Red Flags to Watch for in Nursing Homes (And What Legal Action You Can Take)

Choosing a nursing home for an aging loved one is one of the most difficult decisions a family can make. You trust the facility to provide care, safety, and dignity during one of the most vulnerable stages of life. But unfortunately, elder abuse and neglect remain far too common across the United States. According to the World Health Organization, 2 in 3 staff members in long-term care facilities reported that they had committed abuse in the past year—a statistic that’s both alarming and unacceptable.

Whether you’re visiting frequently or only occasionally, it’s critical to be vigilant and know the warning signs that something might be wrong. Below are the most common red flags to watch for in nursing homes—along with the legal steps you can take if abuse or neglect is suspected.

1. Unexplained Injuries or Bruises

One of the most immediate red flags is the presence of unexplained injuries—such as bruises, cuts, sprains, or fractures. While some accidents are inevitable, a pattern of frequent or unreported injuries could indicate neglect or even physical abuse.

Tip: Ask staff to document and explain any injuries. If their explanation is vague or inconsistent, investigate further. Keep records and take photographs when possible.

2. Sudden Behavioral Changes

Emotional or psychological abuse may not leave visible marks, but its impact can be just as damaging. Signs of mental distress—like withdrawal, anxiety, depression, or agitation—should not be ignored. If your loved one becomes unusually fearful around certain staff members, this may point to emotional mistreatment.

The National Institute on Aging recommends paying close attention to changes in demeanor and speaking privately with residents when possible.

3. Poor Hygiene or Unsanitary Conditions

A clean, well-maintained environment is non-negotiable in any healthcare setting. If residents appear unwashed, if bedding is soiled, or if bathrooms are consistently dirty, this could signal systemic neglect or understaffing.

During your visits, observe how staff handle personal care routines. Are they rushed? Are they attentive? Do they treat residents with respect?

4. Medication Mismanagement

Missed doses, overdosing, or changes in medication without physician approval are all serious concerns. Overmedication (especially with sedatives or antipsychotics) has been used in some facilities to suppress residents who are deemed “difficult,” a practice sometimes referred to as chemical restraint.

According to Human Rights Watch, nearly 180,000 nursing home residents in the U.S. receive antipsychotic medications each week even though they don’t have diagnoses that warrant them.

5. Staff Shortages and High Turnover

A consistently short-staffed facility can lead to resident neglect, even if the staff isn’t intentionally abusive. Overworked caregivers are more prone to errors and may not be able to provide the level of attention each resident needs. High turnover can also disrupt continuity of care and may signal poor management.

Check Medicare’s Care Compare website to review staffing levels and facility performance before selecting a home or when evaluating ongoing concerns.

6. Residents’ Fear or Reluctance to Speak

If your loved one seems hesitant to speak openly, especially in front of staff, this may indicate fear of retaliation. In some cases, abuse victims may feel ashamed, confused, or scared to report what’s happening. Make time for private conversations and listen without judgment.

What Legal Actions Can You Take?

If you suspect neglect or abuse in a nursing home, you have legal options to protect your loved one and hold the facility accountable.

1. File a Formal Complaint

Start by filing a complaint with your state’s licensing or long-term care ombudsman office. You can find your local ombudsman through the National Long-Term Care Ombudsman Resource Center.

2. Request an Investigation

The state’s Department of Health or regulatory authority can investigate potential violations, including safety breaches or staff misconduct. If urgent, you can contact Adult Protective Services or even local law enforcement.

3. Consult an Attorney

Legal action may be necessary in cases of serious harm, neglect, or wrongful death. A qualified elder law or personal injury attorney can help you gather evidence, pursue compensation, and ensure the facility faces appropriate consequences.

At the end of the day, your loved one has the right to live in safety and dignity. The law is on your side—don’t hesitate to use it.

A Final Word

Being proactive and observant can make all the difference in protecting your loved one from harm. While many nursing homes provide quality care, the sad reality is that abuse and neglect still occur more often than we’d like to believe. Know the signs. Ask questions. And if something doesn’t feel right—trust your instincts.

If you suspect abuse or neglect, consulting a nursing home abuse lawyer in Georgia can provide the legal clarity and support you need to take action.