Nursing Home Laws by State
By FindLaw Staff | Legally reviewed by Laura Temme, Esq. | Last reviewed November 04, 2023
This article has been written and reviewed for legal accuracy, clarity, and style by FindLaw’s team of legal writers and attorneys and in accordance with our editorial standards.
The last updated date refers to the last time this article was reviewed by FindLaw or one of our contributing authors. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please contact an attorney in your area.
Nursing home abuse is a serious problem in the United States. Half of all nursing home attendants have admitted to abusing or neglecting elderly patients. The elderly are some of the most vulnerable members of our society. The law has certain safeguards in place to help prevent such abuses. Both federal and state governments have enacted laws to protect elderly residents.
Federal Funding Laws
Separate from state laws, federal laws also affect nursing homes. The Nursing Home Reform Act of 1987 sets general guidelines to prevent physical and emotional abuse and neglect. Since the passage of this law, many states have enacted more stringent requirements. These laws place greater responsibility on nursing care facilities to ensure the safety of the elderly.
Certified nursing homes can choose to receive federal Medicare or Medicaid funding. But in order to get the funds, they must at least comply with federal nursing home regulations. Federal nursing home laws provide a minimum requirement for regulations. But states can enact tougher laws as they see fit.
Overview of Nursing Home Laws by State
Here is an overview of nursing home laws by state, including:
- State definitions of abuse
- Nursing home staff minimum requirements
- How to report a suspected violation
If you suspect nursing home abuse, you should consider reporting it to the Adult Protective Services (APS) agency in your state.
State |
State Code/Abuse |
Staffing Requirement |
Where to Report Suspected Abuse |
Alabama |
Abuse: The infliction of physical pain, injury, or the willful deprivation by a caregiver or other person of services necessary to maintain mental and physical health. (Emotional abuse is defined separately.) |
|
|
Alaska |
Abuse: The intentional, knowing, or reckless non-accidental and non-therapeutic infliction of physical pain, injury, mental or emotional distress, fear (including coercion and intimidation), and sexual assault. |
|
|
Arizona |
Abuse: The intentional infliction of physical harm; injury caused by negligent acts or omissions; unreasonable confinement; sexual abuse or sexual assault. (Emotional abuse defined separately.) |
|
|
Arkansas |
Abuse: Any purposeful and unnecessary physical act which inflicts pain on or causes injury to an endangered or impaired adult, including sexual abuse; or any intentional or demeaning act which subjects an endangered or impaired adult to ridicule or psychological injury in manner likely to provoke fear or alarm; any purposeful threat that a reasonable person would find credible and nonfrivolous to inflict pain on or cause injury to an endangered or impaired person. |
|
|
California |
Abuse of an elder or dependent adult: Includes physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering; the deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering. Criminal elder abuse: Any person who, under circumstances or conditions likely to produce great bodily harm or death, willfully causes or permits any elder or dependent adult, with knowledge that he or she is an elder or a 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. |
|
|
Colorado |
Abuse: A nonaccidental act or omission committed against an "at-risk" person that results in bodily injury, death, confinement or restraint, or criminal sexual abuse. |
|
|
Connecticut |
Abuse: Includes, but is not limited to, the willful infliction of physical pain, injury, or mental anguish, or the willful deprivation by a caretaker of services which are necessary to maintain physical or mental health. |
|
|
Delaware |
Abuse: Includes physical abuse by unnecessarily inflicting pain or injury on an adult who is impaired; patterns of emotional abuse including ridiculing or demeaning an adult who is impaired or threatening physical or emotional harm; sexual abuse; medication diversion. |
|
|
District of Columbia |
Abuse: Intentional or reckless infliction of serious physical pain or injury; use or threatened use of violence to force participation in sexual conduct; repeated intentional imposition of unreasonable confinement, resulting in severe mental distress; repeated use of threats or violence, resulting in shock or an intense, expressed fear for one's life or of serious physical injury; or intentional or deliberately indifferent deprivation of essential food, shelter, or health care in violation of a caregiver's responsibilities, when that deprivation constitutes a serious threat to one's life or physical health. |
|
|
Florida |
Abuse: Willful act or threatened act that causes or is likely to cause significant impairment to a vulnerable adult's physical, mental, or emotional health. Abuse includes acts and omissions. Criminal abuse of an elderly person or disabled adult: Intentional infliction of physical or psychological injury upon an elderly person or disabled adult; an intentional act that could be reasonably expected to result in physical or psychological injury; or, active encouragement of any person to commit an act that results in physical or psychological injury to an elderly person or disabled adult. |
|
|
Georgia |
Institutional abuse: Any intentional or grossly negligent act or series of acts or intentional or grossly negligent omission to act which causes injury to a resident, including, but not limited to, assault or battery, failure to provide treatment or care, or sexual harassment of the resident. |
|
|
Hawaii |
Abuse: Physical abuse, psychological abuse, sexual abuse, financial exploitation, caregiver neglect, or self-neglect. |
|
|
Idaho |
Abuse: Intentional or negligent infliction of physical pain, injury, or mental injury. Criminal abuse of a vulnerable adult: Any person who abuses or neglects a vulnerable adult under circumstances likely to produce great bodily harm or death is guilty of a felony punishable by up to ten years in prison and up to a $25,000 fine; other abuse or neglect of a vulnerable adult is a misdemeanor; includes financial exploitation |
|
|
Illinois |
Institutional abuse: Any physical, mental, or sexual injury to an eligible adult, including exploitation of such adult's financial resources. |
|
|
Indiana |
Exploitation of endangered adult: A person who recklessly, knowingly, or intentionally exerts unauthorized use of personal services or the property of an endangered adult for the person's own profit or advantage or for the profit or advantage of another person. |
|
|
Iowa |
Dependent adult abuse/neglect: (1) Any of the following as a result of the willful or negligent acts or omissions of a caretaker: (a) Physical injury to, or injury which is at a variance with the history given of the injury, or unreasonable confinement, unreasonable punishment, or assault of a dependent adult; (b) The commission of a sexual offense under chapter 709 or section 726.2 with or against a dependent adult; (c) Exploitation of a dependent adult which means the act or process of taking unfair advantage of a dependent adult or the adult's physical or financial resources for one's own personal or pecuniary profit, without the informed consent of the dependent adult, including theft, by the use of undue influence, harassment, duress, deception, false representation, or false pretenses; (d) The deprivation of the minimum food, shelter, clothing, supervision, physical or mental healthcare, or other care necessary to maintain a dependent adult's life or health. (2) The deprivation of the minimum food, shelter, clothing, supervision, physical or mental health care, and other care necessary to maintain a dependent adult's life or health as a result of the acts or omissions of the dependent adult. (3) Sexual exploitation of a dependent adult who is a resident of a health care facility, as defined in section 135C.1, by a caretaker providing services to or employed by the health care facility, whether within the health care facility or at a location outside of the health care facility. |
|
|
Kansas |
Abuse: Any act or failure to act performed intentionally or recklessly that causes or is likely to cause harm to an adult, including: (1) Infliction of physical or mental injury; (2) any sexual act with an adult when the adult does not consent or when the other person knows or should know that the adult is incapable of resisting or declining consent to the sexual act due to mental deficiency or disease or due to fear of retribution or hardship; (3) unreasonable use of a physical restraint, isolation, or medication that harms or is likely to harm an adult; (4) unreasonable use of a physical or chemical restraint, medication, or isolation as punishment, for convenience, in conflict with a physician's orders or as a substitute for treatment, except where such conduct or physical restraint is in furtherance of the health and safety of the adult; (5) a threat or menacing conduct directed toward an adult that results or might reasonably be expected to result in fear or emotional or mental distress to an adult; (6) fiduciary abuse; or (7) omission or deprivation by a caretaker or another person of goods or services which are necessary to avoid physical or mental harm or illness. |
|
|
Kentucky |
Abuse: Infliction of injury, sexual abuse, unreasonable confinement, intimidation, or punishment that results in physical pain or injury, including mental injury; deprivation of services by a person which are necessary to maintain the health and welfare of a person, or a situation in which an adult, living alone, is unable to provide or obtain for himself the services which are necessary to maintain his health or welfare. |
|
|
Louisiana |
Abuse: Infliction of physical or mental injury on an adult including infirm persons residing in a state-licensed facility) by other parties, including but not limited to such means as sexual abuse, abandonment, isolation, exploitation, or extortion of funds or other things of value, to such an extent that his health, self-determination, or emotional well-being is endangered. |
|
|
Maine |
Abuse: Infliction of injury, unreasonable confinement, intimidation, or cruel punishment that causes or is likely to cause physical harm or pain or mental anguish; sexual abuse or sexual exploitation; financial exploitation; or the intentional, knowing, or reckless deprivation of essential needs. “Abuse" includes acts and omissions. |
The minimum nursing staff-to-resident ratio shall not be less than the following:
Maine Long Term Care Facilities: State Licensing Regulations |
|
Maryland |
Abuse: The sustaining of any physical injury by a vulnerable adult as a result of cruel or inhumane treatment or as a result of a malicious act by any person, including sexual abuse. |
|
|
Massachusetts |
Institutional Abuse: an Act or omission which results in serious physical or emotional injury to an elderly person or financial exploitation of an elderly person; or the failure, inability or resistance of an elderly person to provide for him one or more of the necessities essential for physical and emotional well-being without which the elderly person would be unable to safely remain in the community; provided, however, that no person shall be considered to be abused or neglected for the sole reason that such person is being furnished or relies upon treatment in accordance with the tenets and teachings of a church or religious denomination by a duly accredited practitioner thereof. |
|
|
Michigan |
Vulnerable adult abuse: Harm or threatened harm to an adult's health or welfare caused by another person. Abuse includes, but is not limited to, nonaccidental physical or mental injury, sexual abuse, or maltreatment. |
|
|
Minnesota |
Abuse: Non-accidental conduct which produces or could reasonably be expected to produce physical pain or injury, including: hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable adult; use of repeated or malicious oral, written, or gestured language toward a vulnerable adult or the treatment of a vulnerable adult which would be considered by a reasonable person to be disparaging, derogatory, humiliating, harassing, or threatening; use of any aversive or deprivation procedure, unreasonable confinement, or involuntary seclusion, including the forced separation of the vulnerable adult from other persons against the will of the vulnerable adult or the legal representative of the vulnerable adult; and |
|
|
Mississippi |
Abuse: A willful act or omission that results in physical pain, injury, or mental anguish on or to a vulnerable person, the unreasonable confinement of a vulnerable person, or the willful deprivation of services necessary to maintain the mental or physical health of a vulnerable person; includes sexual abuse. |
|
|
Missouri |
Abuse: Infliction of physical, sexual, or emotional injury or harm including financial exploitation by any person, firm, or corporation. |
|
|
Montana |
Abuse: (a) the infliction of physical or mental injury; or (b) the deprivation of food, shelter, clothing, or services necessary to maintain the physical or mental health of an older person or a person with a developmental disability without lawful authority. |
|
|
Nebraska |
Abuse: Any knowing or intentional act on the part of a caregiver or any other person which results in physical injury, unreasonable confinement, cruel punishment, sexual abuse, or sexual exploitation of a vulnerable adult. |
|
|
Nevada |
Abuse: Willful and unjustified: (a) Infliction of pain, injury or mental anguish on an older person; or (b) Deprivation of food, shelter, clothing, or services which are necessary to maintain the physical or mental health of an older person. (Exploitation defined separately.) |
|
|
New Hampshire |
Abuse: Any act or omission by a person which is not accidental and harms or threatens to harm an incapacitated adult's physical, mental, or emotional health or safety. |
|
|
New Jersey |
Institutional abuse: Willful infliction of physical pain, injury, or mental anguish; unreasonable confinement; or the willful deprivation of services which are necessary to maintain a person's physical and mental health. |
||
New Mexico |
Institutional abuse: Knowingly, intentionally, or negligently and without justifiable cause inflicting physical pain, injury, mental anguish; intentional deprivation of services necessary to maintain physical or mental health; sexual abuse. |
|
|
New York |
Abuse: Non-accidental use of force that results in bodily injury, pain or impairment, including but not limited to, being slapped, burned, cut, bruised, or improperly physically restrained; (b) “Sexual abuse" means nonconsensual sexual contact of any kind, including but not limited to, forcing sexual contact or forcing sex with a third party; (c) “Emotional abuse" means willful infliction of mental or emotional anguish by threat, humiliation, intimidation, or other abusive conduct, including but not limited to, frightening or isolating an adult. |
|
|
North Carolina |
Institutional abuse: Willful or grossly negligent infliction of physical pain, injury, or mental anguish, unreasonable confinement, or the willful or grossly negligent deprivation by the administrator or staff of an adult care home of services which are necessary to maintain mental and physical health. |
|
|
North Dakota |
Abuse: Any willful act or omission of a caregiver or any other person which results in physical injury, mental anguish, unreasonable confinement, sexual abuse or exploitation, or financial exploitation to or of a vulnerable adult. |
|
|
Ohio |
Abuse: The infliction upon an adult by self or others of injury, unreasonable confinement, intimidation, or cruel punishment with resulting physical harm, pain, or mental anguish. |
|
|
Oklahoma |
Institutional abuse: Willful infliction of injury, unreasonable confinement, intimidation, or punishment, with resulting physical harm, impairment or mental anguish. |
|
|
Oregon |
Institutional abuse: (a) Any physical injury caused by other than accidental means; (b) Neglect that leads to physical harm through the withholding of services necessary to maintain health and well-being; (c) Abandonment, including desertion or willful forsaking of an elderly person or a person with a disability or the withdrawal or neglect of duties and obligations owed an elderly person or a person with a disability by a caregiver or other person; (d) Willful infliction of physical pain or injury; (e) Use of derogatory or inappropriate names, phrases or profanity, ridicule, harassment, coercion, threats, cursing, intimidation or inappropriate sexual comments or conduct of such a nature as to threaten significant physical or emotional harm to the elderly person or person with a disability; (f) Causing any sweepstakes promotion to be mailed to an elderly person or a person with a disability who had received sweepstakes promotional material in the United States mail, spent more than $500 in the preceding year on any sweepstakes promotions, or any combination of sweepstakes promotions from the same service, regardless of the identities of the originators of the sweepstakes promotion and who represented to the court that the person felt the need for the court's assistance to prevent the person from incurring further expense; (g) Wrongfully taking or appropriating money or property, or knowingly subjecting an elderly person or person with a disability to alarm by conveying a threat to wrongfully take or appropriate money or property, which threat reasonably would be expected to cause the elderly person or person with a disability to believe that the threat will be carried out; (h) Sexual contact with a nonconsenting elderly person or person with a disability or with an elderly person or person with a disability considered incapable of consenting to a sexual act. |
|
|
Pennsylvania |
Abuse: The occurrence of one or more of the following acts: (1) the infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain, or mental anguish; (2) the willful deprivation by a caretaker of goods or services which are necessary to maintain physical or mental health; (3) sexual harassment, rape, or abuse. |
|
|
Rhode Island |
Abuse: Includes, but is not limited to, hitting, kicking, pinching, slapping, or pulling of hair; conduct that physically harms a patient except where it is a part of care and treatment; harassment. |
|
|
South Carolina |
Abuse: Includes physical abuse and psychological abuse. |
|
|
South Dakota |
Abuse: Physical harm, bodily injury, or attempt to cause physical harm or injury, or the infliction of fear of imminent physical harm or bodily injury on a disabled adult. |
|
|
Tennessee |
Abuse: Infliction of physical pain, injury, or mental anguish, or the deprivation of services by a caretaker which are necessary to maintain the health and welfare of an adult or a situation in which an adult is unable to provide or obtain the services which are necessary to maintain that person's health or welfare. |
|
|
Texas |
Abuse: (a) The negligent or willful infliction of injury, unreasonable confinement, intimidation, or cruel punishment with resulting physical or emotional harm or pain to an elderly or disabled person by the person's caretaker, family member, or other individual who has an ongoing relationship with the person; or (b) sexual abuse of an elderly or disabled person. |
|
|
Utah |
Abuse: Knowingly or intentionally attempting to cause harm, causing harm, or making another person fear harm; the unreasonable or inappropriate use of physical restraint, medication, or isolation that causes harm or is likely to cause harm to a vulnerable adult; emotional or psychological abuse; sexual offenses as defined by Utah criminal statutes; deprivation of life-sustaining care except as directed by a person's advance health care directive. |
|
|
Vermont |
Abuse: (a) Any treatment of a vulnerable adult which places life, health, or welfare in jeopardy or which is likely to result in impairment of health; (b) Any conduct committed with an intent or reckless disregard that such conduct is likely to cause unnecessary harm, unnecessary pain, or unnecessary suffering to a vulnerable adult; (c) Unnecessary or unlawful confinement or unnecessary or unlawful restraint of a vulnerable adult; (d) Any sexual activity with a vulnerable adult by a caregiver who volunteers for or is paid by a caregiving facility or program. This definition shall not apply to a consensual relationship between a vulnerable adult and a spouse, nor to a consensual relationship between a vulnerable adult and a caregiver hired, supervised, and directed by the vulnerable adult; (e) Intentionally subjecting a vulnerable adult to behavior which should reasonably be expected to result in intimidation, fear, humiliation, degradation, agitation, disorientation, or other forms of serious emotional distress; (f) Administration, or threatened administration, of a drug, substance, or preparation to a vulnerable adult for a purpose other than legitimate and lawful medical or therapeutic treatment. |
|
|
Virginia |
Abuse: Knowing and willful conduct that causes physical injury or pain; or (ii) knowing and willful use of physical restraint, including confinement, as punishment, for convenience or as a substitute for treatment, except where such conduct or physical restraint, including confinement, is a part of care or treatment and is in furtherance of the health and safety of the incapacitated person. |
|
|
Washington |
Abuse: Nonaccidental physical injury or condition, sexual abuse, or negligent treatment of a state hospital patient under circumstances which indicate that the patient's health, welfare, or safety is harmed thereby. |
|
|
West Virginia |
Abuse: The infliction or threat to inflict physical pain or injury on or the imprisonment of any incapacitated adult or facility resident |
|
|
Wisconsin |
Abuse: Physical abuse, emotional abuse, sexual abuse, treatment without consent, unreasonable confinement, or restraint. |
|
|
Wyoming |
Abuse: The intentional or reckless infliction, by the vulnerable adult's caregiver, person of trust or authority, professional, family member or other individual of: injury, unreasonable confinement, cruel punishment, sexual abuse, intimidation, exploitation, or taking inappropriate photographs. |
|
Disclaimer: State laws are always subject to change, usually by enacting new legislation. They can also be altered through court decisions and other means. Contact an attorney or conduct your own legal research to verify the state law(s) you are researching.
What Qualifies as Abuse or Neglect
Mistreatment of your loved one might be classified differently, depending on your state. It can be confusing to determine what constitutes nursing home neglect or what types of injuries can form the basis of abuse cases. In general, all types of abuse and neglect share common signs. Personal injury cases involving nursing home negligence and abuse may involve:
- Complaints of unusual pain and suffering
- Broken bones, malnutrition, excessive bruising, or bedsores
- Poor or lacking medical care (including medical malpractice leading to wrongful death)
- Other physical or emotional signs of mistreatment by staff members
If your loved one is a nursing home resident who suffered from these types of abuse, you have options. A nursing home abuse lawyer or personal injury attorney may be able to help. Even before consulting an attorney, you can take steps to report nursing home abuse. Start by reaching out to your local Adult Protective Services (APS) office.
Get a Nursing Home Abuse Claim Evaluation
Nursing home neglect and abuse laws can differ widely from state to state. Additionally, different laws can apply to nursing homes and assisted living facilities. While the federal government sets a minimum standard of care, states are free to set higher standards. If you have questions about nursing home abuse or how to report a suspected violation, you may want to speak with an attorney. Get started today with an evaluation of your potential nursing home abuse claim. Some attorneys may provide free case evaluations.
By speaking with a personal injury lawyer, you can enforce your legal rights. You can ensure that you or your family members are made whole for nursing home injuries. Your personal injury claim is just one phone number away. Contact a nursing home abuse attorney today. Keep in mind that every state has a statute of limitations (time limit law), after which claims may be barred, so act quickly.
Next Steps
Contact a qualified personal injury attorney to make sure your rights are protected.
Help Me Find a Do-It-Yourself Solution
Stay up-to-date with how the law affects your life
Learn more about FindLaw’s newsletters, including our terms of use and privacy policy.