How To Prove Nursing Home Abuse and Neglect

Picture of teddy bear neglected on dirty back street alley. Used as main feature for How To Prove Nursing Home Abuse and Neglect article.

Licensed California nursing homes provide shelter and care to around 110,000 elderly persons. While many of these facilities treat residents with the dignity and care they deserve, residents may still experience abuse or neglect by staff or administrators.

According to the California Attorney General, California experienced double the national rate of gross neglect, abuse, and exploitation of the elderly in 2009. 13% of all claims made to the California Office of the State Long Term Care Ombudsman involved these types of mistreatment.

Knowing how to prove nursing home mistreatment and what steps to take with the help of a nursing home abuse lawyer can help hold negligent parties accountable.

Understanding Nursing Home Abuse and Neglect

There are several types of abuse and neglect in nursing homes. Abuse can be committed in a single action or repeatedly across several weeks, months, or years.
Examples of abuse and neglect in nursing homes can include physical, emotional, or sexual mistreatment.

Physical Abuse

Physical abuse involves direct physical action, such as hitting, punching, striking with objects, or burning. Abuse may include threatening residents with violence or subjecting them to unnecessary roughness when bathing or dressing. Physically restraining older individuals or administering medications inappropriately is also considered physical abuse.

Emotional Abuse

Verbal or non-verbal emotional abuse includes shouting, insulting, using offensive language, threatening physical harm, intimidation, or humiliation. Isolating elders from loved ones and friends can also be used as a manipulative tactic and is considered emotional abuse.

Sex Abuse

Sexual abuse occurs when an older person is subjected to unwelcome touching, groping, rape, or forced sexual activity. It may also include forcing an elderly resident to watch or view pornographic material or taking inappropriate photos or videos of the elderly resident.


Neglect involves the deliberate or negligent refusal to fulfill responsibilities and obligations towards an older adult. This can include failing to provide patients with essentials such as food, water, clothing, personal hygiene, and medication. Neglect can be willful or result from poor training, lack of resources, or short staffing at a facility.

Recognizing Signs of Nursing Home Neglect and Abuse

Knowing the signs of elder neglect and abuse can help you protect your loved one and take swift action if you suspect mistreatment. If you see any of the following physical or behavioral signs or symptoms in your loved one, they may be experiencing abuse or neglect.

Physical Signs and Symptoms

Physical indications of elder abuse can encompass several symptoms, including:

  • Bedsores on your loved one’s lower body
  • Sudden and unexplained weight loss
  • Appearing over or under-medicated due to negligent medication errors
  • Physical injuries such as broken bones, burns, and tooth loss

You can also check for signs of sexual abuse, including unexplained bruises around the chest and bleeding in the genital areas. Signs of sexual mistreatment can also include blood on sheets or your loved one’s clothing.

Behavioral Changes

Recognizing behavioral changes as signs of elder abuse can be challenging. As a result of emotional abuse, people often exhibit behaviors associated with dementia, such as rocking and self-soothing.

If you notice the following behavioral changes in your loved one when you visit, it may indicate abuse:

  • Emotional agitation
  • Extreme withdrawal or non-responsiveness
  • Changes in sleep and eating patterns
  • Excessive apologizing
  • Depression and anxiety
  • Fear or anxiety around a specific staff member

Neglect-Related Red Flags

Symptoms of neglect in nursing homes are often more subtle than physical abuse. This is because neglect is a form of inaction, which can take weeks or months to become apparent. Signs of nursing home neglect include:

  • Poor personal hygiene or inadequate diet that results in dehydration, malnutrition, and untreated bed sores
  • Unsanitary living conditions, such as dirt, fleas or lice, soiled bedding, feces or urine odors, and inadequate clothing
  • New or untreated medical conditions, such as scabies, bed bugs, or bed sores

California Legal Standards and Regulations for Proving Nursing Home Abuse and Neglect

Proving nursing home abuse and neglect under< California’s Elder Abuse and Dependent Adult Civil Protection Act(EADACPA) requires a comprehensive understanding of the law. The Act was enacted to address the growing problem of elder abuse and codifies various forms of abuse, including physical, emotional, financial, and neglect.

A nursing home abuse and neglect lawsuit must include the following elements:

  • The nursing home or care facility owed your loved one a duty of care as a resident
  • The facility and its staff breached this duty of care due to the facility’s negligence or abuse
  • The breach resulted in abuse and injury

To prove nursing home abuse in a legal claim, you must present evidence that shows that the nursing home is responsible for your loved one’s abuse. The evidence should demonstrate the nursing home staff’s liability due to oppression, recklessness, fraud, or malice toward your loved one. It must also show that the responsible party committed the abuse with indifference or conscious disregard for your loved one’s safety and well-being.

What Should You Do if You Suspect Nursing Home Neglect?

If you suspect your loved one is suffering abuse in a California nursing home, there are steps you can take to initiate an investigation and protect their rights. As you prepare to report the abuse to the EADACPA, take the following actions:

Gather Evidence

You need evidence to build a legal case for your loved one, which means you must gather as much proof of abuse or neglect as possible. This can include medical records, photos or videos, witness statements, and facility inspection records.

  • Medical records detailing your loved one’s injuries: If the nursing home is part of Medicare or Medicaid programs, you can access your loved one’s nursing home records to check for discrepancies, such as unexplained injuries. The records may show evidence of abuse or neglect, such as treatments for injuries, hospitalizations for dehydration or malnutrition, and medical interventions for bed sores.
  • Photographs and videos of the facility’s conditions: Visit the nursing home regularly and observe the living conditions, cleanliness, and overall environment. Take pictures of any concerns that may indicate neglect, such as dirty linens and unsanitary conditions.
  • Witness statements: If another resident or staff member witnessed the mistreatment of your relative, you may be able to use their statement to prove your claim. You can work with your attorney to interview nursing home staff, residents, or visitors to the facility to obtain testimony of direct abuse and neglect or the overall conditions of the residence to prove your claim.
  • Inspection records: You can use previous state inspections and citations as evidence to demonstrate a nursing home’s history of non-compliance with state regulations. Public websites, such as Cal Health Find and Nursing Home Compare, provide inspection histories and information on nursing homes. You can access these records to show the facility has a history of regulatory violations.

Report the Neglect

You can contact the appropriate authorities to report your suspicions of nursing home neglect. These authorities include local law enforcement, the long-term care Ombudsperson office, and the California Department of Public Health (DPH). The DPH can begin an investigation after you provide them with all the details and evidence you have collected.

The DPH’s district office will investigate your complaint within 10 days of receiving your complaint. The DPH will begin an investigation within 24 hours if you file a complaint regarding your loved one’s serious injury or death due to nursing home abuse.

If you disagree with the DPH investigation results, you can request an informal conference with the district office. After the conference, you will receive a decision on the investigation findings within 10 days.

If you still do not agree with the investigation findings, you can write a formal appeal request to the Center for Health Care Quality (CHCQ), which will conduct an additional investigation and make a final decision that cannot be appealed. After exhausting the formal complaints process, you may still have the option of filing a civil case against the nursing home for compensation.

Consult With an Attorney

If your loved one suffers abuse or neglect and you want to file a complaint or take legal action, consider working with an attorney specializing in filing California nursing home lawsuits. A knowledgeable attorney can provide legal guidance, evaluate your evidence, and advise you on how to file your claim within the two-year deadline. An attorney can also help you navigate the legal process and seek nursing home abuse compensation.

Taking Action Against Nursing Home Abuse and Neglect

Nursing home residents in California are vulnerable; it may be up to you to protect your loved one’s safety and well-being if they are mistreated by those who should be handling their care.

Protect your loved one’s rights and address the abuse by reading current nursing home abuse articles, gathering evidence, and seeking legal assistance.