Nursing Home Laws by State

Nursing home abuse is a serious problem in the United States. Half of all nursing home attendants have admitted abusing or neglecting elderly patients at some point in their careers, according to research from 2010. The elderly are some of the most vulnerable members of our society, and the law has certain safeguards in place in order to help prevent such abuses. Accordingly, both federal and state governments have enacted legislation to help combat nursing home abuse.

Here’s how the laws work with one another: Certified nursing homes can opt to receive federal Medicare or Medicaid funding. However, 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. Again, states that do not wish to receive federal Medicare or Medi-Cal funding are free to enact their own laws, assuming they are constitutional.

Here is an overview of nursing home laws by state, including the state definition of abuse, nursing home staff minimum requirements, and 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, willful deprivation by a caregiver or other person of services necessary to maintain mental and physical health. Emotional abuse defined separately.

Alaska

Abuse: The willful, intentional, reckless, non-accidental, and non-therapeutic infliction of physical pain injury or mental distress or 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 intentional or unnecessary physical act which inflicts pain on or causes injury to 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 harm.

Adult Protective Services

California

Abuse: Under § 15610.07 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;

Abuse: Under Cal. Pen. Code § 368 occurs when 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

Mistreatment (abuse): An act or omission which threatens health, safety, or welfare of an at-risk adult…or which exposes the adult to a situation or condition that poses an imminent risk of death, serious bodily injury or bodily injury to the adult.

Connecticut

Abuse: 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

Institutional Abuse: Includes (a) physical abuse by unnecessarily inflicting pain or injury to a patient or resident. This includes, but is not limited to hitting, kicking, sexual molestation; (b) emotional abuse which includes, but is not limited to, ridiculing or demeaning a patient or resident, making derogatory remarks to a patient or resident, or cursing directed toward patient or resident, or threatening to inflict physical or emotional harm on a patient. Mistreatment shall include the inappropriate use of meds, isolation, or physical or chemical restraints on or of a patient or resident.

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.

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: Actual or imminent physical injury, psychological abuse or neglect, sexual abuse, financial exploitation, negligent treatment, or maltreatment as further defined in this chapter.

Idaho

Abuse: Intentional or negligent infliction of physical pain, injury, or mental injury.

 

Illinois

Institutional Abuse: Any physical injury, sexual abuse, or mental injury inflicted on a resident other than by accidental means.

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

Dependant 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 physical pain, injury, or mental injury, or the 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 with resulting physical harm or pain or mental anguish; sexual abuse or exploitation; or the willful deprivation of essential needs.

Maryland

Institutional Abuse: The non-therapeutic infliction of physical pain or injury, or any persistent course of conduct intended to produce or resulting in mental or emotional distress; “Abuse” does not include the performance of an accepted medical procedure that a physician orders.

Massachusetts

Institutional Abuse: The willful infliction of injury, unreasonable confinement, intimidation, including verbal or mental abuse, or punishment with resulting physical harm, pain, or mental anguish or assault and battery; provided, however, that verbal or mental abuse shall require a knowing and willful act directed at a specific person.

Michigan

Vulnerable Adult Abuse: (1) A caregiver is guilty of vulnerable adult abuse in the first degree if the caregiver intentionally causes serious physical harm or serious mental harm to a vulnerable adult. (2) A caregiver or other person with authority over the vulnerable adult is guilty of vulnerable adult abuse in the second degree if the reckless act or reckless failure to act of the caregiver or other person with authority over the vulnerable adult causes serious physical harm or serious mental harm to a vulnerable adult. (3) A caregiver is guilty of vulnerable adult abuse in the third degree if the caregiver intentionally causes physical harm to a vulnerable adult. (4) A caregiver or other person with authority over the vulnerable adult is guilty of vulnerable adult abuse in the fourth degree if the reckless act or reckless failure to act of the caregiver or other person with authority over a vulnerable adult causes physical harm to a vulnerable adult.

Minnesota

Abuse: See statute

Mississippi

Abuse: The willful or non-accidental infliction of physical pain, injury, or mental anguish on a vulnerable adult, the unreasonable confinement of a vulnerable adult, or the willful deprivation by a caretaker of services which are necessary to maintain the mental and physical health of a vulnerable adult. “Abuse” shall include sexual abuse.

Missouri

Abuse: Infliction of physical, sexual, or emotional injury or harm including financial exploitation by any person, firm, or corporation.

  • Sufficient staff to attain or maintain the highest practicable level of physical, mental and psychosocial well-being
  • Missouri Code of Regulations

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.

  • Sufficient staff to meet the nursing needs of the residents, reflecting current concepts of restorative and geriatric care.
  • Montana Secretary of State

Nebraska

Abuse: Knowing, intentional, or negligent act or omission on the part of a caregiver, a vulnerable adult, or any other person which results in physical injury, unreasonable confinement, cruel punishment, sexual abuse, exploitation, or denial of essential services to 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.

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: Any act or failure to act performed intentionally, knowingly or recklessly that causes or is likely to cause harm to a resident, including: (1) physical contact that harms or is likely to harm a resident of a care facility; (2) inappropriate use of a physical restraint, isolation, or medication that harms or is likely to harm a resident; (3) inappropriate use of a physical or chemical restraint, medication, or isolation as punishment or in conflict with a physician's order; (4) medically inappropriate conduct that causes or is likely to cause physical harm to a resident; (5) medically inappropriate conduct that causes or is likely to cause great psychological harm to a resident;(6) an unlawful act, a threat, or menacing conduct directed toward a resident that results and might reasonably be expected to result in fear or emotional or mental distress to a resident.

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.

  • Sufficient staff to accomplish the purposes of needs assessment, care planning and supervision.
  • Nursing Home Rules

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

Institutional Abuse: Knowingly causing physical harm or recklessly causing serious physical harm to a resident by physical contact with the resident or by use of physical or chemical restraint, medication, or isolation as punishment, for staff convenience, excessively, as a substitute for treatment, or in amounts that preclude habilitation and treatment.

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 to a resident of a long-term care facility which has been caused by other than accidental means. (b) Failure to provide basic care or services, which failure results in physical harm or unreasonable discomfort or serious loss of human dignity. (c) Sexual contact with a resident caused by an employee, agent, or other resident of a long-term care facility by force, threat, duress, or coercion. (d) Illegal or improper use of a resident's resources for the personal profit or gain of another person. (e) Verbal or mental abuse as prohibited by federal law. (f) Corporal punishment. (g) Involuntary seclusion for convenience or discipline.

 

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: The subjection of an elderly person to the willful infliction of physical pain, or willful deprivation of services by a caretaker or other person with a duty of care for the elderly person. Abuse also includes neglect, abandonment, and exploitation.

South Carolina

Abuse: Means physical abuse or psychological abuse. See statute for more information.

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: (a) Attempting to cause, or intentionally or knowingly causing physical harm or intentionally placing another in fear of imminent physical harm; (b) physical injury caused by criminally negligent acts or omissions; (c) unlawful detention or unreasonable confinement; (d) gross lewdness; or (e) deprivation of life-sustaining treatment

Vermont

Abuse: (A) Any treatment of an elderly or disabled 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 an elderly or disabled adult; (C) Unnecessary confinement or unnecessary restraint of an elderly or disabled adult; (D) Any sexual activity with an elderly or disabled adult by a caregiver, either, while providing a service for which he or she receives financial compensation, or at a caregiving facility or program; (E) Any pattern of malicious behavior which results in impaired emotional well-being of an elderly or disabled adult.

Virginia

Abuse: Willful infliction of physical pain, injury, or mental anguish or unreasonable confinement.

 

 

 

Washington

Abuse: Willful action or inaction that inflicts injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult. In instances of abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish.

West Virginia

Abuse: Infliction or threat to inflict physical pain or injury on or the imprisonment of any incapacitated adult or facility resident

Wisconsin

Abuse: Willful infliction on an elder person of physical pain or injury or unreasonable confinement.

Wyoming

Abuse: Willful infliction, whether by another person or self-inflicted, of physical pain, injury, unreasonable confinement or deprivation, which conduct threatens the welfare and well being of a disabled adult.

Note: State laws are always subject to change, usually through the enactment of new legislation but also through court decisions and other means. Contact an attorney or conduct your own legal research to verify the state law(s) you are researching.

Get a Free Nursing Home Abuse Claim Evaluation

Nursing home abuse laws can differ widely from state to state. 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 a free evaluation of your potential nursing home abuse claim.

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