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Abuse and Neglect

Abuse, as defined below, is not to be tolerated by anyone, including staff, patients, consultants, volunteers, family members or legal guardians, friends or other individuals in any nursing home. Patients have the right to be treated with respect and dignity, free of abuse and neglect as outlined in federal regulations concerning Patient’s Rights.

 Nursing homes are not to employee individuals who have been found guilty of abusing, neglecting, or mistreating patients by a court of law or who have a confirmed finding entered into a state nurse aide registry concerning abuse.


 Abuse: the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish.

 Neglect: the failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness. Neglect occurs when nursing home staff fail to monitor and/or supervise the delivery of patient care and services to assure that care is provided as needed by the patient. Some examples of neglect might include: lack of assistance in eating, drinking, walking, bathing, toileting, or ignoring call bells/lights. Neglect can cause depression, dehydration, incontinence, and/or pressure sores.

 Verbal Abuse: the use of oral, written, or gestured language that willfully includes disparaging and derogatory terms to patients or their families, or within their hearing distance regardless of their age, ability to comprehend, or disability.

 Sexual Abuse: includes but is not limited to, sexual harassment, sexual coercion, or sexual assault. Indicators of possible abuse include bruises around breast or genital area, cuts or lacerations around breast or genital area, clothes with blood stains, tear marks, soreness around breast, genital, or anal area, difficult walking or sitting, individual may withdrawal from family and friends, individual may flinch at movements, or individual may be frightened by opposite gender.

 Physical Abuse: includes hitting, slapping, pinching, and kicking. Indicators of possible abuse include cuts, lacerations, welt marks- possible sign of using restraints, burn marks from cigarettes, malnutrition or dehydration, hair loss from someone grabbing/pulling hair, sores on the body, open wounds, weight gain or weight loss, poor skin conditions, unexplained injuries such as fractures and breaks, bruises, scratches, bite marks, finger prints, frequent trips to the emergency room, black eyes, broken fingernails, over or under medicated, depression or withdrawal from family and friends, changes in behavior; mood swings, or may seem frightened, teary eyed. It also includes controlling behavior through corporal punishment.

 Mental Abuse: includes, but is not limited to, humiliation, harassment, threats of punishment or deprivation. Indicators of possible abuse include patient being emotionally upset, disturbed, nervous behavior, repeated actions, negative attitude, agitation, anger, rocking, sucking, or biting.

 Involuntary Seclusion: the separation of a patient from other patients, or from her/his room or confinement to her/his room against the patient’s will. Indicators of possible abuse include untreated sores, malnutrition/dehydration, unsanitary living conditions, health conditions not being cared for, dirty bed linens and clothes, a strong odor from lack of hygiene, obvious weight loss or weight gain, bed sores, begs for food, or needs medical or dental care.

Misappropriation of Patient Property: the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a patient’s belongings or money without the patient’s consent. Indicators of possible abuse include withholding money from the elder, cashing checks without permission of the elder, personal belongings begin to disappear, not providing services that are needed, or unusual items charged on a credit card.


  • nursing supervisor on duty.
  • nursing home Administrator and/or Director of Nursing.
  • local police.
  • State Department of Human Services, Adult Protective Services.
  • State Ombudsman.
  • State Survey Agency.

Many states have laws requiring the reporting of abuse and neglect.

 Keep accurate records regarding the abuse or neglect and steps you took to report it!