California Nursing Home Abuse and Neglect Law

California nursing home abuse

Nursing home care should be just that — caring. But sometimes elder care isn’t what it seems.

For many people, spending time in a nursing home is an inevitability. Sometimes moving a loved one into some kind of long-term care facility is essential for their well-being. If you’re caring for a family member in long-term care, do you know how to spot signs of abuse and neglect? Here’s what to look for, and what your options are in California.

Are you part of the “sandwich generation”? They’re the ones caught between raising their own growing families and managing care for aging parents.

Whether that sounds like you or not, you might be in a position to be considering nursing home care for an older loved one, or perhaps you’re concerned about the quality of care your older loved one is currently receiving at a nursing home or senior care facility.

Not everyone who lives or spends time in a nursing home is elderly, though. Long-term care is necessary for someone with a chronic condition, trauma, or illness that limits their ability to manage daily needs. There are a variety of ways someone could receive long-term care, including:

  • Adult day services
  • Home health care
  • Hospice
  • Homemaker services
  • Home telehealth
  • Continuing care retirement community
  • Supportive housing programs
  • Assisted living facilities
  • Family caregiving
Facing factsThe Centers for Disease Control and Prevention (CDC) reports that there were 1,600 nursing homes in the U.S. as of 2016. Within them, there were 1.7 million licensed beds.

Nursing home and elder care statistics

  • The CDC estimates that about 13% of people (1 in 8) age 85 or older live in a nursing home or long-term care facility, as compared to 1% of people age 65 to 74. As of the CDC’s most recent report, about 1.4 million people across the country were living in nursing homes.
  • 52% of people age 65 or older will require long-term care at some point in their lives. An estimated 47% of men and 58% of women age 65+ will require long-term care.
  • Senior men require long-term care for an average of 1.5 years, whereas women average around 2.5 years of care.
  • 14% of people need long-term care for longer than 5 years.
  • 8% of people between the age of 40 and 50 have a disability that requires them to obtain long-term care services.
  • It’s estimated that only 7% of elder abuse cases are reported to authorities.

Nursing home occupancy rates in California

California is home to about 1,250 licensed long-term care nursing facilities that house 400,000 people. The nursing facility occupancy rate in California is 87%.

The state of California licenses assisted living facilities and Residential Care Facilities for the Elderly (RCFEs). These facilities are inspected every 5 years and most residents stay an average of 28 months.

With life expectancies increasing every decade, it’s no wonder that more and more people need to live in a nursing home at some time. If you’re managing care for a loved one, there are things you can keep an eye on at their nursing home or other facility in order to make sure they’re being well cared for.

What is nursing home abuse?

Nursing home abuse can exist in a variety of ways, and it’s not always obvious when it’s happening.

Nursing home abuse includes:

  1. Physical abuse, or any event or condition that causes physical injury or harm. It could be intentional, like aggressive handling. It can also be from neglect, such as a lack of physical care or overuse of restraints.
  2. Sexual abuse is unwanted sexual attention or exploitation. It also involves issues of consent. A patient who experiences dementia, Alzheimer’s Disease, or other cognitive deficit that leaves them unable to know what’s happening or express their wishes is incapable of providing consent.
  3. Neglect can be unintentional. Often, it happens when a facility is inadequately staffed to appropriately care for residents’ needs. Neglect includes failing to provide personal hygiene, food, clothing, or water.
  4. Financial exploitation is when a caregiver takes advantage of a patient’s financial situation. This can mean stealing a resident’s personal property, but it could also be theft from a bank account, using the patient’s personal information to apply for credit, or other types of identity theft for personal gain.
  5. Psychological or emotional abuse can be the most difficult to detect. A caregiver might yell, criticize, shame, or humiliate a patient in a way that causes anxiety, upset, or behavior changes.
  6. Resident-to-resident abuse happens, too. Not all abuse is at the hands of a caregiver. This is usually physical, psychological, or sexual. It’s the caregiver’s responsibility to keep every patient safe and free from harm by other individuals, no matter who they are.

Signs of nursing home abuse

Lots of people make the difficult choice to move a loved one to a nursing home because they simply can’t take on or keep up the responsibility of day-to-day care themselves. But even if you’re not responsible for the daily care of an older friend or family member, there are things you can watch for — even from afar — to ensure their nursing home care is appropriate.

Here are some of the signs of nursing home abuse.

Physical abuse
  • Visible bruises, scars, or welts
  • Unexplained broken bones, sprains, or dislocations
  • Broken eyeglasses
  • Rope marks on wrists, ankles, or other signs of restraint
  • Failure to take medication properly
  • Refusal of caregiver to allow you to be alone with your loved one
Sexual abuse
  • Vaginal or anal bleeding that’s not related to a preexisting medical condition
  • Stained, bloody, or torn undergarments
  • STDs or other genital infections
  • Bruising or other marks near genitals or breasts
  • Your loved one is left alone in public (outside the facility or residence)
  • Unusual weight loss or signs of dehydration
  • Bedsores
  • Unsafe living conditions like lack of heat or air conditioning, fire hazards, or unclean water
  • Being dressed inappropriately for the temperature or weather conditions
  • Unclean appearance
  • Soiled bed linens, dirty clothes, bugs, or other unclean or unsanitary conditions
Emotional abuse
  • Symptoms of dementia, like sucking their thumb, mumbling, rocking, or other behaviors that are unusual for that individual
  • Your loved one is unable to leave the facility, make phone calls, send mail, or have visitors
Financial abuse
  • Sudden changes in financial status, like withdrawals from your loved one’s bank account or an ATM
  • Receipts for goods, services, or subscriptions your loved one hasn’t purchased
  • Changes to power of attorney, insurance policy beneficiaries, property titles, or wills
  • Missing cash
  • Added signatures for their credit card or other financial documents
  • Lack of medical care, even though your loved one can afford it


Enjuris tip: Sometimes, financial abuse can come in the form of healthcare fraud. It could be a factor if you suspect that your family member is:

  • Receiving too much or too little medication
  • Receiving poor care when services have been paid for in full
  • Receiving duplicate bills for the same services, medications, or assistive devices
Insufficient staff or staff that lacks adequate training can also be signs of fraud.

How to prevent nursing home abuse

You can’t be there every day.
You live far away.
Your loved one has a hard time communicating.

These are all reasons why it’s hard to know what’s happening inside the doors of a nursing home. And they’re all understandable. A lot of people feel guilty or stressed about putting a family member in a nursing home, but you shouldn’t. The vast majority of people in nursing homes are well-cared for, content, and as healthy as possible.

However, elder abuse and neglect is a problem in nursing homes in California and nationwide.

There are a few ways you can reduce the likelihood that your loved one will be a victim of nursing home abuse:

  1. Appoint a guardian. If you’re unable to visit regularly, contact a volunteer agency to see if you can find a helper who can visit your loved one regularly. A person who has family or friends “drop in” is less likely to suffer abuse.
Enjuris tip: In Southern California, you can contact the Friendly Visitor program to find a visitor for your family member. Other resources include: Council on the Aging, San Diego County Health & Human Services volunteer program, California Department of Aging, and Elder Helpers.
  1. Review financial statements. If your loved one isn’t able to manage their own financial details, be sure that you or another trusted family member are regularly reviewing their financial statements. Even a fast monthly or quarterly skim of bank accounts, credit card bills, and legal documents is enough to check for any unusual transactions or changes.
  2. Unannounced visits. If you’re able to visit, do so without the facility knowing ahead of time that you’re coming. They can’t require you to call ahead, though it’s reasonable to expect that you’d come during daytime or evening hours and not when residents are likely to be sleeping. It’s your family member — you have a right to visit whenever you want. If your family member has specific caregivers on certain shifts, get to know those people. A caregiver will feel more accountability when you know them by name and see their interactions or relationship with the person in their care.

What to do if you suspect nursing home abuse in California

California law includes the Elder Abuse and Dependent Adult Civil Protection Act (EADACPA). This law is intended to deter neglect and abuse of vulnerable adults. It allows for a nursing home resident or other dependent adults to recover money damages if they’ve been a victim of elder abuse.

Enjuris tip: Document everything! If you suspect that a loved one is being abused or neglected, write down everything that seems relevant, no matter how small.

Keep a list of dates and observations. If you see a strange bruise, your family member says something unusual, or the number of pills in their possession seems a little off, make a note of it. This could be your best evidence if you need to pursue the matter further.

The dependent adult can file a lawsuit themselves if they have the ability to do so. If the person is deceased, the estate or interested family members might have the right to sue for injuries the person suffered before their death, along with punitive damages. If the neglect or abuse was the cause of the person’s death, the family member might be able to file a wrongful death claim.

The California Ombudsman Program is under the California Welfare & Institutions Code § 9700. This program investigates and attempts to resolve any complaints of a senior or dependent adult in a long-term care facility.

If you suspect abuse or neglect in a California nursing home, you can locate your local Ombudsman’s office by calling 1-800-231-4024. You may also contact the California Attorney General’s Elder and Dependent Adult Abuse Reporting Hotline at 1-888-436-3600.

Contact a California personal injury lawyer

If you’ve determined that abuse has occurred or is occurring, a personal injury lawyer will help you work with the appropriate state agencies to protect your loved one and to file an injury claim.

It’s common for an older adult to slip and fall, be forgetful, or bruise more easily than you might. That’s why it can be difficult to detect abuse — you might see concerning things and they could just be part of the natural aging process.

But if unusual things happen often or regularly, or they seem out of the ordinary, don’t hesitate to insist that your loved one visit their doctor for a thorough examination to rule out other health issues.

If you still believe that abuse or neglect could be happening, we invite you to use the Enjuris lawyer directory to find a California personal injury lawyer. Your lawyer will guide you through the legal process with compassion and skill to get the results you need for yourself and your family.


California Association of Health Facilities, Facts and Statistics
75 Must-Know Statistics About Long-Term Care, (2018)


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