Nursing Home Malpractice: Understanding Risks and Legal Options

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May 9, 2025

Last Updated on August 26, 2025 by Linda Mae Anderson

Updated August 2025: We have updated the article to reflect significant 2025 developments, including stricter CMS enforcement of nursing home care standards, new per day and per instance financial penalties, higher average settlements for nursing home neglect, expanded federal scrutiny on billing for remote patient monitoring and durable medical equipment, and the growing importance of abuse allegation readiness programs. Recent trends in ergonomic and inclusive assistive technology are also included. New authoritative sources have been added.

Understanding Nursing Home Malpractice

Nursing home malpractice is a pivotal concern in elder care, involving scenarios where professional negligence within a nursing home setting causes harm to a resident. This form of malpractice often highlights chronic or systemic failures to maintain expected standards of care. According to Medicare.gov, 7,654 health citations in nursing homes were linked to abuse, neglect, and exploitation, illustrating the significant scale of the issue. Furthermore, INSURICA indicates that medical malpractice represents the most severe financial losses in these facilities, with a median severity of $1.2 million. The Centers for Medicare & Medicaid Services (CMS) is responsible for overseeing compliance in nursing homes. However, with rising demand for elder care services, ensuring consistent enforcement presents a substantial challenge. In 2025, CMS and the Office of Inspector General (OIG) have heightened their enforcement, introducing stricter penalty frameworks, including per day and per instance fines up to $10,000, and have significantly expanded oversight in response to widespread concerns over quality, billing compliance, and abuse reporting.[1][2]

Common Types and Causes of Nursing Home Malpractice

Nursing home malpractice can express itself in various forms, such as falls, medication errors, and insufficient staffing. The Nursing Home Abuse Center notes that falls are prevalent, occurring 1.5 times per resident annually, often due to inadequate supervision or improper usage of assistive devices. Medication errors, such as administering inappropriate prescriptions particularly to dementia patients, also pose significant risks. According to the BBGA, the financial repercussions of these issues can be severe, emphasizing the need for enhanced regulatory measures and safety protocols. Recent trends show increased regulatory attention on billing for remote patient monitoring (RPM) and durable medical equipment (DME), areas now exposed to OIG audits for potential fraud and compliance violations, contributing to higher malpractice risk for facilities.[3]

Fall prevention strategies in nursing homes are an important part of addressing these common types of malpractice, as they specifically tackle the injuries arising from neglect of safety measures in elder care facilities. In addition, innovations in assistive technology, particularly products with improved ergonomic and inclusive designs, are being adopted to minimize neglect and meet stricter quality and safety standards.[1]

Recognizing the Warning Signs of Malpractice and Abuse

Early detection of abuse or neglect is crucial for successful intervention. Warning signs include unexplained injuries, sudden behavioral changes, poor hygiene, and frequent hospital admissions. Family members and caregivers play a critical role in spotting and reporting these issues. As noted by SeniorLiving.org, only 16% of abuse cases are reported, highlighting the necessity for vigilance. Sharing real-life anecdotes, such as stories of sudden weight loss or unaccounted-for bruises on residents, can help families better recognize and address potential abuse, safeguarding their loved ones. With new regulatory emphasis, health systems are increasingly adopting abuse allegation readiness programs and providing improved training for staff to identify and respond to abuse and neglect more effectively.[4][5]

Legal Options and What to Do If Malpractice Occurs

Should there be suspicion of malpractice, understanding the legal recourse is vital. Comprehensive documentation, including records of incidents, communications, and observed injuries, forms the foundation of any case. Consulting legal professionals specialized in elder care malpractice is advisable. INSURICA emphasizes the importance of expert advice in navigating the complexities of malpractice claims, essential for obtaining justice on behalf of residents. In 2025, legal and financial risks for care facilities have risen sharply, as the average settlement amounts for nursing home neglect have climbed to about $251,000, and penalties from regulatory bodies have become more substantial.[6][5]

Improving Safety and Alternatives to Nursing Homes

In light of the challenges faced by the industry, both preventative measures and alternatives to conventional nursing home care are increasingly sought-after. According to NIC, much focus is on enhancing safety protocols and investing in quality improvement initiatives. Many families prioritize exploring in-home care solutions that ensure safety and autonomy while eschewing the risks inherent in nursing home residency. As regulations grow stricter, facilities and families are prompted to adopt more advanced and ergonomically designed assistive technologies, which not only comply with quality standards but also lower the risk of neglect.

While the concerns of nursing home care can be daunting, there are effective strategies to help seniors maintain independence in their own homes. The use of innovative mobility aids like VELA chairs offers a practical solution for those looking to age in place. VELA Chairs are medically approved and designed for home use, offering enhanced safety through features such as a central brake for stability, electric height adjustability for ease of access, and support for daily activities like cooking and dressing. Such solutions not only promote freedom of movement while reducing caregivers’ workload but also provide peace of mind for family members knowing their loved ones can move safely and independently.

Supporting Aging in Place: A Practical Option

For many older adults, the prospect of remaining at home rather than moving to a nursing home is highly appealing. Mobility solutions like supportive seating for elderly individuals play a crucial role in making this possible. The VELA Chair offers features that enhance safety, such as a central brake, which provides stability during activities like cooking and cleaning. Its electric height adjustability allows seniors to easily sit and stand, reducing the risk of falls and fatigue associated with such movements. Additionally, the chair’s design allows for easy movement while seated, making daily activities more manageable and less tiring.

This kind of support can significantly delay the need for nursing home admission by promoting independence and reducing strain on informal caregivers. While VELA is not the only solution, its proven benefits in promoting a safe and active home environment make it a practical choice for many families looking to support their loved ones in aging gracefully and comfortably in their own homes.

FAQ

What are common types of nursing home malpractice cases in the USA?

Common types of nursing home malpractice include falls, medication errors, and issues stemming from insufficient staffing. Falls are particularly frequent, occurring 1.5 times per resident each year, often due to inadequate supervision or improper use of assistive devices. Medication errors, such as administering the wrong prescriptions—especially to dementia patients—also pose serious risks and highlight systemic care failures in many facilities.

What are the first steps to take if you suspect nursing home malpractice?

If you suspect nursing home malpractice, the first critical step is to document all relevant incidents. This includes keeping detailed records of injuries, communications, and any unusual changes in the resident’s condition. Consulting with legal professionals who specialize in elder care malpractice is also essential. Expert legal guidance can help you navigate the complexities of a potential claim and advocate effectively for your loved one’s rights.

What evidence is needed to prove nursing home malpractice?

To prove nursing home malpractice, comprehensive documentation is key. This includes medical records, incident reports, communication logs, and physical evidence of harm such as photos of injuries. Observations related to sudden behavioral changes, unexplained injuries, and frequently repeated hospital visits may also support a case. Gathering and organizing this evidence lays a strong foundation for any legal claim.

Can family members sue a nursing home for malpractice on behalf of a resident?

Yes, family members can take legal action on behalf of a resident if nursing home malpractice is suspected. Consulting with legal professionals who specialize in elder care is strongly recommended to ensure the proper legal steps are taken and the resident’s rights are fully protected throughout the process.

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Author

  • Senior Living Consultant & Occupational Therapist

    Linda Mae Anderson is a certified occupational therapist with over 20 years of experience working with seniors in both assisted living facilities and private home care settings. She holds a Master’s degree in Occupational Therapy from the University of North Carolina at Chapel Hill and has specialized in adaptive equipment and helping aids that support independence in aging populations.

    Originally from Des Moines, Iowa, Linda moved to the Blue Ridge Mountains for the community and the peaceful lifestyle — and stayed because she found a calling in helping seniors age with dignity and comfort.