent story in the Triangle Business Journal reported that NC will have a nursing shortage of 12,500 by 2033. “That’s a big problem. This means that nursing homes need to get creative in attracting nurses, including better pay and financial incentives, better work schedules, etc.,” said Henson.
And if a nursing home is understaffed, it’s a safe bet there is a paucity of medical records. So, when Henson gets a case, she must play detective.
“We have to put the pieces of the puzzle together. That’s the hardest part of our job. When we get a case, we start reaching out to staff members. Sometimes they’ll talk to us, and they’ll tell us things you’re never going to find in the records,” said Henson.
Nursing homes are often a daisy chain of owners, much like a pyramid. “I’ve spent 20-plus years figuring out how this corporate structure works. You have to do some digging to know who to sue and to determine who the proper defendants are because it’s not going to be identified in the nursing home records.”
“I like to go to the top of the company chain. I don’t want to just show what happened to Grandma. The ‘what’ is she fell because nobody was helping her, and she broke her hip. It’s the ‘why’ that matters. And ‘the why’ is usually corporate greed,” said Henson. “Nursing homes accept high-risk residents with needs they cannot meet. It’s a recipe for disaster. A perfect storm.”
The federal Centers for Medicare and Medicaid Services (CMS) regulate nursing homes. It can take enforcement actions against nursing homes that don’t comply with federal requirements, and it has the power to close a facility. But, said Henson, some nursing home operators view CMS disciplinary fines as merely a cost of doing business.
Getting Past the Cap
Under tort reform in North Carolina, medical malpractice cases and noneconomic damages are currently capped at $656,730.
“So if you’re only able to prove what happened but not why, you’re not likely to establish the egregious conduct. Those decisions were made by people at the top who need to be held fully accountable for what happens to a patient,” said Henson.
“But if I can prove why something happened, then I can obtain full accountability for my client. So, I go after all the companies all the way to the top because that’s who makes the decisions that place the residents at risk.”
We Are Family
Thomas Henson, Sr., and Robert Fuerst started the Henson Fuerst law firm almost 50 years ago, in 1976. Today, the partners are Thomas Jr., David Henson (Carma’s husband), Carma Henson, and Rachel Fuerst.
“Tom and Bob never had a written partnership agreement, and we still don’t. We just trust each other that much,” said Henson.
“Like every family, we have our spats, but that’s really all they are,” said Henson. “Every single one of us knows that we can count on the other. We all have a common interest. We all have the same goals, and that’s to do great work for our clients and to represent and give a voice to people who don’t otherwise have a voice.”
We Are Family Redux
The “We Are Family” leitmotiv extends to the North Carolina Advocates for Justice (NCAJ). Henson will be sworn in as the president at its annual convention in Charlotte in June.
Her husband held this position in 2020-2021. She will be the first Native American to hold this post. Henson has been a member of NCAJ for 26 years. “NCAJ is the single most important professional organization in my career – the best of the best have taught me, mentored me and trained and honed me into the skilled advocate that I am. Membership for a trial lawyer is essential.”
NCAJ grew its membership by 12% in 2024 to 2,000 members through an aggressive recruiting drive. Bringing in new members will be at the top of Henson’s to-do list as well.
“We are trying to attract more members, younger members, and a more diverse membership,” said Henson. “We’ve got all these young people who are getting into the practice, and we want to get them into the NCAJ. Many young lawyers prefer to connect digitally which is a challenge for all professional organizations today, but I believe it is critical that they go a step further and truly get involved by going to events or conventions.
“Nothing can replace face-to-face networking, building personal relationships, finding mentors and learning from one another,” Henson continued. This year’s convention will be June 18-21. It will include CLEs and A Night at the NASCAR Hall of Fame Museum networking event.
Nursing Home Accountability
Henson is also the chair-elect of the American Association of Justice’s Nursing Home Litigation Group. “Our goal is to stay abreast of what’s going on legislatively and with the regulatory issues so lawyers that handle these cases are aware of what’s coming down the line.”
“We help educate the legislators on how certain changes they are considering will affect nursing home residents. And we provide lawyers who practice in this area the most updated resources and brain power because the ultimate goal is to protect the elderly,” said Henson.
“Holding wrongdoers responsible and accountable motivates me. My motivation is to help people, but I also want to stick it to the corporations that treat human beings as widgets as a way to make money. These are human beings. They went to war. They have sacrificed. They took care of us when we were young, and now it’s their turn to be taken care of.”
These are human beings. They went to war. They have sacrificed. They took care of us when we were young, and now it’s their turn to be taken care of.”
At a Glance
Henson Fuerst, P.A.
3110 Edwards Mill Rd. Suite 100
Raleigh, NC 27612
919-781-1107
www.hensonfuerst.com
Practice Areas
- Nursing Home Abuse and Neglect Cases
- Catastrophic Personal Injury
- Medical Malpractice
Education
- Juris Doctorate, University of North Carolina School of Law
- Bachelor’s Degree, University of North Carolina at Chapel Hill
Professional Associations
- American Association for Justice, Chair-Elect of Nursing Home Litigation Group, 2024-Present
- North Carolina Advocates for Justice, President-Elect, 2024-2025
- North Carolina Advocates for Justice, Chair of the Nursing Home Litigation Section, 2012-2013, 2023-2024
- North Carolina Bar Association
- Phi Alpha Delta, Past Chapter Justice
Recent Seminar Presentations
- AAJ’s Nursing Home Litigation Group Elder Abuse Colleges, May 2022 and May 2023
- AAJ’s 2022 Summer Convention and 2021 Winter Convention
- AAJ’s Advanced Depositions College, January 2022 and January 2023
- Keynote Speaker at Atlantic Province of Trial Lawyers Association Conference, June 2022
- New Jersey Association for Justice’s Boardwalk Seminar, April 2022
- Arkansas Trial Lawyer’s Association Day at the Races Seminar, March 2022
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