Nursing Home Neglect

Nursing home neglect happens when the nursing home or any caregiver fails to respond to a resident’s needs — including physical, emotional and social needs. Withholding food, water, medications or access to health care and basic personal needs also constitutes as nursing home neglect.

Terry Turner, writer and researcher for RetireGuide
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APA Turner, T. (2022, August 10). Nursing Home Neglect. RetireGuide.com. Retrieved August 14, 2022, from https://www.retireguide.com/retirement-planning/elder-law/types-of-elderly-abuse/nursing-home-neglect/

MLA Turner, Terry. "Nursing Home Neglect." RetireGuide.com, 10 Aug 2022, https://www.retireguide.com/retirement-planning/elder-law/types-of-elderly-abuse/nursing-home-neglect/.

Chicago Turner, Terry. "Nursing Home Neglect." RetireGuide.com. Last modified August 10, 2022. https://www.retireguide.com/retirement-planning/elder-law/types-of-elderly-abuse/nursing-home-neglect/.

What Is Nursing Home Neglect?

Nursing home neglect is a specific type of nursing home abuse which involves poor care or a failure to provide care that causes harm to a nursing home resident.

Nursing home neglect typically includes the refusal or failure of nursing home caregivers to fulfill their responsibilities to a resident. This includes failure to provide basic needs that result in physical or mental harm to any resident in the home’s care.

Examples of Nursing Home Neglect
  • Failure to call a doctor, nurse or other health care provider when needed
  • Failure to change a resident’s bedding regularly
  • Failure to change a resident’s clothing regularly
  • Failure to clean a resident daily
  • Failure to provide enough food and water
  • Failure to respond to residents’ calls or disabling call buttons
  • Failure to treat bedsores, infections and other illnesses or injuries
  • Leaving a resident unattended for long periods of time

Types of nursing home abuse include physical, mental, verbal and sexual abuse. All types of nursing home abuse are considered a form of elder abuse.

Nursing home abuse can be committed by a member of the nursing home’s staff, another resident, a guest or other people who pass through the home. But nursing home neglect tends to fall directly on the nursing home and its staff.

What Causes Nursing Home Neglect?

Causes of nursing home neglect include inadequate training, negligence in hiring new applicants and understaffing.

Inadequate Training

Nursing homes may fail to adequately train new hires, leading to improper care for residents, medication mistakes and other problems that lead to neglect.

Inadequate training has long been a leading cause of nursing home neglect. In fact, nursing staff identified inadequate training as a major factor in nursing home neglect and abuse in a 2003 report from the National Research Council.

More recently, researchers found that care managers in neglect and abuse cases lacked awareness of elder neglect and did not have strategies to identify or manage nursing home neglect, according to a 2020 study in BMC Health Services Research.

Negligent Hiring

Failure to perform adequate background checks when hiring nursing home staff can increase the risk of neglect.

A thorough vetting system should check for proper licenses and certifications for new hires and review any background of criminal history or drug and alcohol abuse.

Staff Shortages

Low wages and long hours can fuel staff shortages at nursing homes. Understaffing can also increase stress among overworked caregivers.

Understaffing can cause nursing homes to fail to meet basic resident needs, according to a 2020 elder law case study of a large, for-profit nursing home chain that appeared in the journal Inquiry.

The COVID-19 pandemic only made staff shortages worse. More than 20% of nursing homes in the United States reported staffing shortages in December 2020, according to a study by the U.S. Public Interest Research Group.

What Are the Types of Nursing Home Neglect?

There are several types of nursing home neglect — most of them are based on lack of care that the resident is incapable of providing for themself.

Abandonment
Abandonment is any action when the nursing home or its staff deserts a resident without regard for the resident’s well-being. This can include ignoring a person for an extended period or dismissing a resident from the home without a plan for their continued care.
Medical neglect
Medical neglect includes failure to address or meet a resident’s medical needs. This can be failure to contact a doctor or provide basic medical services when necessary.
Failure to provide basic needs
Neglect of basic needs happens when a nursing home fails to provide adequate food, water and a safe, sanitary living environment.
Failure to provide personal care
Personal care neglect happens if a nursing home fails to provide for a resident’s personal hygiene. This includes failure to change clothes and bedding or failing to assist with bathing and other personal hygiene issues which the resident is unable to do themselves.
Self-neglect
Self-neglect occurs when a person ceases to care for themself. This is typically what creates unsafe or unsanitary living conditions for some older adults. It can happen in a nursing home if the staff fails to intervene to prevent self-neglect.
Emotional neglect
Emotional or social neglect can occur when a nursing home staff prevents residents from interacting with other people. This can happen if the staff fails to provide mobility assistance such as wheelchairs, canes or walkers. Isolating residents with physical or mental conditions can also cause social neglect.

What Are the Signs of Nursing Home Neglect?

Signs of neglect are wide ranging. You should look for them when visiting a relative in a nursing home.

Signs of Nursing Home Neglect
  • Bed sores or other preventable conditions
  • Broken eyeglasses or frames
  • Dirty clothes
  • Hazardous, unsafe or unsanitary living conditions
  • Lack of physical or medical aids — such as eyeglasses, dentures, hearing aid, medications or walker
  • Physical signs of punishment — such as being restrained
  • Signs of inadequate care
  • Signs of trauma — such as rocking back and forth
  • Stops taking part in activities they enjoyed
  • Trouble sleeping
  • Unexplained bruises, burns, cuts, scrapes or scratches
  • Unwashed hair
  • Withdrawn or acts violent or agitated
Source: National Institute on Aging

Nursing Home Neglect Resources: How to Report Nursing Home Neglect

You can report nursing home neglect to the staff of the nursing home or to state and federal agencies.

If you see signs of nursing home neglect, talk to the older adult to find out what happened. Take your concerns to the staff immediately. If the issue isn’t resolved, ask to talk with senior members of the nursing home.

Senior Nursing Home Staff to Contact Immediately
  • Supervisor
  • Social worker
  • Director of nursing
  • Administrator
  • Your doctor
Source: U.S. Centers for Medicare & Medicaid Services

If it is a serious problem — or is still not resolved — you can contact your local nursing home ombudsman or other state and federal agencies that investigate and address nursing home neglect.

Agencies to Contact in Event of Nursing Home Neglect
Local nursing home ombudsman
The Long-Term Care Ombudsman Program is a network of state agencies that can resolve nursing home neglect problems at a local level. It advocates for residents of nursing homes, assisted living facilities and other long-term care homes.
Eldercare Locator
The Eldercare Locator is a federal government resource for finding local resources for older adults in any community in the United States. You can visit the Eldercare Locator website or call toll free at 1-800-677-1116.
National Center on Elder Abuse (NCEA)
The National Center on Elder Abuse is focused on a national response to elder abuse and neglect. It can connect you with other federal and state agencies that deal with nursing home neglect.
State Survey Agency
Medicare has agreements with state survey agencies in every state. These agencies conduct surveys to make sure nursing homes follow Medicare requirements. You can talk to someone directly through live chat at the Medicare website or call Medicare at 1-800-633-4227 (TTY at 1-877-486-2048) to report Medicare fraud or nursing home abuse.
Last Modified: August 10, 2022

7 Cited Research Articles

  1. National Institute on Aging. (2020, July 29). Elder Abuse. Retrieved from https://www.nia.nih.gov/health/elder-abuse
  2. Myhre, J., et al. (2020, March 12). Elder Abuse and Neglect: An Overlooked Patient Safety Issue. A Focus Group Study of Nursing Home Leaders’ Perceptions of Elder Abuse and Neglect. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069163/
  3. U.S Government Accountability Office. (2019, July 23). Nursing Homes: Improved Oversight Needed to Better Protect Residents From Abuse. Retrieved from https://www.gao.gov/products/gao-19-433
  4. U.S Government Accountability Office. (2019, July). Transcript For: Protecting Nursing Home Residents From Abuse (Podcast). Retrieved from https://www.gao.gov/assets/700/699778.txt
  5. Harrington, C. and Edelman, T.S. (2018, July 20). Failure to Meet Nurse Staffing Standards: A Litigation Case Study of a Large US Nursing Home Chain. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055099/
  6. National Institute on Aging. (2017, May 1). How to Choose a Nursing Home. Retrieved from https://www.nia.nih.gov/health/how-choose-nursing-home
  7. Hawes, C. (2003). Elder Abuse in Residential Long-Term Care Settings: What Is Known and What Information Is Needed? Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK98786/#ch14.s40