Too often, that trust is broken. Chronic understaffing, poor training, and corporate cost-cutting can leave residents without the basic care they need. The result isn’t just “poor service”, it can mean pressure ulcers, preventable falls, infections, serious deterioration, or wrongful death.

If something about your loved one’s care feels wrong, you’re not “being difficult.” You may be seeing warning signs of neglect. Recognizing those signs early and knowing what to do next, can protect your family member and preserve critical evidence for a legal claim.

This guide explains:

• What nursing home neglect is
• 15 key warning signs you should watch for
• How to document and report concerns
• Your loved one’s legal rights
• How McEldrew Purtell investigates and proves neglect cases

What Is Nursing Home Neglect?

Nursing home neglect happens when a facility or its staff fail to provide the basic care, supervision, or services necessary to keep a resident safe and healthy.

Neglect usually involves omissions, not outright violence. Things like:

• Not turning or repositioning a bedbound resident
• Missing important medication doses
• Ignoring changes in a resident’s condition
• Leaving a resident in soiled clothing for hours

Even if no one intended to hurt your loved one, the facility can still be responsible for the harm caused by neglect.

Neglect vs. Abuse

Both neglect and abuse are serious and can happen at the same time.

• Neglect is usually:
  • Passive — staff fail to do what they should
  • Systemic — caused by understaffing, bad policies, or poor training
  • Gradual — harm builds over days, weeks, or months
• Abuse is usually:
  • Intentional — someone means to cause harm or fear
  • Individual — carried out by a specific staff member or resident
  • Immediate — bruises, fractures, or emotional trauma may appear quickly

You do not have to label what’s happening in legal terms before you act. If something feels unsafe or demeaning, it deserves attention.

Common Types of Nursing Home Neglect

Neglect can show up in different ways. Families often notice more than one type at the same time.

Medical Neglect

• Missed, late, or incorrect medications
• Ignored changes in condition (shortness of breath, confusion, pain, fever)
• Poor wound care for bedsores, surgical sites, or infections
• Failure to call a doctor or send a resident to the hospital when needed

Personal Care Neglect

• Infrequent bathing or hair care
• Residents left in wet or soiled briefs or clothing
• Long waits for help getting to the bathroom
• Failure to help residents move, turn, or transfer safely

Nutritional Neglect

• Noticeable weight loss or clothes suddenly hanging loose
• Dry mouth, cracked lips, or other signs of dehydration
• Meals placed out of reach with no help to eat
• Ignored dietary restrictions (diabetes, swallowing issues, etc.)

Emotional and Social Neglect

• Residents left alone in their rooms all day
• Staff speaking harshly, ignoring requests, or being visibly impatient
• No effort to involve residents in activities or social interaction

Environmental Neglect

• Strong odors of urine or feces
• Dirty linens or unchanged trash
• Broken equipment, poor lighting, or cluttered hallways
• Call bells or bed alarms that don’t work or are turned off

15 Warning Signs of Nursing Home Neglect

Any one of these can be a red flag. Multiple signs together are a serious warning that your loved one may not be safe.

Physical & Medical Red Flags

1. Bedsores or skin breakdown – Open wounds on heels, hips, the tailbone, or shoulders are often preventable with basic repositioning and skin care.
2. Unexplained bruises, cuts, or fractures – Especially when staff offer vague or changing explanations or “no one knows” what happened.
3. Frequent falls – Repeated falls can signal poor supervision, lack of assistance, or unsafe conditions.
4. Sudden weight loss – Clothing fits differently, bones appear more prominent, or you notice your loved one is eating very little.
5. Signs of dehydration – Dry mouth, cracked lips, confusion, dizziness, or dark, concentrated urine may mean your loved one isn’t getting enough fluids.
6. Poor hygiene – Dirty nails, matted hair, strong body odor, or consistent soiled clothing/bed linens.
7. Repeated infections or worsening health conditions – UTIs, pneumonia, or uncontrolled diabetes that seem to keep coming back.

Behavioral & Emotional Red Flags

1. Withdrawal or depression – Your previously social loved one seems flat, tearful, or uninterested in visits or activities.
2. Fear around certain staff or areas – They cling to you, beg you not to leave, or seem terrified when particular staff enter the room.
3. Sudden confusion or changes in alertness – A rapid mental status change that doesn’t match their diagnosis may point to medication issues, infection, or other neglect.
4. Sleep changes or extreme fatigue – They’re constantly exhausted, or they report being woken frequently at night without explanation.

Environmental & Operational Red Flags

1. Unanswered call lights and long waits for help – You see call bells flashing for long periods, or your loved one tells you it “takes forever” to get assistance.
2. Dirty, chaotic, or unsafe facility conditions – Strong odors, clutter, spills, or broken equipment in hallways or resident rooms.
3. Overwhelmed or constantly changing staff – Staff seem rushed, stressed, or unfamiliar with residents’ names and needs, and you notice high turnover.
4. Missing belongings or strange billing issues – Personal items disappear, or facility bills contain unexplained charges or sudden fee increases.

Trust your instincts. If you feel something is wrong, you’re not overreacting. It’s time to start documenting.

What To Do If You Suspect Nursing Home Neglect

1. Document Everything

Good documentation is critical for both safety and any future legal claim.

• Keep a written log of dates, times, and specific incidents
• Take photos of visible injuries, unsafe conditions, or poor hygiene
• Save bills, letters, and emails from the facility
• Record who you spoke with (name, title) and what they said

2. Raise Concerns in Writing

Start by putting the facility on notice:

• Speak to the charge nurse or unit manager
• Escalate to the Director of Nursing and Administrator
• Follow up with a written complaint and ask for a written response

Even if you don’t expect the facility to fix the problem, this creates an important paper trail.

3. Involve Outside Agencies When Needed

If the facility doesn’t respond or your loved one remains unsafe, you can escalate further:

• Your state’s Long-Term Care Ombudsman
• The state health department or licensing agency
• Adult Protective Services (APS)
• Local law enforcement for serious injury, assault, or suspected criminal conduct

These agencies can investigate, issue citations, or refer matters for enforcement.

4. Seek Emergency Medical Care

If your loved one appears seriously ill or injured, do not wait for the facility to act. Call 911 or insist on immediate transfer to a hospital.

Your Loved One’s Legal Rights

Residents of Medicare- or Medicaid-certified nursing homes have rights under federal and state law, including:

• The right to receive necessary care and services
• The right to be treated with dignity and respect
• The right to be free from abuse and neglect
• The right to participate in decisions about care
• The right to have complaints heard without retaliation

When a facility violates these rights and a resident is hurt, families may have claims for:

• Negligence (failure to meet the standard of care)
• Violation of resident rights
• Corporate negligence (unsafe policies, chronic understaffing, cost-cutting)
• Wrongful death, if neglect leads to a resident’s death

Each state has strict deadlines (statutes of limitation) for filing claims. Waiting too long can permanently bar you from recovering damages, no matter how strong your case is.

How McEldrew Purtell Investigates Nursing Home Neglect

At McEldrew Purtell, our focus is on catastrophic injury and wrongful death, including cases arising from nursing home neglect and abuse.

When families come to us with concerns, our team:

• Reviews medical records and facility charts – We look for missed medications, late interventions, falsified notes, and inconsistencies.
• Analyzes staffing and corporate policies – Chronic understaffing, high turnover, and “profit-first” policies are often at the heart of neglect cases.
• Consults with medical and nursing experts – Independent experts help us determine how the care should have been delivered and where the facility fell short.
• Preserves evidence early – We send preservation demands to prevent the destruction of records, surveillance footage, and electronic data.
• Builds a clear, compelling timeline – For judges, juries, and insurers, we demonstrate how neglect unfolded and how it caused injury or death.

Our goal is two-fold: accountability for what happened to your loved one, and changes that make the facility safer for other families.

Choosing a Safer Nursing Home

If you’re evaluating facilities or considering moving your loved one, you can:

• Use tools like Medicare’s Care Compare website to review staffing, inspection history, and quality measures for nursing homes.
• Visit more than once, including evenings and weekends
• Watch how staff interact with residents when they don’t know you’re looking
• Ask direct questions about staffing ratios, turnover, training, and how the facility responds to falls, infections, or complaints

No facility is perfect, but you should not see patterns of poor hygiene, obvious understaffing, or residents calling out for help with no response.

Frequently Asked Questions

How do I know if my loved one is experiencing neglect versus “normal aging”?

Aging and illness can cause natural decline, but sudden changes such as rapid weight loss, new bedsores, repeated falls, or dramatic shifts in mood or behavior are not “just part of getting older.” When in doubt, have your loved one evaluated by an independent medical provider and speak with a lawyer familiar with nursing home cases.

Can we move our loved one and still pursue a claim?

Yes. In many situations, moving your loved one is the safest choice, and it does not prevent you from bringing a claim for past neglect or abuse. If possible, consult an attorney before the move so key records and evidence can be preserved.

What if the facility says we signed an arbitration agreement?

Many nursing homes include arbitration clauses in admission paperwork. These agreements are not always enforceable, and even when they are, you may still have strong legal options. Do not assume you have no case until an attorney reviews the documents.

How long do we have to take legal action?

The answer depends on your state and the type of claim (injury vs. wrongful death). Some deadlines are as short as one to two years. Because evidence can disappear quickly, it’s important to speak with an attorney as soon as you suspect neglect.

Talk to a Nursing Home Neglect Attorney

If you’re seeing warning signs of nursing home neglect, you don’t have to handle this alone and you don’t have to “wait and see” while your loved one suffers.

McEldrew Purtell’s attorneys investigate serious nursing home neglect and wrongful death cases, and we understand how painful it is to discover that a trusted facility failed your family.

• Free, confidential consultation
• No fee unless we recover compensation for you
• Representation in catastrophic injury and wrongful death cases involving nursing homes and other long-term care facilities

Call (215) 545-8800 or contact McEldrew Purtell online today to discuss your potential nursing home neglect case and learn how we can help protect your loved one and your family.