Understanding the Most Common Causes of Nursing Home Negligence

Placing a loved one in a nursing home is one of the hardest decisions a family can make. You want to trust that your loved one will be safe, cared for, and treated with dignity. And most of the time, nursing home staff genuinely want to provide that care.

But even well-meaning facilities can fall short. Negligence often starts small, with a missed medication dose here, a call button that goes unanswered there. These aren't always isolated mistakes. Sometimes, they're symptoms of deeper problems, like understaffing, poor training, or facilities that are stretched too thin to provide proper care.

When you know what to look for, you're better equipped to spot the warning signs early. Below are five of the most common causes of nursing home negligence, and what they actually look like in practice.

Chronic Understaffing and High Turnover

You may notice it during visits. The call button has been blinking for 20 minutes, or the aide who used to help your loved one at breakfast is gone, replaced by someone who doesn't know he needs his food cut up.

On their own, these moments might not mean much. But when they become the norm, they're often pointing to an understaffing issue.

Understaffing is one of the most common drivers of nursing home negligence. When there simply aren't enough hands on deck, even the most dedicated caregivers can't keep up. 

Some red flags to watch out for:

• Call lights that go unanswered for long stretches
• Residents waiting for help with meals, toileting, or hygiene
• Staff who seem rushed, overwhelmed, or stretched too thin
• Familiar faces disappearing after just a few weeks

High turnover is often an issue in itself. New caregivers may not know that your loved one is a fall risk, or that they need help swallowing, or that they become anxious at night. Even well-meaning staff can't fill in those gaps fast enough, and that's when neglect takes root.

Breakdowns in Communication and Care Planning

Good nursing home care depends on information flowing smoothly between shifts, staff, and family members. When that breaks down, you might find yourself repeating the same details to different staff members or noticing that critical information, like dietary restrictions or fall risks, isn't being passed along.

Communication breakdowns happen most often during:

• Shift changes
• Transfers between units
• Days when temporary or agency staff fill in
• Care plan updates that don't reach everyone

These might seem like small oversights. But over time, they add up, and they can affect everything from fall prevention to medication management to basic nutrition.

Medication Management Errors

Most nursing home residents take multiple medications every day, sometimes a dozen or more. When doses are missed, side effects go unmonitored, or medications are changed without explanation, the impact can be immediate and may indicate broader negligence.

Medication errors often stem from:

• Heavy workloads and rushing through med rounds
• Incomplete or illegible documentation
• Communication gaps between doctors and nursing staff
• Lack of follow-up when something changes

Because medications are given daily, often multiple times a day, mistakes tend to go unnoticed. And if the underlying system isn't fixed, the same mistakes keep cycling through.

Failure to Prevent Bedsores, Infections, and Related Injuries

Bedsores, infections, or skin breakdowns don't appear overnight. These injuries develop slowly, which means they're also preventable with the right care.

Prevention comes down to basics: repositioning residents regularly, maintaining hygiene, ensuring proper nutrition, and catching small changes before they become big problems. But when staffing is thin, or routines are rushed, those basics are often the first to go.

That's when families start noticing red flags:

• Skin redness or open sores
• Strong or unusual odors
• Recurring infections
• Signs of poor hygiene, like unchanged bedding or unwashed clothes

If you're seeing these warning signs, it's worth asking direct questions about your loved one's care routine and documenting what you observe.

Inadequate Supervision and Fall Prevention

Falls are one of the most common and preventable injuries in nursing homes. When they happen, especially more than once, it’s a sign that the facility staff isn’t properly monitoring your loved one.

Common warning signs include:

• Repeated falls, especially in the same resident
• Unexplained bruises or injuries
• Residents wandering without supervision
• Long waits for help with walking or transfers

These injuries should show up in medical reports, but there’s a chance the staff aren’t properly maintaining records, either. If you notice red flags, ask questions, and request copies of records the facility has available.

What Families Can Do

Nursing homes have a legal and ethical duty to keep residents safe. That responsibility doesn't disappear when they're short-staffed or overwhelmed. When supervision lapses, when concerns go unanswered, or when the same preventable injuries keep happening, that's negligence.

At Morgan & Morgan, we help families look beyond vague excuses and surface-level explanations. We review care records, ask the hard questions, and hold facilities accountable when they fail to meet their obligations. If something feels wrong, trust that instinct, and know that you don't have to navigate this alone.

If you’re concerned about negligence in your loved one’s nursing home, we’re here to help. Get started with our team today with a free, no-risk case evaluation.

Frequently Asked Questions

1. What qualifies as nursing home negligence?

Nursing home negligence occurs when a facility fails to provide the level of care required to keep residents reasonably safe and healthy. This can involve acts or omissions that lead to harm, including neglect of basic needs, medical errors, or inadequate supervision.

2. How can families tell the difference between aging and neglect?

Aging can involve gradual changes, but neglect often shows patterns. Repeated issues, worsening conditions without explanation, or injuries that could have been prevented may signal a problem with care rather than normal aging.

3. Are nursing homes responsible for staffing levels?

Yes. Nursing homes are responsible for maintaining adequate staffing to meet residents’ needs. While staffing challenges are common, facilities are still required to provide appropriate care.

4. What should families document if they suspect neglect?

Families may find it helpful to keep notes about changes in condition, injuries, conversations with staff, and dates and times of concerning incidents. Documentation can help establish patterns over time.

5. Do nursing home negligence laws vary by state?

Yes. Laws and regulations governing nursing homes vary by state. Standards of care, reporting requirements, and legal options can differ depending on where the facility is located.

6. When should a family consider speaking with a lawyer?

If concerns go unanswered or a resident has been harmed, speaking with a lawyer may help families understand their options. An experienced legal team can review records, ask questions that facilities may avoid, and help determine whether negligence played a role.