Nursing Home Abuse and Neglect: Signs and How to Report It

Families trust nursing homes with people who often cannot speak up for themselves. Knowing the warning signs and the right places to report makes a real difference.

Types of abuse and neglect

• Physical abuse: hitting, rough handling, improper restraints
• Neglect: failure to provide food, water, hygiene, medication, repositioning or supervision
• Emotional abuse: threats, humiliation, isolation
• Sexual abuse
• Financial exploitation: theft of money or belongings, pressure to change documents

Warning signs

• Unexplained bruises, fractures or repeated falls
• Pressure ulcers (bedsores), which often signal residents are not being turned
• Sudden weight loss, dehydration, poor hygiene, soiled bedding
• Over-sedation or medication errors
• Fear of certain staff, withdrawal, agitation
• Missing money, belongings, or unusual account activity
• Staff discouraging visits or not letting you be alone with the resident

Residents' rights

Nursing homes that take Medicare or Medicaid must follow federal rules that give residents the right to be free from abuse, neglect, misappropriation of property and exploitation, including unnecessary physical or chemical restraints (42 CFR 483.12). Facilities must report alleged violations to the administrator and the state survey agency within short deadlines and must investigate.

How to report

1. Emergency: call 911.
2. Facility: report to the administrator and director of nursing in writing, and ask what they will do.
3. Long-term care ombudsman: every state has an ombudsman program that advocates for residents and helps resolve complaints (ACL).
4. State survey agency (usually the health department): investigates complaints against licensed facilities.
5. Adult protective services or law enforcement, especially for financial exploitation or criminal conduct. The Justice Department's Elder Justice site lists reporting contacts.

Document what you see

Write down dates, times, names and what you observed. Photograph injuries and conditions. Keep copies of care plans and medical records, which residents and their legal representatives can request.

Check the facility's record

Medicare's Care Compare tool shows star ratings, staffing levels and inspection results for certified nursing homes.

Legal options

Families may bring civil claims for negligence, abuse, or violation of residents' rights, and wrongful death claims if a resident died. Check the admission paperwork for an arbitration clause, which a lawyer can review. Talk to a personal injury lawyer who handles nursing home cases. For abuse outside facilities, see signs of elder abuse.

Sources

1. Cornell Law School LII: 42 CFR 483.12, Freedom from abuse, neglect, and exploitation
2. Administration for Community Living: Long-Term Care Ombudsman Program
3. U.S. Department of Justice: Elder Justice Initiative
4. Medicare: Care Compare