Nursing Home Abuse and neglect
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Abuse and Neglect in a Nursing Home
Families place enormous trust in nursing homes, skilled nursing facilities, and assisted living/adult care homes. When a facility breaks that trust through abuse, neglect, understaffing, or unsafe practices, the consequences can be devastating—falls, pressure injuries, medication errors, dehydration/malnutrition, infections, and even wrongful death. North Carolina law recognizes residents’ rights and provides multiple pathways to hold facilities and responsible individuals accountable.
What counts as “abuse” or “neglect”?
Nursing home cases often involve one or more of these patterns:
Neglect
- Failure to prevent bedsores/pressure injuries
- Untreated infections, poor wound care, poor hygiene
- Malnutrition or dehydration
- Unsafe transfers leading to falls/fractures
- Medication mistakes (wrong drug/dose, missed meds)
- Failure to supervise (wandering/elopement)
- Delayed response to call lights or medical decline
Abuse
- Physical abuse (hitting, rough handling, improper restraints)
- Sexual abuse or unwanted contact
- Emotional/psychological abuse (threats, humiliation, isolation)
- Financial exploitation (theft, coercion, misuse of accounts)
Key North Carolina resident rights and protections
North Carolina recognizes specific rights for residents in nursing homes and adult care homes, and the Long-Term Care Ombudsman Program helps residents and families understand and exercise those rights.
In addition, North Carolina’s “patient’s rights” statute (often relevant to facility care and treatment issues) includes rights such as dignity and adequate/appropriate care consistent with federal and state law.
Mandatory reporting (vulnerable/disabled adults): North Carolina law imposes a duty to report suspected abuse, neglect, or exploitation of a disabled adult to the county Department of Social Services (Adult Protective Services).
How a law firm typically helps:
A North Carolina nursing home abuse & neglect practice generally focuses on:
- Rapid investigation (records preservation letters, chart review, staffing analysis)
- Medical and liability review (often with nursing/medical experts where needed)
- Identifying responsible parties (facility ownership chain, management companies, staffing agencies, individual wrongdoers)
- Claim strategy (regulatory leverage + civil claims for compensation)
- Resolution through settlement or trial, with an emphasis on accountability and safety improvements
Damages that may be available
Depending on the facts, damages can include:
- Medical expenses and increased care needs
- Pain and suffering, emotional distress
- Disability, disfigurement (e.g., advanced pressure wounds)
- Out-of-pocket costs to relocate the resident
- Wrongful death damages (under NC law, pursued by the estate’s representative)
- Potential punitive damages in egregious, willful, or reckless cases (fact-specific)
the facts
North Carolina’s older adult population is increasing rapidly:
- The proportion of residents aged 65+ is growing, and the 85+ segment — most likely to require nursing home care — could increase more than 100% by 2040. This demographic trend is expected to increase demand for long-term care and associated legal issues around quality and abuse/neglect.
- According to America’s Health Rankings data from late 2024, only about 24.4% of North Carolina licensed nursing home beds were rated four or five stars (on Medicare’s Care Compare five-star system) over a recent three-month period — notably lower than the national average.
- Quality ratings and inspection histories are often a starting point for identifying systemic issues in facilities and can support claims of neglect or unsafe conditions.
- Staffing shortages correlate with higher risk of neglect, falls, infections, and delayed care — critical elements in building liability claims.
- Rising demand highlights that families and policymakers are increasingly concerned about elder care quality, which underscores the relevance and urgency of legal advocacy in this area.
The Growing Problem of Elder Abuse in Care Facilities
Unfortunately, as the elderly population continues to grow, the incidence of nursing home injury, negligence and abuse has increased.
Despite the efforts of governmental agencies to help oversee the care and services provided by nursing homes, and federal and state standards established to ensure the safety of patients, more than one million nursing home residents are abused in some manner each year.
Whether the abuse consists of recurrent negligence or a single incident that causes injury, the victim has a right to damages.
Nursing home abuse can include the following:
- Gangrene
- Over-sedation
- Bedsores
- Malnutrition or dehydration
- Lack of adequate medical care
- Wrong medication
- Sexual assault
- Lack of supervision
- Coercion
- Physical or mental abuse
- Falls leading to broken bones, concussions, or other injuries
- The use of inappropriate nursing care
OUR attorneys
Mona Lisa Wallace
PARTNER
Founding partner; 40+ years in complex civil and disease/cancer litigation
To obtain a free and confidential review of the facts surrounding an incident or series of events, feel free to call us at 800.849.5291 or email us.
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For over 40 years, helping people through their most difficult moments has been the driving force behind our work. That commitment extends beyond the courtroom through Wallace & Graham Gives, our charitable program dedicated to supporting community and educational initiatives that strengthen lives across our region.