How Body Checks Protect Those In Care

For those who may be unable to report pain or describe an injury, body checks provide an early warning sign to assess a person and help tell that story.   

In this episode, we explore why body checks are far more than paperwork; they are a vital tool for protection, dignity, and early intervention. We're joined by Serena Sturman-Pupons, Deputy Counsel at the Justice Center and a former nurse, to discuss how a careful eye can ensure that every person receives the medical attention and protection they deserve.  

Join us for a conversation on the importance of body checks, the best practices and sensitivities to consider, and why having a physical record is a powerful way to advocate for the people in care. 

But first, to help us kick off the New Year, we sit down with the agency’s Acting Executive Director, Maria Lisi-Murray, to reflect on the progress made in 2025 and preview her plans for 2026.

Transcript

Erin Hogan (00:11):

Hello, and welcome to the “Could This Happen in Your Program?” podcast, where we find collaborative solutions for protecting New Yorkers in care. For those who may be unable to report pain or describe an injury, body checks provide an early warning sign to assess a person's well-being. Today, we're joined by Serena Sturman-Pupons, Deputy Counsel at the Justice Center and a registered nurse, to discuss how a careful eye can ensure that every person receives the medical attention and protection they deserve.

Join us for a conversation on the importance of body checks, the best practices and sensitivities to consider, and why having a physical record is a powerful way to advocate for people in care.

But first, to kick off the new year, we're joined by Acting Executive Director Maria Lisi-Murray to discuss the Justice Center highlights from 2025 and preview her plans for the months to come.

Erin Hogan:

Well, welcome, Maria. Thank you so much for joining us today. What I'd like to do is just, for our listeners, give them a briefing on some of the highlights of our focus as an agency from 2025, and then let you preview some plans that you have for this year.

Maria Lisi-Murray (01:19):

Excellent. Thank you for having me.

Erin Hogan (01:20):

So, tell us what were some of the highlights from 2025?

Maria Lisi-Murray (01:24):

So, 2025, for myself personally and for the agency, really was the year of listening and getting out to visit providers, speak to them, find out what their needs were, how we could best serve our provider community, and support the individuals who are providing the actual direct care to the people we protect. So I felt it was very important to get out and actually understand how our agency could function better in a support role for those individuals. From that, we were able to glean, I think, a lot of information about what could be useful in terms of supporting prevention efforts.

(02:04):

So we really did focus on where prevention could be taking us, where as an agency we could be using our 12 years of data in order to drive better tools and better supports for the people who are caring for New York's most vulnerable. Additionally, over the last year, we established our strategic plan committee. We have individuals from different ranks in our management who have participated in helping to develop the agency strategic plan. I think this was an excellent opportunity to identify who the agency future leaders are and really take the temperature about where the agency should be going for the next five years from individuals within the Justice Center who are actually doing the work.

Erin Hogan (02:54):

I know I've appreciated seeing the updates on the strategic plan, which I know is going to be rolling out in 2026, and I think it's great that you've taken the tact to identify individuals who are boots on the ground doing the work to generate the strategic plan so that it's truly reflective of the work we do.

Maria Lisi-Murray (03:13):

Absolutely. I think listening to the people who actually do the tasks, whether it's out in the field providing direct care or whether it's internal to the Justice Center, doing the direct day-to-day work, I think that's where you really get the best information about where we should be going.

Erin Hogan (03:31):

And so, give us a little preview for this year. What are your plans for 2026? What can we expect to see?

Maria Lisi-Murray (03:37):

So, as I already said, we're rolling out our strategic plan this year that will cover the next five years moving forward. And again, it's really been developed by the folks at the Justice Center who see what we're doing and where our needs are and where the agency really should be moving, obviously with guidance from our executive team. But I'm very excited for our strategic plan. I think it's going to chart a really amazing course for the Justice Center and set us up to do some really amazing things over the next five years. Again, as I talked about, we are developing more of the prevention resources. We are rolling out different opportunities for toolkits, trainings. We are finding that the providers find our toolkits useful, and if we can drive prevention in the service system, I feel like that's a responsibility of this agency in addition to investigating the abuse and neglect allegations.

Erin Hogan (04:38):

Yeah, I know some of our trainings have been so popular, and the toolkits have been so popular, that we've been requested to develop training. So I think we can also probably expect some new training programs to roll out in 2026. So, really excited to hear.

Maria Lisi-Murray (04:53):

Yes. And it's driven by the data, right? It's driven by visiting individuals and by looking at the data the Justice Center has amassed over the last 12 years to make sure that what we're providing is of use and of support.

Erin Hogan (05:04):

Amazing. Well, thank you so much for that brief update. It's a great little preview for 2026, and we'll dive into the rest of our program. But thank you so much for joining us.

Well, welcome back, everyone. Again. We are here with Serena Sturman-Pupons, who's our Deputy Counsel here at the Justice Center, and you're also a registered nurse, and I'm always very intrigued by the different types of professionals we have at the Justice Center, and I think you're shining example of that given your background. So to kick things off, just because I always think it's interesting, can you tell us a little bit about your professional history? I don't think we often see an attorney who's also a, and I feel like that gives you a really interesting perspective for the work we do here. So yeah, could you give us a little bit about that?

Serena Sturman-Pupons (06:04):

Absolutely. Yeah. Thank you for asking and thank you for having me here.

Erin Hogan (06:06):

Yeah.

Serena Sturman-Pupons (06:08):

My background as a nurse started with when I was really in high school and I started to become interested in healthcare generally, and specifically I became interested in helping individuals who really needed a voice. So I started off advocating for individuals receiving healthcare, and that brought me to nursing. And I was thrilled with nursing. I loved it. I loved being at the bedside and helping patients and advocating for them. And after doing that for many years, I started to feel like I wanted to do something a little broader.

(06:48):

I felt that I had a tremendous impact on the individuals that I worked with one-on-one, but I felt like I wanted to do something that involved advocacy in a broader way. And after a lot of thought and research and some prayer, I went to law school. I decided that law was the way for me to advocate.

Erin Hogan (07:11):

That's amazing. That's amazing. It's funny because we just had Maria on, and I feel like she also has that interesting background where she started in a profession and then decided midway through, I want to go to law school. So I just think it's so interesting and a really unique history that you have, but I do think it makes you very uniquely suited for a position with the Justice Center, where your role right now is making determinations on investigations that come through our agency. So, because you have that background, I'm assuming it really helps inform your ability to make those determinations.

Serena Sturman-Pupons (07:52):

Thank you. Yeah, I feel like it really does. I work very closely with the units that make the final legal determination for the administrative cases that come through the Justice Center. And the nice thing about my background is not only do I have the benefit of some clinical information and knowledge and a sense of the vulnerability of the individuals relying on their caregivers, but I also have a sense of the difficulty that caregivers have in trying to meet the needs of the individuals they're caring for and all of the other directions that they might be pulled in. So I do think that it gives me a unique perspective so I'm able to see a bigger picture.

Erin Hogan (08:40):

Absolutely. So the topic that we're here to talk about today is body checks, which is a very important tool used by those purveyors of care. And so we want to talk a little bit about why for our listeners body checks are so important and how we at the Justice Center utilize body check documentation to inform our investigation. So can you just speak sort of broadly to that?

Serena Sturman-Pupons (09:09):

Absolutely. It's so important to follow your agency's policies and procedures for body checks, and also make sure that if an individual has a specific plan that requires body checks at certain times, those are being followed so carefully. Not only is that really important for the individual, for their safety, for their wellbeing, and that can also inform care and issues that might need to come up and be addressed. But also, if there is an incident that occurs that is suspicious, or there's a suspicious injury of unknown origin, we rely on that information enormously. That helps us establish a timeline. It helps us rule things in and rule things out. It's incredibly important. And from the provider side of things, I would say I came from a world where if you didn't document it, you didn't do it. And so, from that sense, it's really to the caregiver's benefit, not only to provide the quality care that they want to provide, but also to protect themselves and to make sure that they're documenting that they're doing this important task and what the condition is of the individual that they're caring for.

Erin Hogan (10:31):

And can we back up just a little bit? Can you define for me what a body check is?

Serena Sturman-Pupons (10:36):

So I'm going to speak in really broad terms. A body check is basically typically a somewhat brief exam of the body looking for bruises or other marks that may not be otherwise explained. So, typically it's going to be policy specific, it's going to be individual specific.

Erin Hogan (10:58):

Okay. Okay. And so you mentioned that oftentimes body check procedures are part of a standard care plan. Are there any other incidents that would prompt a body check and can you speak to those?

Serena Sturman-Pupons (11:12):

Sure. So the incidents that come to mind most readily are following a physical intervention. We want to make sure that somebody gets, is assessed and gets whatever medical or clinical interventions that they need. We would also maybe after an elopement, after somebody was out from under our supervision so we could make sure that they were safe and kind of do an assessment there. Also, individuals who are at risk for falling those kinds of circumstances, we really want to make sure that we're doing a thorough job in assessing if they've had an injury from something like that.

Erin Hogan (11:48):

But beyond obvious physical signs, so like a bruise or a laceration. Are there any other things that would be checked in a body check or something that's maybe under, I don't want to say undervalued, but not conducted enough as part of the body check process maybe that you even see come across your desk in some determination cases.

Serena Sturman-Pupons (12:10):

What we see come across to my unit is individuals who may, may not have a body check in their personal plan, but are behaving in a certain way that indicates they may have maybe in pain if an individual's not able to articulate that they're hurting or where they're hurting. It's really important for the individuals who work with that person to be sensitive to their typical behaviors and expressions of pain. And then if there's something that seems out of the ordinary and it's appropriate with your protocol and your procedure, then that might be a time to say, maybe something happened that wasn't witnessed. Maybe this person fell and we didn't know.

Erin Hogan (13:03):

So, something like guarding behavior or like a physical response to doing a manual exam.

Serena Sturman-Pupons (13:11):

Sure, yeah. Some expression of pain or discomfort or something that's not normal. Somebody who's walking in a crotched over manner. Those types of things. There are body checks. We tend to think of an injury like a bruise, but a body check can also reveal something like a distended abdomen for somebody who has a bowel protocol or something of that nature. There's so much good information that can be obtained by the check.

Erin Hogan (13:42):

How do you maintain that personalized care while also respecting the boundaries of the individual receiving the body check?

Serena Sturman-Pupons (13:53):

That's a really good question. So this is such a sensitive topic because it is a privacy issue, and we do recommend that people approach a body check with genuine empathy to the fact that somebody is being examined in a very intimate manner. We also recommend most places will have a policy that says, do this in a private area. Try to make sure that you're doing this where a person is disrobed the least. And just ways to be sensitive to the fact that something that might be a routine task for a caregiver is still a really, could be a really big deal to somebody who may not otherwise be able to say, I'd like to be in a private room, or I'd like to have another staff present.

Erin Hogan (14:47):

And from a legal perspective, in what way does a staff member's documentation inform the work that you do?

Serena Sturman-Pupons (14:55):

So, it's really, really critical because we rely on that information to assess the injury, to assess what kind of injury was there, what kind of care and treatment was provided or should have been provided, and like I said, as a timeline for the investigation. So documenting very, very thoroughly is so important. And we look for documentation that's really about objective observation. So describing the size, the color, these types of things, not so much it looks really bad or it's really dark, describing the coloring, describing one could say coin size. We do also appreciate photographs. Photographs are often very critical piece of information to really keep a record through time of when the injury was first discovered through to the time when it's completely healed. And typically providers will have protocols to follow on how to take a photograph using the agency equipment. We always recommend if you have a little ruler to put that there to document who took the picture and what date and time it was taken, because all of that information is very critical to the investigation.

Erin Hogan (16:15):

Great. So as part of our, “Could This Happen in Your Program?” podcast, what we like to do is go through a fictional case narrative that we use for training. So after a brief break, we're going to read through the narrative for our listeners and then we'll talk to you about what some of the pitfalls in this specific case that you see that our listeners could hopefully avoid in the future. Sure.

Case Narrative:

Lucas had just returned to work from a week-long vacation. He immediately noticed that Sean, one of the people receiving services, had a large bruise on his arm. He looked in Sean's binder of personal information and the house communication log, but did not see any occurrence reports or body checks documentation about the bruise. Lucas took a picture of the bruise with his personal cell phone and texted the photo to his friend, a coworker Brian, who had worked with Sean while Lucas was on vacation. Lucas texted, “what happened to Sean??”

Well welcome back, Serena. Thank you so much again for joining us. So we just heard this case narrative. We have Lucas here who's returned from a vacation and he sees a bruise on Sean's arm and is unclear as to where it came from. He's texted the individual who was supposed to be caring for Sean while he was out, Brian, and trying to figuring out what happened. What do you see are some of the failures here in this case scenario and things that you would define as a pitfall of care?

Serena Sturman-Pupons (17:49):

It's a good question. What stands out to me in this scenario is the lack of documentation by Brian initially and then by Lucas upon his discovery of the bruise or injury. And kind of related to that notification of a supervisor and kind of following other appropriate protocols regarding obtaining clinical care and assessment that may be needed. And the other part that really jumps out is the use of the phone.

Erin Hogan (18:23):

Yeah.

Serena Sturman-Pupons (18:24):

Lucas, while I think it may be that his intentions were well-meaning to get to the bottom of what had happened, reaching out to Brian, it was not appropriate for him to use his personal cell phone to take the picture. We really encourage provider agencies and facilities to have photography equipment on hand so that suspicious injuries or any injury of unknown origin, such as this, can be documented or really just even if the origin is known, so that we can assess the healing and the care that was delivered. So not only did he take the picture with his phone, but then he emailed it or he texted it, he sent it via a text. And that's also unacceptable.

Serena Sturman-Pupons (19:10):

Basically, that opens him up to a whole bunch of more liability, really, and it opens his phone up to our investigation. We need those pictures, we need that information. And I'm sure Lucas didn't intend to kind of need to hand his personal life over to our investigation. Again, I think that he was well-intended and Brian may have been as well, but this was not documented appropriately and protocols were not followed.

Erin Hogan (19:40):

So I think morale of the story here from our interview is document, document, document. Over document. And make sure that the appropriate methods of communication are being used to share that documentation or a finding that you have.

Serena Sturman-Pupons (19:56):

Yes. I would just like to add also, please follow your agency's policies and procedures, whatever protocols they have in place when a body check is performed. Not only on how to perform it, how to document it, how to record your findings, but also in terms of obtaining clinical care, any type of follow-up actions that need to be taken, every place should have its own guidance for folks on this. So hopefully that can be helpful.

Erin Hogan (20:25):

Yeah, an important reminder for sure. Well, Serena, thank you so much for joining us today, and we hope to have you back again soon. You covered a very important topic, so we appreciate your time. It's my pleasure.

Serena Sturman-Pupons (20:37):

Thank you for having me.

Erin Hogan (20:37):

Thank you.