Nursing Home Abuse and Neglect

Wear Trial Law brings claims against California skilled nursing facilities for pressure injuries, falls, malnutrition and dehydration, medication errors, elopement, and untreated infections. Nearly all of these injuries are preventable, and nearly all trace to the same root cause: staffing below what the facility’s own residents required. Consultations are free and confidential.

The injuries that signal neglect

Pressure injuries. Bedsores are largely preventable through repositioning, nutrition, and skin assessment. A stage three or four pressure injury acquired in a facility is not an unlucky outcome — it is a documented failure of care over days or weeks.

Falls. Facilities are required to assess fall risk and implement interventions. A resident documented as a high fall risk who falls repeatedly presents an obvious question about whether the care plan was followed.

Malnutrition and dehydration. Both are specifically named in the statutory definition of neglect. Weight loss records and intake-and-output charting are the evidence.

Medication errors. Wrong drug, wrong dose, missed doses, or chemical restraint through inappropriate use of antipsychotics.

Elopement. A resident with documented cognitive impairment who leaves the facility unnoticed reflects a failure of supervision and of the alarm and monitoring systems the facility was required to maintain.

Untreated infections and sepsis. Delay in recognizing and escalating a change in condition is one of the most common patterns in facility death cases.

Understaffing is usually the real defendant

Individual caregivers in these facilities are often doing their best under impossible assignments. The decision that produced the harm was made above them, in a budget.

California sets a minimum number of direct care service hours per patient day for skilled nursing facilities, with a specified portion provided by certified nursing assistants. Facilities are required to maintain staffing records. Comparing required hours against actual rosters, shift by shift, is one of the most productive things a plaintiff can do in discovery — and it is the evidence that converts an “isolated incident” defense into a pattern.

Corporate structure matters too. Many facilities are owned through layered entities, with management companies, licensees, and real estate holders separated on paper. Identifying who actually controlled staffing budgets is part of the work.

The records that decide these cases

The complete medical chart, including nursing notes and the gaps in them. Care plans and whether interventions were implemented. Medication administration records. Wound care documentation and photographs. Weight logs and intake-and-output records. Fall risk assessments and post-fall reports. Staffing schedules against actual time records. State survey findings, deficiency citations, and plans of correction. Prior complaints and the facility’s own incident logs. Corporate ownership and management agreements.

Residents’ rights violations

Beyond a neglect claim, California provides a private right of action for violations of a nursing home resident’s rights under Health and Safety Code section 1430(b), with statutory damages and attorney’s fees available. These claims are frequently pleaded alongside an elder abuse claim and can add substantial value where a facility committed repeated violations.

When records are missing

If a facility cannot produce records it was required to keep, that is not the end of the case. As of January 1, 2026, California law permits a court to apply a lower standard of proof to the Elder Abuse Act’s enhanced remedies where a skilled nursing facility has committed spoliation of evidence. Missing documentation has become a liability for facilities rather than a shield.

FAQ

• My parent developed a bedsore. Is that automatically a case? Not automatically, but facility-acquired pressure injuries at stage three or four warrant a hard look.
• The facility says my parent was “non-compliant.” This is a standard defense. Facilities are required to care for residents who resist care, and to document their attempts.
• We signed an arbitration agreement. Frequently challengeable, particularly regarding family members who never signed. See the wrongful death page.
• Can we get the facility’s staffing records? Yes, through discovery. Facilities are required to maintain them.
• How long do we have to file? Generally two years, but call promptly — records are retained on fixed cycles.

Call 415-233-9688 for a free, confidential review.