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Fear of Retaliation: The Realities for Nursing Home Residents

Why do so many accounts of nursing home abuse go unreported or unresolved? A recent survey report by the Long Term Care Community Coalition (LTCCC), a nonprofit dedicated to improving care for nursing home residents, sheds some light on the answer.

In the report, the LTCCC surveyed complaints against 100 nursing homes throughout the U.S. in an attempt to determine why nursing home residents who experience abuse often don’t report it.

The report found that 240 residents were retaliated against after reporting nursing home abuse, and many more went unreported out of fear of coming forward. These results are shocking, but LTCCC hopes advocates, caregivers, and government officials will use the report to improve the dire conditions in too many homes.

Do you believe a loved one has suffered from nursing home abuse? They do not have to suffer in silence. Learn how we can help with a free case review.

Understanding the LTCCC Report

The LTCCC report, which was published in June 2023, included the results of complaints filed over a 5-year time period.

The reviewed complaints were from facilities located in 30 states, including:

Here are some key findings of the LTCCC report:

  • Firsthand accounts of abuse in nursing home facilities
  • Potential risk factors that contributed to abuse, such as lack of facility staff and underpaid staff
  • Reasons why residents are often scared to voice concerns or report abuse

The coalition called these findings “groundbreaking” for igniting change for residents.

What Is Retaliation?

Retaliation in nursing homes occurs when staff continue to harm or neglect a resident after they reported concerns.

In the investigation, the LTCCC researchers found evidence throughout facilities of four levels of retaliation: fear of consequences, threats, perceived verbal abuse and neglect, and actual abuse. Every one of the complaints investigated mentioned a resident’s fear of consequences.

Consequences of reporting abuse could be emotional or physical and often infringe on residents’ rights. The continuous fear of consequences is a barrier for residents when they consider whether to voice their concerns about the care they are receiving.

Throughout the report, nursing home residents shared the following experiences.

Dismissed or Delayed Complaints

Over and over, residents surveyed said that they had reported abuse or mistreatment but that their complaints were dismissed, not addressed, or “swept under the rug.”

Fear of Physical Abuse

Many residents reported fear of additional physical abuse from staff. One man in an Illinois nursing home was physically assaulted in his room, and another had a cup of ice water thrown on his head. Others reported being kicked, slapped, punched, and hit in the face.

Fear of Financial Abuse

A number of the residents surveyed experienced fear of or actual financial abuse. One resident in an Illinois nursing home reported credit card theft, but staff falsely told police investigating the theft that she had a daughter and was cognitively impaired.

Feelings of Anxiety

Almost all nursing home residents felt fear or anxiety, saying they “don’t know what they would do” to being “extremely fearful” of reporting any abuse or mistreatment because of staff members who “make you pay.”

Medical Neglect

Many residents were neglected. For example, two residents in a California facility reported they were left in their beds for hours due to staffing shortage issues, leading to bedsores for one of the residents.


Many residents detailed how they were threatened by nursing home staff members to “keep your mouth shut.”

Retaliation After Reporting Sexual Abuse

Several residents experienced sexual abuse in the nursing home and feared reporting it due to retaliation or did report it and experienced consequences afterward.

What Changes Need to Be Made for Nursing Home Reform?

Many changes must be made to address the fear of retaliation in skilled nursing facilities. From actual physical violence to the debilitating mental health effects of the fear of abuse and retaliation, nursing home residents deserve better.

Some ways the LTCCC recommends working toward reform include:

  1. Recognizing fear of retaliation as a reporting barrier. Currently, people that advocate for better-quality care for nursing home residents, such as ombudsmen, focus only on actual retaliation and how it affects residents — not the fear of it.
  2. Expanding federal funding for nursing homes. Federal funding for nursing homes has remained stagnant for years, leaving facilities unable to retain skilled staff because of poor wages.
  3. Improving investigation timelines. State surveyors meant to hold nursing homes accountable for reports of abuse have been overworked and underfunded, causing tremendous backlogs in cases. Many reports are not investigated until a year or more after the initial report is received, forcing residents to endure dangerous conditions.

You can also get involved in advocating for nursing home residents across the nation. Whether by writing your local and state representatives or by watching carefully for signs of abuse, all of us can make a difference for those who need it most.

Find Help for Nursing Home Abuse

Sadly this recent LTCCC reveals that too many residents who report abuse are still neglected or even retaliated against. If your loved one is one of the many nursing home residents experiencing abuse or neglect nationwide, they do not have to suffer in silence.

A nursing home abuse lawyer may be able to help you and your loved one get the justice you need — and the quality of care they deserve. A lawyer can work alongside you to build a case and take legal action against the facility and staff members responsible for the abuse.

Nursing Home Abuse Center may be able to help you find an experienced nursing home abuse law firm near you. Don’t wait — reach out today at (855) 264-6310 or get started with a free case review.

Nursing Home Abuse Support Team

The Nursing Home Abuse Center (NHAC) was founded to bring justice to those affected by nursing home and elder abuse. Our mission is to educate and empower victims of abuse and their families to take a stand against this unlawful mistreatment. We work to return dignity back to those who have been broken down by nursing home abuse and neglect.

  1. Long Term Care Community Coalition (2023 June). “‘They Make You Pay.’ How Fear of Retaliation Silences Residents in America’s Nursing Homes.” Retrieved from Accessed on August 4, 2023.
  2. USA Today (16 June 2023). “Why aren’t nursing home residents reporting abuse? Fear of retaliation, study finds.” Retrieved from Accessed on August 4, 2023.