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Nursing Home Abuse in California

California’s Elder Residents

In 2016, California had 39,250,017 residents and 19.2% of those residents (or approximately 7,519,886) were over the age of 60. Currently, California has the highest population of people over the age of 60 in the United States. The densest populations of people over the age of 60 reside in Mono County and Placer County. The largest population of nursing home residents is around Santa Monica (Southwest California) and San Jose (West Central California).

What is Nursing Home Abuse?

Nursing home abuse is abuse that takes place at a nursing facility. There are many types of abuse and can be carried out by staff or other residents. The most common types of abuse at nursing homes include physical, sexual, emotional, healthcare abuse and fraud.

  • Physical abuse is when someone inflicts physical pain or injury on another.
  • Sexual abuse includes touching, fondling, intercourse or any other sexual activity when the older adult is unable to consent or understand, physically forced or threatened.
  • Emotional abuse consists of threats of abuse, intimidation, harassment or verbal assault.
  • Healthcare abuse may consist of neglect or deprivation. Neglect is when there is a failure to provide necessities like food, clothing or medical care. Deprivation is when a staff member denies a person of food, medicine, therapy, medical care or assistance.
  • Financial abuse usually occurs when there is a misuse or withholding of a person’s financial resources.

Nursing home abuse frequently happens at the same facilities. For example, a study performed from 2000-2002 found that in California, 71 percent of reports of nursing home abuse occurred in approximately 23 percent of nursing home facilities.

How to Identify Nursing Home Abuse

Family members are the most crucial in identifying nursing home abuse. The best way to identify nursing home abuse is to spend time with your loved one. The more time you spend with your loved one, the easier it will be to spot nursing home abuse.

Physical Signs of Nursing Home Abuse:

  • Bruises or unseen injuries that are painful to the touch
  • Sudden weight loss
  • Dehydration
  • Malnutrition
  • Skin damage (cuts or bed sores)

Behavioral Signs of Nursing Home Abuse:

  • Fear
  • Depression
  • Confusion, anxiety
  • Withdrawal
  • Hesitation to speak openly
  • Unresponsiveness
  • Anger

Staff may give signs of nursing home abuse when they are easily angered by a resident, don’t allow someone to speak for themselves, have conflicting stories of an incident or restrict a resident from participating in activities.

Types of Elder Abuse in California

Criminal Elder Abuse

Elder abuse as a crime can have a range of punishments depending on the age of the abused and the severity of the abuse. Punishment for elder abuse can include fines and imprisonment.

According to California Penal Code Section 368: Any person who knows or reasonably should know that a person is an elder or dependent adult and who, under circumstances or conditions likely to produce great bodily harm or death, willfully causes or permits any elder or dependent adult to suffer, or inflicts thereon unjustifiable physical pain or mental suffering, or having the care or custody of any elder or dependent adult, willfully causes or permits the person or health of the elder or dependent adult to be injured, or willfully causes or permits the elder or dependent adult to be placed in a situation in which his or her person or health is endangered, is punishable by imprisonment in a county jail not exceeding one year, or by a fine not to exceed six thousand dollars ($6,000), or by both that fine and imprisonment, or by imprisonment in the state prison for two, three, or four years.

Bottom line, if you are caring for someone who is elderly and you make the choice to abuse that person or neglect their needs you will face criminal charges.

Civil Elder Abuse

Under the California Welfare and Institutions Code Section 15610, there are definitions that govern if the law has been broken. You may want to refer to this code and its definitions if you feel like your loved one is a victim of nursing home abuse.

How to Report Nursing Home Abuse in California

If a loved one is in immediate harm at a nursing home call 911. If the abuse does not require immediate attention report the incident to police by calling your local non-emergency number.

California has Adult Protective Services (APS) in every county. These agencies investigate accusations of abuse, neglect or exploitation. APS also works to educate about the requirements of reporting and are responsible for cross-reporting to law enforcement and other public agencies.

To find your local APS click here. {@chris – not sure if we should include this}

Another option is to report nursing home abuse to the California Department of Aging Long-Term Care Ombudsman. This program is a community supported volunteer-based program and its services are free and confidential. You may contact this organization if you have questions or concerns regarding the quality of care, suspicion of abuse (physical, mental, sexual or financial), witnessing or to request an Ombudsman attend a meeting.

The State CRISIS line is open 24 hours a day, 7 days a week and can be reached by calling 1-800-231-4024.

How Does the State of California Treat Nursing Home Abuse?

California takes nursing home abuse very seriously. They have three programs designed to bring accountability to anyone who abuses the elderly.

  • Violent Crimes Unit: Prosecutes crimes against the elderly in nursing facilities such as rape, murder, false imprisonment and assault and battery.
  • Facilities Enforcement Team: Investigates and prosecutes nursing homes, hospitals, and residential care facilities that adopt or promote policies and practices that lead to neglect or below standard care like providing enough staffing, preventing malnutrition or dehydration, or falsifying charts.
  • Operation Guardians: Works to identify, investigate and prosecute instances of abuse or neglect in any of the approximately 1300 skilled nursing facilities.
  • California Department of Public Health (CDPH), Licensing and Certification Division (L&C) and the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) regulates California’s nursing homes. They work together to conduct on-site inspections, respond to complaints and events, and ensure that payments meet federal requirements.

Under California law, abuse of the elderly is both a civil and criminal offense. If found guilty, nursing home abuse cases can result in fines and imprisonment.

How Nursing Home Abuse Can Be Litigated

In 1987 Congress passed OBRA which was landmark legislation created to address standards in nursing home care. The key part of this legislation stated that a person’s condition should not worsen by being placed in nursing home care.


Assessment is the key to a resident’s care in a nursing home. If a person is not properly assessed when they first enter the nursing home all future care is compromised. The most common assessment tool is the minimum data set or MDS. Once the MDS is completed it can be used to create the resident assessment protocol or RAP sheet. The RAP sheet should list all of a patient’s medical conditions that require planning.


The second step in patient care is planning. Once the assessment is complete it is the responsibility of the nursing home to complete a plan to meet all of the patient’sƒ’ medical needs. This plan should never be general and should always be specific to the individual needs of each patient. Interventions are the key to any good plan. Interventions are ways to prevent situations that could lead to injury or neglect.


Communication of the plan and execution of the plan are critical. If a great plan is in place but there is a failure in communication or execution the chance of neglect or abuse can increase drastically. If a plan is in place but is not working, then a reevaluation should be done to create a new plan to ensure the best care. The best nursing homes reevaluate constantly to ensure the absolute best care for their residents.

The Endgame

When it comes to nursing home litigation it is extremely important that the attorney be aware of the previous steps. Nursing homes are responsible for following these key steps to protect residents: assessment, planning, execution and reevaluation. If they do not follow these steps they can be held liable for injuries that occur.

Public Examples of Nursing Home Abuse in California

Nursing home abuse cases can range based on the type of case and the amount of neglect or abuse in the case. Here are a few public examples of results:

  • Fall in Los Angeles, $1,250,000 settlement
  • Fall in San Mateo, $1,844,000 settlement
  • Fall in San Diego, $500,000 settlement
  • Abuse in Sonoma, $600,000 settlement
  • Abuse in Orange County, $850,000 settlement
  • Abuse in San Diego, $1,338,163 settlement
  • Medical Error in Santa Cruz, $350,000 settlement
  • Medical Error in Orange County, $10,200,000 settlement

Retaining a Nursing Home Abuse Lawyer in California

You’ve reported the abuse or neglect, now what? It’s very important that you find a law firm that specializes in nursing home abuse or has an attorney on staff who specializes in nursing home abuse cases. After the abuse or neglect has been reported you should seek legal help immediately for your case. You may do so by completing a legal case review here.


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.

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