When you move a loved one into a nursing home, you expect that they’ll receive attentive, compassionate care in a safe environment. Unfortunately, many families discover serious problems after admission, including understaffing, dangerous living conditions, or restrictive practices that violate residents’ rights. These issues can place vulnerable residents at risk of preventable physical and emotional harm.
Understanding the most common problems in nursing homes can help you recognize warning signs of abuse and neglect and take action when something feels wrong. If you believe your loved one may be experiencing mistreatment in a California facility, Lanzone Morgan, LLP, can help you pursue accountability. Call 888-887-9777 today for a free consultation.
Common Problems That Affect Nursing Home Residents
Not every nursing home provides the level of care residents deserve. The following problems commonly arise at long-term care facilities —even in otherwise reputable ones:
1. Visitation Restrictions
Staying connected with loved ones is an important part of a nursing home resident’s well-being. Under the federal Nursing Home Reform Law, residents have the right to receive visitors of their choosing at any time. That means family members can visit whenever they’d like, and facilities may not place unreasonable limits on the days, times, or frequency of visits.
Restrictions on visits might violate the rights of nursing home residents. These limitations can isolate residents from their support systems and reduce outside oversight of their care. When a nursing home interferes with a resident’s ability to see loved ones, families may have grounds to take legal action.
2. Refusal To Support Resident and Family Councils
Residents and their families have the right to form and participate in resident and family councils. These groups allow residents and their loved ones to discuss concerns and advocate for improvements in care.
Federal regulations under 42 C.F.R. § 483.10 requires nursing homes to support these groups by providing a private meeting space and allowing members to meet without staff present unless invited. Additionally, the facility must designate a staff member to assist the group and respond to written requests resulting from the meetings.
When nursing homes limit these groups or ignore their concerns, residents and families lose an important avenue for speaking up. Quality nursing homes will respect this critical right and do everything in their power to support open communication between everyone involved in a resident’s care.
3. Restrictions on Freedom and Daily Activities
Federal law requires facilities to provide residents with the freedom to choose their activities and schedules. Residents also have the right to access services and activities both inside and outside the facility. Facilities must allow residents to participate in social, religious, and community activities if they wish.
When nursing homes place unnecessary limits on residents’ freedom, they may be violating these protections. Preventing residents from leaving their rooms, excluding them from social activities within the facility, or denying them permission to visit friends outside the facility can interfere with their right to self-determination.
4. Unnecessary Use of Restraints or Feeding Tubes
Family members visiting a loved one in a nursing home might be surprised to notice the resident is unusually groggy, sometimes to the point of being unable to recognize them. Sluggishness, lethargy, excessive sleeping, disorientation, and the inability to recognize loved ones are often signs of overmedication.
Facilities may use medications to control a high-needs resident’s behavior and limit the amount of assistance they require. Residents have the right under federal law to be free from physical and chemical restraints, and this practice is a serious violation of that right.
In some cases, nursing homes may also use feeding tubes when not medically necessary. Staff may feel that feeding tubes make residents easier to manage because they don’t have to spend time assisting with meals. When used for staff convenience rather than medical need, feeding tubes can create unnecessary health complications and discomfort for residents.
5. Improper Discharges and Transfers
Nursing homes cannot force residents to leave without following strict guidelines. The Nursing Home Reform Law requires facilities to provide at least 30 days’ written notice before discharging a resident or transferring them to another facility. The notice must include the reason for the discharge, the effective date, and the resident’s relocation destination.
Residents also have the right to appeal a proposed discharge and remain in the facility while the appeal is pending. If a facility transfers or discharges a resident without warning or ignores their appeals, it might signal broader issues in how it treats the people in its care.
6. Inadequate Staffing Levels
Many nursing homes struggle to maintain sufficient staffing to meet residents’ needs. High turnover often contributes to this problem, as roughly 42% of Certified Nursing Assistants left their nursing home positions in 2025. When facilities cannot keep up with the staffing demands of daily care, residents may experience delays in assistance with meals, hygiene, mobility, or other basic needs.
While understaffing is one of the most common nursing home complaints, it violates federal regulations. Under 42 C.F.R. § 483.35, facilities must have sufficient numbers of qualified nursing staff to keep residents safe and maintain their overall well-being. When facilities fail to meet these requirements, residents may face neglect, preventable injuries, or declining health.
7. Lack of Proper Staff Training
Nursing home staff members must have the training necessary to care for vulnerable residents. Federal regulations require facilities to provide ongoing mandatory staff training to make sure employees are up to date on care standards under 42 C.F.R. § 483.95.
This training must educate staff on residents’ rights, the prevention and reporting of abuse, infection control, and their responsibilities toward residents. The law also requires at least 12 hours of in-service training per year for nurse aides, covering topics such as dementia management and the care of residents’ special needs.
Without adequate training, residents may be at greater risk of injury and illness. Staff may also fail to recognize changes in a resident’s health that could signal the need for an adjusted care plan.
8. Dangerous Living Conditions
42 C.F.R. § 483.90 requires nursing homes to maintain living conditions that protect residents’ health and safety. Residents may suffer falls or infections when staff members fail to keep all parts of the facility clean, organized, and in proper working order.
Wet floors, poor lighting, inadequate ventilation, overcrowded rooms, missing handrails, cluttered hallways, broken equipment, and pest infestations are common facility-wide issues that can pose risks to vulnerable residents. Failure to regularly clean a resident’s bathroom or change their bedding is another nursing home problem that exposes residents to preventable health hazards. Facilities must also implement proper fire safety measures, and neglecting that responsibility can endanger residents in an emergency.
sing home provides the level of care residents deserve. The following problems commonly arise at long-term care facilities —even in otherwise reputable ones:
9. Nutrition and Food Quality Issues
Nursing home residents are often in frail physical condition and require frequent, well-planned, appetizing meals to remain stable and heal from injuries. Under 42 C.F.R. § 483.60, nursing homes must provide each resident with a nourishing, well-rounded diet that meets their nutritional needs. The law requires facilities to hire a dietitian or other qualified nutrition professional to assess residents’ dietary needs and plan appropriate meals.
All meals should also take into account residents’ allergies, intolerances, religious needs, or personal preferences. The food must also be palatable, meaning it’s enjoyable to eat and served at the right temperature. Facilities must provide at least three meals a day and avoid gaps of more than 14 hours between dinner and breakfast the following day.
Facilities’ food storage and preparation practices must also comply with general food service safety standards. Unsanitary kitchen conditions or improper food handling can expose residents to foodborne illness, which can be life-threatening in vulnerable older adults.
10. Family Dining Restrictions
Sharing meals can be a meaningful way for families to stay connected with loved ones in nursing homes. Sitting together during meals allows residents to enjoy familiar company in a setting that supports social interaction.
When facilities prevent family members from joining residents in the dining room, it can undermine residents’ dignity and reduce their quality of life. Policies like this may signal that a facility prioritizes convenience over residents’ emotional well-being.
11. Disregarding Residents’ Preferences
Nursing home residents have the right to have their needs and preferences respected. Facilities must provide reasonable accommodations for residents’ choices. The law also requires nursing homes to involve residents in developing a person-centered plan of care that reflects their personal and cultural preferences.
When staff members ignore residents’ preferences unnecessarily, residents may feel that they have little control over their daily lives, which can negatively impact their mental health. This practice can show up in many areas of care, such as disregarding residents’ routines, meal choices, cultural practices, or personal care preferences.
12. Failure To Involve Residents in Care Decisions
Residents have the right to receive clear information about their care and health status. Under federal residents’ rights protections, facilities must inform residents about changes to their medical condition or plan of care so they can understand what’s happening and make informed decisions.
Facilities that respect residents’ personhood will involve residents in developing and updating their care plans. Unfortunately, staff members making care decisions without informing residents or asking for their input is one of the most common problems seniors face in nursing homes. It creates an imbalanced power dynamic that disrespects the resident’s autonomy.
13. Requiring Family Members To Accept Financial Responsibility
Some nursing homes attempt to make loved ones financially responsible for a resident’s care. Under 42 C.F.R. § 483.15, facilities cannot require third parties to guarantee payment for a resident’s care.
Family members can sign admission paperwork as the resident’s representative, but only to manage the resident’s own money. Such arrangements do not mean they are agreeing to pay the nursing home bill themselves.
14. Unequal Treatment of Medicaid Recipients
Many nursing home residents rely on Medicaid to cover the cost of long-term care. While some states allow facilities to limit the number of Medicaid-certified beds they offer, 42 U.S.C. § 1396r(c)(4)(A) prohibits nursing homes from discriminating against residents because they use Medicaid. \
Therefore, facilities must apply the same policies and standards of care to residents regardless of whether they pay privately or through Medicaid. If a nursing home provides fewer services or limits access to certain amenities for Medicaid recipients, it may be failing to meet its legal obligations.
15. Abuse and Neglect
Nursing home residents have the right to a dignified existence free from abuse and neglect. Violations of this fundamental right may involve failing to supervise residents, ignoring basic care needs, or allowing preventable injuries, such as falls or bedsores, to develop. These are examples of neglect, which occurs when staff fail to provide the care and attention residents need to remain safe and healthy.
While neglect is often a more common nursing home problem, abuse may also occur when staff members intentionally cause physical or emotional harm to residents. Abusive conduct includes hitting, pushing, making verbal threats, or shouting insults at residents. Humiliation and intimidation can also constitute abuse and cause lasting harm.
How To Advocate for Your Loved One When Care Concerns Arise
Nursing homes have a legal and ethical duty to provide safe, respectful care for their residents. When facilities fail to meet these responsibilities, family members are often the first to notice that something is wrong. When that happens, you can play a powerful role in advocating for the care your loved one deserves.
Document Your Concerns
Start by writing down what you observe and taking photos of any visible injuries or poor living conditions.
Speak With Staff Members
For less urgent concerns, consider having a friendly conversation with your loved one’s nurses or aides. In some situations, staff simply may not realize there’s a problem until someone brings it to their attention.
Get Facility Leadership Involved
If the issue continues or involves serious violations, bring your concerns to the nursing home’s administrators. Submit your report in writing to create a clear record of communication.
Report Serious Violations to Authorities
If you’re concerned that your loved one’s safety is at risk or the facility fails to address your concerns promptly, state authorities can step in to investigate. For complaints against a nursing home, call the California Department of Public Health at (800) 554-0354. If you need to report active abuse or neglect at a nursing home, contact the California Department of Aging Long-Term Care Ombudsman CRISIS Line at (800) 231-4024.
Follow Up and Stay Involved
After you report your concern, continue to check in on your loved one and monitor the situation. Follow up with the facility or agency handling the complaint to ensure it’s taking steps to resolve the issue. If the matter has been resolved, remain an active visitor and stay engaged in your loved one’s care.
Speak With an Attorney
If you suspect that your loved one has suffered physical or emotional harm at a nursing home, speak with a nursing home abuse attorney about your legal options. The right legal team can help you understand your rights, determine if the facility has violated any elder abuse laws in California, and potentially pursue legal action against the facility.
We’re Here To Help You Hold a Negligent Nursing Home Accountable
Common problems in nursing homes can result in serious harm to vulnerable adults. You do not have to handle these complex issues alone. With over 75 years of combined experience standing up for vulnerable adults throughout California, Lanzone Morgan, LLP, can help you pursue the accountability your family deserves.
Our attorneys have recovered more than $250 million in compensation for elder abuse victims and their families. If you believe improper care has caused harm to your loved one, our team is ready to listen to your concerns and guide you through each step of the legal process.
Contact us online or call 888-887-9777 to start moving forward with a free consultation.