Medical Neglect in Nursing Homes Under the Law

Medical neglect in a nursing home involves a failure to provide proper care to a resident. It does not require deliberate intent to cause harm. Instead, it arises when caregivers or facility administrators fail to act with the level of attention and caution owed to residents. This failure can include:

• Ignoring important medical needs
• Failing to provide timely treatment
• Neglecting to follow a physician’s orders
• Disregarding instructions in a resident’s care plan

Although medical neglect can sometimes overlap with intentional abuse, its hallmark feature is an omission or careless inaction that causes an injury or worsens an existing condition.

Warning Signs of Neglect

In identifying medical neglect, changes in both a resident’s physical and mental health offer important clues. Bedsores, now often termed pressure injuries, can develop when a person is left in one position for too long without adequate repositioning or skin care. Chronic dehydration, unexplained weight loss, frequent infections, and unmanaged chronic conditions may also signal neglect. Poor personal hygiene, lapses in administering medication, and inadequate attention to individualized care plans can quickly undermine a resident’s well-being. Emotional or behavioral changes, such as depression, anxiety, social withdrawal, or an unexplained fear of a caregiver, may accompany physical neglect. The state of the living environment—such as unsanitary conditions or regular understaffing—can likewise show that the facility is not meeting its duty to provide for basic health and safety.

Federal Regulations and the Standard of Care

Federal law imposes minimum requirements for facilities that receive Medicare or Medicaid funds. Under the Nursing Home Reform Act of 1987, these facilities must help each resident achieve or maintain their highest level of physical, mental, and psychosocial well-being. This mandate, combined with state regulations and licensing requirements, establishes a standard of care that determines how a reasonably prudent caregiver should act in similar circumstances. If a nursing home’s staff fails to meet this standard, and the resident suffers an injury, the facility may be liable for negligence. Common areas where breaches occur include inadequate staffing, improper recordkeeping, delayed treatment, or neglecting to follow care plans for residents with chronic or complex medical needs.

Identifying Responsible Parties

Responsibility for medical neglect can rest with the nursing home itself, individual staff members, or both. A facility may be liable for its own failures, such as inadequate hiring, training, or supervision of employees. Under the principle of vicarious liability, a nursing home can also be held responsible for the negligent acts of its employees when those acts occur within the scope of employment. If a physician who provides care in the facility fails to adhere to professional standards, that doctor may bear liability under a separate medical malpractice claim. Liability questions may grow more complex if the physician is considered an independent contractor rather than a direct employee of the facility, depending on the contractual relationship and the facts of the case.

Proving a Negligence Claim

A plaintiff in a medical neglect case must generally prove four elements. The first is that the nursing home owed a duty of care to the resident. The second is that the facility breached that duty by failing to meet the applicable standard of care. The third is that the resident suffered harm. The final element is causation linking the facility’s breach of duty to the harm. Parties often exchange records, depose witnesses, and rely on expert testimony during an investigative phase known as discovery. If the parties cannot reach a settlement, the case may proceed to trial, where a judge or jury evaluates the evidence to decide whether negligence occurred.

Types of Damages Available

If a court finds a nursing home liable for medical neglect, the injured resident may be entitled to compensatory damages. These may include the costs of past and future medical treatment needed to address health problems caused or worsened by neglect. Damages also may account for pain and suffering, emotional distress, and other forms of non-economic harm. In cases in which a resident dies, surviving family members may be able to pursue a wrongful death claim, which can include compensation for funeral expenses and the loss of the resident’s companionship. If the nursing home’s conduct is deemed especially reckless, a court may impose punitive damages intended to punish the wrongdoing and deter similar behavior.

Statutes of Limitations

Laws known as statutes of limitations control the filing deadlines for personal injury or wrongful death actions arising from medical neglect. These deadlines vary by state and may differ for a resident who survives the neglect versus a family pursuing a wrongful death claim. Some jurisdictions have provisions that extend the filing period if the harm was not immediately discoverable, although such exceptions are narrowly tailored and must be analyzed based on the specific circumstances. Once the statutory period expires, the right to bring a claim typically ends. Understanding and tracking the relevant filing deadline is crucial to protecting legal interests.

Last reviewed May 2025