Nursing Home Abuse

Nursing home abuse is the mistreatment of residents of skilled nursing facilities. Laws protect vulnerable residents, yet abuse and neglect often cause injuries, psychological harm, and damages. Legal action, including lawsuits, can bring justice and recover damages for abused patients.

What is Nursing Home Abuse?

Nursing home abuse is the negligence or intentional acts that lead to a resident’s physical or emotional harm. Neglect is usually included in this definition, as is deliberate abuse or mistreatment. Categories of nursing home abuse include:

  • Physical abuse, such as hitting or inappropriate use of restraints
  • Mental or psychological abuse, which may include verbal abuse or withholding communication with loved ones
  • Sexual abuse, including inappropriate touching or exposure
  • Exploitation, such as financial abuse and trading money for favors
  • Neglect, which may include inadequate medical care, poor nutrition, or failure to turn patients resulting in bed sores

Facts about Nursing Home Abuse and Neglect

Five million Americans every year are victims of elder abuse, many living in nursing homes. More than one-third of nursing home employees have witnessed physical abuse against a resident. Forty percent admit to psychologically abusing residents.[1]

Psychological abuse is the most common type of abuse in nursing homes. Next most common are financial exploitation, sexual abuse, neglect, and physical abuse.[1]

Ninety percent of nursing homes do not have enough employees to provide adequate care for residents. The ratio of nursing aides to residents is ideally one to six, but in many facilities, it is one to 15 or as high as one to 30.[1]

The most vulnerable residents of nursing homes are most often abused: patients with dementia and women with disabilities. Approximately half of all patients with dementia have experienced some form of abuse.[1]

A report from the Government Accountability Office found that abuse citations in nursing homes doubled between 2013 and 2017. The report called for better oversight and monitoring by the Centers for Medicare and Medicaid Services.[2]

Laws Protecting Nursing Home Residents

Nursing homes that are part of Medicare must follow federal regulations and laws that govern the care of residents and aim to prevent elder abuse and neglect:

  • 1987 Nursing Home Reform Act. In response to a study of abuse in nursing homes, Congress passed this law to establish a Bill of Rights for residents. It includes freedom from abuse and neglect, a right to privacy, a right to be treated with dignity, a right to self-determination, and more.[3]
  • 2010 Elder Justice Act. This law is more expansive and includes all Americans over 60, not just nursing home residents. Purposes of the law include the prevention of elder abuse and the coordination of responses to abuse.[4]

Non-Medicare facilities are governed by state laws, which vary in their protections and rights for residents.

How Do I Know if My Loved One is Being Abused or Neglected?

As the loved one of an elderly resident, you trust the facility to care for them. To find out later, the staff abused or neglected them is devastating. The family must be vigilant, no matter how reputable the residence seems. Know the possible signs of abuse and neglect so you can intervene and take legal action:

  • Unexplained bruises and injuries
  • Changes in behaviors, such as increased fearfulness, anxiety, or depressed mood
  • Malnourishment
  • Bedsores
  • Poor hygiene
  • Worsening medical conditions
  • A dirty room or equipment
  • Depletion of assets or missing money
  • Missing personal items
  • Unexplained changes in living arrangements

What to Do if You Suspect or See Nursing Home Abuse

If you suspect or know that a loved one is being abused or neglected in a nursing home, take these important steps to protect them and seek justice:

  1. Ensure the Resident’s Safety
    Most importantly, take immediate steps to protect your loved one. This may mean moving them to another facility. The other steps you’ll need to take may be delayed or require days or weeks to complete. In the meantime, get your loved one good medical care and move them out of harm’s way.
  2. Talk to the Resident and Document Evidence
    Once you feel they are safe, talk to your loved one about what happened. Do this privately, so they feel comfortable opening up and sharing. Take notes and document any signs of abuse, such as bed sores or injuries. Make a note of your own observations as well, including the state of their room or unusual behaviors.
  3. Talk to Staff and Administrators
    Good employees and nursing home administrators will be open and happy to answer any of your questions. Talk to them about your concerns and question any staff willing to talk about what they have seen.
  4. Report the Incident
    In some cases, talking to the facility may be adequate to resolve a minor issue. However, more serious cases of abuse and unresolved incidents must be reported to the proper authorities. If you suspect intentional physical or sexual abuse, call the police.

    Also, report any issue to the proper state authority. Every state has a protective service you can call. You can also call and make a report to the National Center on Elder Abuse. These reports are essential for resolving your case and preventing future harm to other residents.
  5. Talk to a Nursing Home Abuse Lawyer
    If all of the above steps fail to resolve the issue, or if your loved one has suffered significant damages, talk to a lawyer experienced in nursing home abuse cases. Unfortunately, this happens often enough to warrant specializing in this area of law.

    The right lawyer can evaluate your case and suggest the next steps. These may include filing a civil lawsuit over personal injuries to your loved one. They can help you recover damages through a settlement or a trial if necessary.

Who is Liable for Damages in Nursing Home Abuse?

Nursing home abuse and neglect cases can be confusing. Determining who is responsible and who owes damages is not always straightforward. It may seem as if the employee who caused harm is liable, but in many instances, it is the nursing home. The company is responsible for its employees’ actions or inactions.

Examples in which the nursing home is typically the liable part include:

  • Inadequate or poor hiring, training, and monitoring of staff
  • Failure to provide security for residents
  • Failure to provide food, water, and healthcare
  • Medical neglect, failing to provide adequate medical care
  • Use of harmful restraints
  • Intentional abuse

The employee may also be held liable, especially in cases of intentional abuse. However, in almost all cases, the nursing home is also responsible.

A third party may be considered liable for harm in some cases. These are usually product liability cases. A faulty medical device or piece of equipment, like a wheelchair, could cause harm. The manufacturer is liable. Another example of a third party is a contractor or other worker who failed to maintain equipment or part of the nursing home building resulting in an injury.

Nursing home abuse is a serious issue. It happens too often due to understaffed facilities and staff with insufficient training and too little supervision. If your loved one has suffered harm by abuse or neglect, contact a lawyer to guide your next steps. 

  1. National Association of Nursing Home Attorneys. (n.d.). Facts & Statistics.
    Retrieved from:
  2. United States Government Accountability Office. (2019, July 23). Nursing Homes. Improved Oversight Needed to Better Protect Residents from Abuse.
    Retrieved from:
  3. Klauber, M. and Wright, B. (2001, February). The 1987 Nursing Home Reform Act. Public Policy Institute.
    Retrieved from:,%2C%20and%20psychosocial%20well%2Dbeing
  4. Administration for Community Living. (2017, September 17). The Elder Justice Act.
    Retrieved from: