The 5 Common Traits of Terrible Nursing Homes

Moving a loved one into a nursing home is one of the most difficult decisions for a family to make. This choice can be even more stressful when families have to worry about inadequate care or nursing home abuse. Unfortunately, these problems are all too common. In fact, a 2000 study by the U.S. House of Representatives found that elderly abuse occurred at 1 in 3 nursing homes. According to the 2014 Nursing Home Report Card, nearly 90 percent of all nursing homes were cited for violating state or federal laws.

When assisted living facilities and nursing home owners put profits head of people, the consequences can be serious or even fatal. Knowing the signs of nursing home abuse and neglect can help prevent these tragedies and protect your aging loved one. So, what should you look out for? Here are 5 common traits shared by the worst nursing homes in America.

1.) Physical and behavioral signs of abuse or neglect.

Do residents show signs of frequent and unexplainable injuries such as broken bones, burns, cuts, or bruises? Is clothing or bedding often bloody or stained? Although obvious evidence of physical abuse is very rare, the evidence of neglect is more rampant. This type of evidence includes bedsores, complaints of blisters or aberrations, poor hygiene, weakness, inexplicable weight loss, constant thirst or dry skin (from dehydration), soiled bedding, rooms that are too hot or too cold, and sporadic or excessive medication. Furthermore, if a resident has sudden personality changes, exhibits clinginess or a fear of being left alone, or is often withdrawn and depressed, neglect and/or abuse may be occurring at his or her facility.

2.) Insufficient staffing and high staff turnover.

Although many families look at the lobby or cafeteria when choosing a nursing home, the biggest factor for determining quality of care is often the staffing levels. The best nursing homes have the best staff to resident ratios. Substandard nursing homes will try to cut costs by hiring fewer employees and nurses than they really need. This means that residents receive inadequate attention and human interaction. Furthermore, nursing homes with a high staff turnover rate fail to create an environment where residents and staff get to build relationships.

 3.) The residents lack independence.

The well-being of residents increases if they are able to make their own decisions and have greater freedom. For example, if residents are able to decorate their rooms as they wish, they will be happier. Conversely, if residents are subject to strict rules and overbearing supervision, such as an enforced curfew, they will be less happy.

 4.) A history of violations.

Frequently being cited for deficiencies indicates that the ownership of a nursing home is probably more interested in making money than in providing the best care and lifestyle possible for residents. Nowadays it’s relatively easy to find out which nursing homes have a history of violations. offers a website where people can view the ratings of different nursing homes. The ratings are based on factors such as staffing and inspections, and full reports regarding each nursing home are available. US News’s Best Nursing Homes 2014 offers a similar search engine, as does The National Long-Term Care Ombudsman Resource Center. The Centers for Medicare & Medicaid Services (CMS) manages a Special Focus Facility list which names the worst nursing homes in the country. While looking at the history of a nursing home, however, it is important to keep in mind the severity of each infraction. For example, if a nursing home has only been cited once, but the violation was very severe, then that nursing home may be less desirable than one with many less-serious violations.

5.) For-profit nursing homes.

For-profit nursing homes are consistently proven to be worse than not-for-profit facilities. In 2009, a Government Accountability Office study found that about 55 percent of poorly performing nursing homes were for-profit and chain affiliated. Another study carried out by Physicians for a National Health Program concluded that not-for-profit nursing homes had better staffing. The same study found that bedsores were more prevalent at for-profit facilities. When nursing home ownership is concerned principally with making money, they cut corners to the detriment of residents and their loved ones. Unfortunately, the results can be heartbreaking.

Sokolove Law Team

Contributing Authors

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Last modified: December 28, 2016