Eye Opening Stats on Nursing Home Abuse

Nursing home abuse is a serious public-health and resident-rights concern, but statistics about it are frequently quoted without enough context. Figures may measure different populations, countries, time periods, types of conduct and reporting systems.

For example, a statistic about elder abuse among adults living in the community should not be presented as the percentage of U.S. nursing-home residents who were abused. Likewise, a complaint, regulatory citation or hospital diagnosis does not automatically establish that abuse occurred.

The most useful nursing-home abuse statistics explain:

• Who was studied;
• Where the study occurred;
• Which type of abuse or neglect was measured;
• Whether the information was self-reported, alleged or substantiated;
• The year in which the data were collected; and
• The limitations of the study or reporting system.

This page reviews important statistics and explains what families in Virginia can do when the numbers become a personal concern.

Nursing Home Abuse Statistics at a Glance

Statistic	What it actually measures	Important limitation
Approximately 1 in 6	Adults aged 60 or older who experienced abuse in community settings during the previous year, based on a global research review	Not limited to nursing homes or the United States
64.2% of staff respondents	Staff in selected international institutional studies who self-reported committing at least one abusive act during the previous year	Does not mean 64.2% of residents were abused
Approximately 1 in 5 selected high-risk ER claims	High-risk 2016 Medicare emergency-room claims involving skilled-nursing-facility residents that HHS-OIG estimated involved potential abuse, neglect or injury of unknown source	Not one in five residents or one in five of all ER claims
430 to 875	Increase in nursing-home abuse deficiencies cited nationally from 2013 to 2017	Historical regulatory data, not a current prevalence rate
202,894 complaints	Complaints that Long-Term Care Ombudsman programs worked to resolve in federal fiscal year 2023	Includes many concerns other than abuse
49,610 reports	Reports of suspected adult maltreatment received by Virginia Adult Protective Services in 2025	Includes community and facility settings and does not mean every report was substantiated

Approximately One in Six Older Adults Experience Abuse in Community Settings

The World Health Organization reports that approximately one in six people aged 60 or older experienced some form of abuse in community settings during the preceding year.

The estimate came from a review of 52 studies conducted in 28 countries. Forms of mistreatment included:

• Psychological or emotional abuse
• Financial abuse
• Neglect
• Physical abuse
• Sexual abuse

This is an elder-abuse statistic, but it is not specifically a nursing-home statistic. “Community settings” generally refers to older people living outside institutions.

Review the current World Health Organization elder-abuse fact sheet.

What Does the “Two in Three Staff” Statistic Mean?

WHO also cites institutional studies in which approximately 64.2% of staff respondents reported committing at least one form of abuse during the previous year.

This statistic is often misquoted as:

Two out of every three nursing-home residents are abused.

That is not what the research found.

The statistic refers to staff self-reporting in a limited collection of international institutional studies. It may include actions classified as:

• Psychological abuse
• Neglect
• Physical abuse
• Sexual abuse

It should not be converted into a precise current estimate for Virginia or U.S. nursing-home residents.

What Did HHS Find About High-Risk Emergency-Room Claims?

The U.S. Department of Health and Human Services Office of Inspector General reviewed Medicare emergency-room claims involving skilled-nursing-facility residents during calendar year 2016.

The review covered:

• 37,607 selected high-risk emergency-room claims;
• 34,820 Medicare beneficiaries residing in skilled nursing facilities; and
• Diagnosis codes considered to present a heightened risk of abuse or neglect.

HHS-OIG estimated that approximately one in five of those selected high-risk claims resulted from potential abuse or neglect, including injuries of unknown source.

The agency also found that skilled nursing facilities failed to report many qualifying incidents to state survey agencies as federal requirements directed.

This finding does not mean one in five nursing-home residents was abused. It applied only to emergency-room claims preselected through high-risk diagnosis codes.

Read the HHS-OIG skilled nursing facility report.

Are Nursing Home Abuse Incidents Underreported?

Government reviews have documented reporting failures, delays and incomplete information. However, no single current figure can accurately show the percentage of all U.S. nursing-home abuse that goes unreported.

Underreporting may occur because:

• A resident has dementia or communication limitations.
• The resident fears retaliation or relocation.
• The resident depends on the suspected person for daily care.
• Family members believe an injury resulted from age or illness.
• Staff do not recognise an incident as reportable.
• Records are incomplete.
• A facility delays or fails to make the required report.
• An injury has several possible explanations.

Underreporting should not be used to assume that every unexplained injury proves abuse. It supports the need for prompt, independent investigation.

What Do Federal Nursing Home Deficiency Statistics Show?

State survey agencies inspect Medicare- and Medicaid-certified nursing homes for compliance with federal requirements.

The U.S. Government Accountability Office reported that cited abuse deficiencies increased from 430 in 2013 to 875 in 2017. GAO described abuse citations as relatively rare but found that both their number and severity had increased during the period reviewed.

A cited deficiency may indicate that surveyors found noncompliance with a federal requirement. It does not necessarily show:

• How many residents were harmed;
• Whether an individual resident has a civil claim;
• Whether the citation was appealed;
• Whether the condition was corrected; or
• Whether abuse was committed by a staff member, resident or visitor.

Not Every Nursing Home Citation Is an Abuse Citation

CMS publishes health-deficiency data covering many categories, including:

• Resident assessment
• Care planning
• Accident prevention
• Quality of care
• Medication administration
• Food and nutrition
• Infection control
• Abuse, neglect and exploitation

One facility may receive several citations during one survey. Therefore, the number of citation rows should not be presented as the number of abusive facilities or injured residents.

Families can search current facility information through Medicare Care Compare and Virginia’s nursing-home inspection resources.

What Do Long-Term Care Ombudsman Complaints Show?

Long-Term Care Ombudsman programs advocate for residents of nursing homes, assisted living facilities and similar settings.

In federal fiscal year 2023, Ombudsman programs:

• Worked to resolve 202,894 complaints;
• Resolved or partially resolved 71% of complaints to the satisfaction of the resident or complainant;
• Provided more than 502,000 instances of information and assistance to individuals; and
• Visited 60% of nursing homes at least quarterly.

These figures show the volume of problems brought to resident advocates. They do not represent 202,894 proven cases of abuse.

Ombudsman complaints may concern:

• Discharge or eviction
• Responses to requests for assistance
• Physical abuse
• Staffing
• Medication
• Food
• Resident rights
• Quality of life

How Many Adult Maltreatment Reports Does Virginia Receive?

Virginia Adult Protective Services reported receiving 49,610 reports of suspected adult maltreatment during 2025.

APS serves:

• Adults aged 60 or older; and
• Adults aged 18 or older who are incapacitated.

The total includes suspected abuse, neglect and exploitation occurring in community and facility settings. It should not be described as the number of confirmed nursing-home abuse cases.

How Many Nursing Homes Are in Virginia?

As of 2026, the Virginia Department of Health reports that the Commonwealth has:

• Nearly 300 licensed nursing homes;
• More than 33,000 licensed beds; and
• All but eight facilities certified for federal Medicare or Medicaid reimbursement.

VDH conducts state licensing inspections and federal certification surveys and investigates complaints involving nursing homes.

Assisted living facilities are regulated separately by the Virginia Department of Social Services.

What Counts as Nursing Home Abuse or Neglect?

Physical abuse

Examples may include:

• Hitting, pushing or kicking
• Rough handling
• Unreasonable restraint
• Intentional overmedication
• Improper punishment

Emotional or psychological abuse

Examples may include:

• Threats
• Humiliation
• Intimidation
• Harassment
• Forced isolation

Sexual abuse

Sexual contact without valid consent may constitute abuse. A resident’s cognitive or physical condition may affect the ability to provide consent.

Financial exploitation

Examples may include unauthorized or improper use of:

• Bank accounts
• Credit or debit cards
• Government benefits
• Property
• Checks
• Legal documents

Neglect

Potential neglect may involve failure to provide necessary:

• Food or hydration
• Hygiene
• Medication
• Wound care
• Supervision
• Fall-prevention measures
• Repositioning
• Medical monitoring
• Emergency treatment

A pressure injury, fall, infection or weight loss does not automatically establish neglect. The resident’s condition, care plan, risk factors and treatment records must be reviewed.

What Warning Signs Should Families Watch For?

Potential warning signs include:

• Unexplained bruises, burns or fractures
• Repeated injuries
• Pressure injuries that worsen
• Sudden weight loss or dehydration
• Poor hygiene
• Medication errors
• Fear of a particular staff member or resident
• Sudden withdrawal or unusual anxiety
• Missing money or possessions
• Unexplained changes to financial or legal documents
• Repeated unanswered call bells
• Inconsistent explanations of an injury
• Delay in notifying the family or physician

One sign may have an innocent or medical explanation. A recurring pattern or serious unexplained event warrants closer examination.

What Should You Do When You Suspect Abuse?

1. Address immediate danger. Call 911 when the resident faces urgent physical harm or needs emergency medical care.
2. Request medical evaluation. Ask that injuries, symptoms and changes in condition be assessed and documented.
3. Report the concern in writing. Notify facility leadership and keep a copy of the complaint.
4. Preserve evidence. Save photographs, messages, names, dates and relevant documents.
5. Contact Adult Protective Services. Virginia APS accepts reports involving adults aged 60 or older and qualifying incapacitated adults.
6. File a VDH complaint. VDH investigates complaints involving Virginia nursing homes and skilled nursing facilities.
7. Contact the Long-Term Care Ombudsman. The Ombudsman may help residents understand and exercise their rights.
8. Check inspection records. Review state surveys, federal deficiencies and plans of correction.
9. Request the complete chart. Obtain care plans, nursing notes, medication records, incident records and hospital-transfer documents.
10. Review the legal deadline. Regulatory investigations do not necessarily preserve a civil claim.

Where Should a Virginia Nursing Home Complaint Be Filed?

For a nursing home, skilled nursing facility or nursing facility, families may use the Virginia Department of Health complaint process.

A complaint should identify:

• The facility
• The resident
• The relevant dates
• The people involved
• The specific conduct or care problem
• The injury or change in condition
• Witnesses and supporting records

Complaints concerning assisted living facilities generally should be submitted to the Virginia Department of Social Services rather than VDH.

What Is the Difference Between an APS Report, VDH Complaint and Lawsuit?

Process	Primary purpose	Possible result
Adult Protective Services report	Investigate suspected abuse, neglect or exploitation and assess protective-service needs	Protective services, referrals or other intervention
VDH complaint	Investigate a nursing home’s compliance with licensing and certification requirements	Findings, corrective action or regulatory enforcement
Ombudsman complaint	Advocate for the resident and help resolve health, safety, welfare or rights concerns	Resident-directed problem resolution and advocacy
Civil lawsuit	Seek compensation for legally proven injury or death	Settlement, judgment or dismissal

Filing one type of report does not automatically begin the others.

Do Statistics Prove That a Particular Nursing Home Was Negligent?

No. National or global statistics do not establish liability against an individual facility.

A civil case generally requires facility-specific evidence showing:

1. The facility or provider owed the resident a legal duty.
2. The provider failed to meet the applicable standard.
3. The failure caused or materially contributed to injury or death.
4. The resident or statutory beneficiaries sustained compensable damages.

Potential evidence includes:

• The resident’s complete medical chart
• Care plans and assessments
• Medication and treatment records
• Staffing schedules
• Incident reports
• Inspection findings
• Photographs and video
• Hospital and emergency records
• Witness statements
• Facility policies and training records

Are Nursing Home Cases Considered Medical Malpractice?

Many are. Virginia treats qualifying nursing homes as health care providers.

Claims involving professional nursing services may include:

• Patient-care staffing
• Medical monitoring
• Fall prevention
• Hydration and nutrition
• Pressure-injury prevention and treatment
• Medication administration
• Medical transfer decisions

These cases frequently require qualified expert opinions concerning the standard of care and causation.

Other claims—such as intentional assault, theft or certain premises hazards—may require a different legal analysis.

How Long Do Families Have to File?

A Virginia personal injury action generally must be filed within two years after the claim accrues.

A wrongful death claim generally must be filed by the deceased resident’s properly appointed personal representative within two years after death.

Different rules or limited extensions may apply based on:

• Fraud or concealment
• Legal incapacity
• The date and nature of the alleged malpractice
• The death of a party
• A prior nonsuit or dismissed action
• Another applicable statute

An APS investigation, VDH complaint, Ombudsman case or insurance discussion does not necessarily extend the deadline.

Frequently Asked Questions

Is one in six a nursing home abuse statistic?

No. The widely cited one-in-six figure concerns adults aged 60 or older in global community settings. It should not be presented as a current U.S. nursing-home prevalence rate.

Does the two-in-three statistic mean two-thirds of residents are abused?

No. It refers to staff respondents in selected international institutional studies who self-reported at least one form of abusive conduct.

Are most nursing home abuse cases unreported?

Government reviews document reporting failures and delays, but there is no single reliable current national percentage covering every form of U.S. nursing-home abuse.

Does a complaint prove abuse occurred?

No. A complaint reports a concern for investigation. The allegation may be substantiated, unsubstantiated or unresolved.

Does a regulatory citation prove a civil lawsuit?

No. A citation may be relevant evidence, but a civil claim still requires proof of duty, breach, causation and damages.

Can a resident be abused by another resident?

Yes. Potential perpetrators may include staff, visitors, family members, contractors or other residents. The facility’s supervision and response may require investigation.

Where do I report a Virginia nursing home?

Concerns may be reported to VDH, Adult Protective Services, law enforcement in an emergency and the Long-Term Care Ombudsman, depending on the circumstances.

Is an assisted living facility the same as a nursing home?

No. In Virginia, nursing homes are regulated by VDH, while assisted living facilities are generally regulated by the Department of Social Services.

Does hiring a lawyer guarantee compensation?

No. The outcome depends on the evidence, standard of care, causation, damages, deadlines and applicable defenses.

Discuss Suspected Nursing Home Abuse With Atkinson Law

Statistics may help families recognise that abuse and neglect are important public concerns, but an individual claim must be supported by records and evidence from the particular facility.

Atkinson Law can review:

• Medical and nursing records
• Care plans and incident documentation
• Staffing and supervision evidence
• Inspection and complaint findings
• Medical causation
• Potential damages
• Virginia filing requirements

Learn more about working with a Norfolk nursing home abuse lawyer.

Call or text 757-648-8579 or contact Atkinson Law to request a free, no-obligation case evaluation.

This page provides general statistical, legal and consumer information. Statistics do not establish that a particular facility committed abuse or neglect. Every case depends on facility-specific evidence, medical causation, applicable law and filing deadlines. Reading this page or contacting the firm does not create an attorney-client relationship.