Nursing Home Abuse Information


In 2003, the National Center for Health Statistics reported that there were 1.5 Americans over age 65 living in nursing homes. That figure is expected to double by 2030. Although the U.S. Nursing Home Reform Act of 1987 guaranteed that nursing home residents have the right to freedom from neglect, abuse and misappropriation of funds, this vulnerable segment of the American population continues to be at risk.


Abuse and neglect are criminal acts. In 2003, according to the National Center on Elder Abuse, state-based Long Term Care Ombudsman programs investigated 20,673 complaints of abuse, neglect and exploitation of nursing home residents nationwide. Sadly, the National Elder Abuse Incident Study of 1998 estimated that only 20 percent of all elder-abuse cases are reported.


According to the National Consumer Voice for Quality Long-Term Care, abuse means intentional infliction of pain or harm, either physically, mentally, verbally, psychologically or sexually. Examples include slapping, hitting, pinching, berating, ignoring, rough handling, improper touching and other unwanted behaviors.


Neglect is the failure to care for a person in a way that would avoid harm or pain. Examples include lack of assistance with eating or bathing; poor hand-washing techniques; incorrect body positioning, and failure to provide medical care. Neglect can be intentional or unintentional.

Misappropriation of Funds

Deliberately misplacing or misusing a resident’s possessions or money without his consent is considered misappropriation of funds. Examples including stealing money or jewelry, or failing to place residents’ funds in separate, interest-bearing accounts when required.


Nursing homes are required under federal law to monitor their operations for abuse and neglect, and to set up programs for handling complaints. Each state is charged with inspecting nursing homes that participate in Medicare/Medicaid at least once a year and to investigate complaints about the care provided. State ombudsman programs also investigate complaints.

Signs of Abuse and Neglect

When you visit a nursing home resident, be alert for the warning signs of abuse and neglect. These can include unexplained injuries; rapid, unexplained weight gain or weight loss; heavy medication or sedation; dehydration; bed sores; lack of medical care; unsanitary conditions; and open wounds, cuts, bruises or welts. An abused or neglected elder might be upset, agitated or withdrawn, or might report being slapped, pushed, shaken or otherwise mistreated. In these situations, or if you observe abuse or neglect by an employee, visitor, volunteer or another resident, report it immediately to the proper authorities.


Anyone can report neglect and abuse. In most states, certain professionals–including nurses and physicians–are required to report it. If a nursing home resident complains of abuse or neglect, or if you suspect that abuse or neglect has occurred, report it immediately to the nursing home administrator; law enforcement officials; the state or local ombudsman; the state agency charged with the protection of adults; or the state agency that licenses nursing homes. You are not required to submit proof of abuse or neglect–simply report the allegation, and the appropriate agency should investigate the matter appropriately.

About this Author

Marcy Brinkley’s articles about health care and legal issues have appeared in “Texas Health Law Reporter” and the “State Bar of Texas Health Law Section Report.” She holds a bachelor’s degree in nursing, a master’s degree in business administration and a Doctor of Jurisprudence.