Worried about a loved one in a nursing home? What to do and who to call

What are the signs of nursing home neglect or abuse?

You know your mother or your dad better than any chart does. If something feels wrong, it deserves a look. Not every fall or bruise means someone did wrong, and older bodies can decline even with good care. But these signs are worth asking about.

• Pressure sores, also called bedsores. A resident should not develop them unless their condition made them unavoidable.
• Repeated falls, or a fall nobody can explain. Each resident should have the supervision and devices needed to prevent accidents.
• Sudden weight loss, dehydration, or soiled clothes and bedding.
• Unexplained bruises, broken bones or new fear of a certain staff member.
• Medications missed, doubled or suddenly changed to make someone quiet.
• Call lights that go unanswered, or a staff that is always short.
• Missing money, jewelry, or sudden changes to bank accounts.

What should I do if I think my parent is being neglected at a nursing home?

1. If there is danger or a crime, call 911. If a medical need is urgent, ask for transfer to a hospital.
2. Take photos of any wounds or conditions, with dates, if your loved one agrees.
3. Write down what you saw, who you spoke to, and the time.
4. Speak to the director of nursing or administrator in writing. Ask what the care plan says and what will change.
5. File a complaint with your state survey agency. You can do this even if you are not the legal guardian.
6. Call the long-term care ombudsman, a free advocate for residents.
7. Ask for the chart and any incident reports in writing. Do this before you move your loved one if you can.
8. Talk to a lawyer who handles nursing home claims if there was serious harm or a death.

Who do I call to report a nursing home?

These offices do different jobs, and you can contact more than one. Residents have the right to complain without being punished for it.

An ombudsman acts only with the consent of the resident or their representative. A state complaint is different. It can lead to an inspection, but it will not pay your family for any harm, and it does not pause any legal deadline.

How can I see a nursing home's inspection reports?

Start with Medicare's Care Compare website. It gives each home an overall star rating, plus separate ratings for health inspections, staffing and quality measures. Stars are a summary, so read the details underneath.

A resident has the right to examine the most recent state or federal survey and any plan of correction. You can also ask the facility or the ombudsman for a copy of the full survey or the last complaint investigation. Look for the same problem coming up in report after report.

Note that these federal rules cover homes that take Medicare or Medicaid. Assisted living and memory care homes follow state rules instead, so ask your state agency what applies.

What records should a family save, and how fast do they disappear?

The chart must be kept for the period state law requires, or five years after discharge if state law is silent. Arizona requires six years for nursing care institutions. But the things that often matter most are not in the chart.

A resident can see their records within 24 hours, excluding weekends and holidays, and get copies with 2 working days notice. If you hold a health care power of attorney or are the legal representative, bring proof. If your loved one has passed, the person handling the estate can usually make this request.

Did we sign away the right to sue? Arbitration agreements in nursing homes

Many families sign a stack of papers on admission day, often in a hard moment. One may be an arbitration agreement, which sends disputes to a private decision-maker instead of a jury.

Federal rules say a home that takes Medicare or Medicaid cannot require this as a condition of admission or continued care, and the resident can cancel within 30 calendar days of signing. Look through the admission packet now. If it is within 30 days, consider canceling in writing.

An older signed agreement may still be enforced. Texas law requires a strong boldface warning on these agreements, but the Texas Supreme Court ruled in a nursing home case that an insurance law exception did not protect that rule from the federal arbitration law.

In Arizona, a court held that the family's wrongful death claims were not covered by the resident's agreements. These issues depend on the exact paper and who signed it, so have a lawyer read it.

Who pays in a nursing home case, and what can it cover?

Usually the facility's liability insurer pays. Many homes are owned by companies with several layers of ownership, so a lawyer will ask who ran and funded the home.

A claim can cover medical care caused by the neglect, a move to a safer home, and pain and suffering. If your loved one has died, a wrongful death or survival claim may apply. Money is rarely the reason families come forward, but these costs are real.

Medicare must be repaid from any settlement for care it paid for because of the injury. Medicaid may also seek repayment. Ask for these amounts before you agree to any offer. If it is a state or county home, a much shorter notice deadline can apply: 180 days in Arizona and six months in Texas.

How do nursing home claims differ in Arizona and Texas?

What mistakes do families make, and how can you avoid them?

• Waiting for the facility to finish its own review before calling anyone.
• Moving your loved one and leaving without copies of the chart.
• Assuming you lost your rights because you signed admission papers.
• Thinking a state complaint protects your legal deadline. It does not.
• Blaming yourself. You trusted people who were supposed to care for your family.

If this has happened to your family, you did not cause it. You can take these steps one at a time, and you do not need to have every answer before you ask for help.

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