Nursing Home Abuse & Neglect: Poor Hygiene

Nursing Home Abuse & Neglect: Poor Hygiene

Understaffing, high turnover rates, and lack of training in nursing homes can lead to poor hygiene in facility residents. Poor hygiene can indicate abuse or neglect and cause infections or other health issues for your loved one. An experienced nursing home abuse and neglect lawyer from Berberian Ain LLP can help you and your family obtain justice for your loved one mistreated in a nursing home facility.

Families of elderly residents expect nursing facilities to provide personal hygiene services for their loved ones, including bathing, dental care, and cleaning and dressing wounds. However, staff members can expose residents to bacteria and potential infections without proper hygiene in nursing home facilities. As a result, an estimated 2 million infections occur yearly among the 1.5 million residents living in 16,000 nursing homes.

When your loved one suffers from an injury due to poor hygiene, you can work with a Glendale nursing home abuse and neglect attorney to investigate your case. Evidence of insufficient hygiene can help you, and your family receive a fair settlement and hold the nursing home responsible for breaching safety protocols and standards of care.

Hygiene Expectations in Nursing Home Facilities

If you have a loved one in a California nursing home, they are guaranteed certain rights regarding the care they receive in their facility. According to state and federal rules, nursing homes must provide residents with a safe and hygienic environment.

Federal regulations require nursing homes to perform comprehensive assessments for residents to determine the appropriate level of care they should receive. Facilities must assess the following elements when a patient arrives and throughout their stay as a resident:

  • Cognitive patterns
  • Normal routines
  • Physical functioning
  • Dental health
  • Medications
  • Continence
  • Behavior and mood patterns
  • Disease and health conditions
  • Necessary treatments and care procedures
  • Discharge potential

When your loved one enters a nursing home, they may have limited physical or mental abilities. The Code of Federal Regulations states that hygiene resident care must include bathing, dressing, grooming, and dental care. Depending on how independent your loved one is, staff may have to assist them with these activities daily.

The California Department of Social Services requires nursing homes to provide residents with a safe and hygienic environment, including sanitary living areas, food preparation, and personal hygiene care. Specifically, facilities must provide clean bedding and supplies for grooming, such as incontinence pads, wipes, and toiletries.

Signs of Poor Hygiene in Nursing Homes

When a nursing home fails to follow federal and state guidelines, it can result in poor hygienic care of patients. Poor hygiene can cause infections, resulting in physical or mental injury or the death of a loved one.

A recent report from the Federal Government Accountability Office cited over 82% of nursing homes for lack of infection prevention and control from 2013 to 2017. Half of these homes had persistent issues throughout the years measured, indicating a widespread and chronic problem.

If you notice the following signs of poor hygiene in a loved one, they may be receiving substandard care from their nursing home. Speak with an elder abuse attorney from Berberian Ain LLP to help you identify these poor hygiene signs and understand your loved one’s rights.

Insufficient Oral Hygiene

There is a severe lack of oral hygiene in nursing homes, with up to 66% of dementia patients having periodontitis. A 2018 study found only 16% of nursing home residents receive oral care, with only 15% maintaining excellent dental hygiene. This means most nursing home residents do not receive proper dental care.

A lack of oral hygiene, including denture care, tooth care, gum care, and overall periodontal health, contributes to the spread of preventable diseases and infections. People with chronic periodontitis, also called gum disease, are more likely to develop atherosclerosis, which can cause blood clots.

Gum disease can also increase a resident’s risk of developing Chronic obstructive pulmonary disease, or COPD, including bronchitis and emphysema, affecting their ability to breathe. If you notice poor oral hygiene in your loved one, it may be a sign that the nursing home is providing negligent care.

Appearance of Bedsores

Nursing home residents who spend most of their time in bed or a chair over an extended period are at risk of developing bedsores. Bedsores develop in residents with limited mobility due to constant pressure on specific areas of their body, such as hips, back, arms, or feet.

Unless the nursing home staff helps the resident move positions frequently, their skin loses blood flow and deteriorates, creating a pressure ulcer. For example, staff may need to move your loved one from their side to their back several times throughout the day or place a pillow under their ankles to keep their heels off the mattress to prevent sores.

According to the Centers for Disease Control and Prevention (CDC), over 1 in 10 nursing home residents suffer from bedsores. Bedsores can feel tender and warm to the touch and show signs of swelling. If left untreated, bedsores can cause infections that can affect the joints and bones, damaging cartilage and tissue and impairing movement.

Bedsores develop over the course of several days or weeks. If you notice a worsening bedsore or staff leaving your loved one in the same position for more than a few hours, it can indicate neglect.

Insufficient Hand Hygiene

Nursing home staff washing their hands.

Poor hygiene in nursing homes can result from a lack of hand washing from nurses and staff. Staff who don’t wash their hands adequately when caring for patients can spread infections. According to the CDC, healthcare providers clean their hands less than half as frequently as they should, causing 1 in 31 patients to experience healthcare-associated infections every day.

A 2022 study has found that the lack of sanitation knowledge and hygiene training led to poor hygiene in nursing home facilities. Many nursing homes also lack hand-washing sinks in accessible locations or don’t have enough washing stations to clean their hands to adequately care for residents.

You may witness nurses helping multiple patients without washing their hands or notice them performing duties such as changing your loved one’s diaper and feeding them without washing their hands. If you are worried about these behaviors, speak with an attorney at Berberian Ain LLP to learn your options.

Uncleanliness in a Nursing Home Facility

Staff members at nursing homes are responsible for regularly cleaning common areas and bathrooms to prevent spreading disease. A lack of cleanliness can lead to widespread illnesses in a nursing home, such as viral gastroenteritis and diarrhea.

Uncleanliness in a nursing home can result from situations including open trash cans or improper disposal or cleaning of materials such as incontinence pads, soiled bedding, or needles in the facility,

The improper preparation and storage of food can also lead to outbreaks of foodborne diseases such as Giardia and Salmonella. Food preparation training must include handling uncooked food, food storage areas, and refrigeration temperatures for staff members preparing food for nursing home residents.

What Causes Poor Hygiene in Nursing Homes?

Most nursing homes are unsanitary because for-profit facilities put profits above quality care for residents. Shareholders expect a return on investment from for-profit facilities, and these facilities pay high executive salaries and bonuses when they lower operating costs.

Unfortunately, these financial incentives motivate for-profit facilities to minimize other costs, such as hiring adequate staff or providing high-quality supplies and infrastructure. This reduction in expenses often translates to lower-quality staffing and higher infection rates, causing an increase in deficiency citations and a decreased quality of life for residents.

Other common reasons for poor hygiene in care facilities include:

Untrained Employees

Nursing home staff often lack training in hygienic practices for elderly residents, including dental and bathing care. For instance, the average time nursing home staff spent brushing residents’ teeth was about 1.25 minutes compared with the recommended 6 minutes for quality dental care. Lack of training in proper cleaning techniques and patient care increases the risk of poor hygiene issues in a nursing home.


Higher staffing levels and an increased number of registered nurses and certified nursing assistants (CNAs) correlate with better quality of care in nursing homes. However, understaffing in nursing home facilities leaves many homes without adequate staff to care for residents and keep the facility clean.

A quarter of nursing facilities had dangerously low staffing levels in 2014. Between 2017 and 2018, over 75% of nursing homes never met the Centers for Medicaid and Medicare Services (CMS) recommended RN staffing levels. The low number of nursing staff can compromise patient safety, especially when nurses and CNAs have to care for many residents during a shift. They may forgo minor but essential steps to proper care, such as washing their hands, compromising the health of their residents.

High Turnover

It is common for nursing home staff to turnover frequently. For instance, the mean turnover rate for all nurses in the United States is about 128% every year. As a result of understaffing, high workloads, and the stress of working with an increased number of residents, nursing facilities have a high turnover rate. Low wages and benefits have also contributed to high turnover rates.

Direct care staff at facilities with high turnovers are likely to have insufficient training. Some may need help to properly clean and assist residents in maintaining their hygiene. This lack of training and support can increase infection rates and other health problems among residents. They may not watch out for nursing home dementia residents who try to elope outside the facility, leading to them suffering potential injuries.

Poor Nursing Facility Hygiene and Abuse

A lack of hygiene within the facility is one of the symptoms of nursing home neglect and abuse. You might also notice the following physical signs of the abuse or neglect of a loved one:

  • Untreated bruises, cuts, and burns
  • Malnourishment
  • Dehydration
  • Lack of mobility assistance
  • Unexplained weight loss
  • Excessive falls and accidents
  • Confusion and depression
  • Lack of hygiene and grooming practices
  • Withdrawal of necessities such as food, clothes, and shoes
  • Refusal to provide shelter or care

Lawsuits Against Nursing Homes for Poor Hygiene

An experienced lawyer specializing in nursing home abuse can help you prove the facility’s negligence if you suspect the mistreatment of a loved one. Your attorney from Berberian Ain LLP can investigate several types of elder abuse, including neglect and abandonment in your case, to ensure the facility is held responsible for all negligent behavior.

Your lawyer can prove the nursing home neglected to care for your loved one or abandoned them by assessing signs of abuse, reviewing medical records or photos of the injuries, and conducting interviews with facility staff, residents, and other witnesses. They can develop a solid legal strategy to help you and your family gain compensation.

Pursue Justice With a Poor Hygiene Lawyer in Los Angeles, California

You and your family should not have to tolerate poor hygiene from a nursing facility that could endanger your loved one’s health and safety. Seek justice and compensation with the help of a compassionate lawyer at Berberian Ain LLP on behalf of your loved one.

Our legal team will protect your relative’s rights and help you seek financial compensation for their damages, including pain and suffering. We can evaluate the facts of your case, investigate the facility’s records, and explore your options, including taking your case to trial.

Contact our office or fill out a contact form to set up a free consultation to learn more about your legal options and move forward with your case.