Complete Elder Abuse Guide

You noticed a bruise no one can explain, a bedsore that wasn’t there last month, or money missing from a parent’s account. Or you’re the one being mistreated by someone you depend on. If you aren’t sure whether you’re overreacting, that’s a normal place to start, and you don’t need proof to ask for help.

Here’s the plain answer. Elder abuse is an intentional act, or a failure to act, by a caregiver or someone else an older adult trusts, that harms them or puts them at risk of harm (CDC). If someone is in danger, call 911. Otherwise, report it: in Michigan, to Adult Protective Services, or for a nursing home, to the state agency that licenses it. Separately, the person who was harmed, or someone acting for them, may have a civil claim for money against whoever is responsible, sometimes including a nursing home. In Michigan, a negligence claim generally must be filed within three years, and a medical malpractice claim within two (MCL 600.5805(2), (8)).

You don’t have to be certain before you call: Michigan’s APS says its staff are trained to handle a report from someone who has only “a feeling” about a situation (MDHHS). The hard part is often the process itself: several agencies with different jobs, records the facility holds, and a deadline that depends on how a court classifies the claim. Michigan’s rules are in the boxes marked “In Michigan.”

Worried about how a parent is being treated? Get a free case review. Four quick questions, no cost, no obligation.

What counts as elder abuse?

An older adult is someone 60 or older (CDC). Abuse takes several forms, and one person can experience more than one (NCEA):

• Physical: hitting, pushing, unnecessary restraints, or over- or under-medication.
• Emotional: insults, threats, intimidation, humiliation and isolation.
• Sexual: non-consensual sexual contact, including with someone who can’t consent. See our sexual abuse guide.
• Financial: stealing or misusing money or belongings, pressuring someone into signing a document, or misusing a power of attorney, guardianship or conservatorship.
• Neglect: failing to provide necessities such as food, water, clothing, shelter and medicine. In a nursing home, it’s the failure to provide the goods and services a resident needs to avoid physical harm, pain, mental anguish or emotional distress (42 CFR 483.5).

About 1 in 10 older adults who live at home experience abuse, including neglect and exploitation (CDC, page reviewed November 7, 2024). That estimate, which the National Center on Elder Abuse also uses, comes from a national survey done in 2008 and published in 2010, in which 1 in 10 adults 60 and older reported emotional, physical or sexual abuse or potential neglect in the past year (Acierno et al., 2010; NCEA). In institutions such as nursing homes, a 2018 review of studies found that 64.2% of staff reported having committed some form of abuse in the past year (World Health Organization, June 2024).

What are the warning signs of abuse and neglect?

Michigan’s Adult Protective Services lists these signs, among others (MDHHS):

Signs of neglect in a nursing home

Nursing homes in Medicare or Medicaid have specific duties:

• Bedsores (pressure ulcers): the home must make sure a resident gets care to prevent them and doesn’t develop them unless their clinical condition shows they were unavoidable (42 CFR 483.25(b)(1)).
• Falls: the environment must be “as free of accident hazards as is possible,” with “adequate supervision and assistance devices to prevent accidents” (42 CFR 483.25(d)).
• Weight loss and dehydration: the home must make sure residents keep acceptable nutrition, such as their usual body weight, unless their condition or preferences rule it out, and offer enough fluids (42 CFR 483.25(g)).
• Medication errors: the error rate must stay below 5%, with no significant errors (42 CFR 483.45(f)). See medication error claims.
• Restraints, including drugs, can’t be used for discipline or convenience (42 CFR 483.12(a)(2)).

A fall or a sore doesn’t prove neglect by itself: the rules allow for unavoidable sores, and in Michigan, a claim that a home simply had to provide “an accident-free environment” states no claim at all (Bryant v Oakpointe Villa Nursing Centre, 2004). The question is whether the home did what it should have.

Where do you report elder abuse, and what happens next?

Nationally, the rule of thumb is to call 911 for immediate danger, report abuse in the community to Adult Protective Services, and report abuse in a nursing home or assisted living to the state licensing agency (NCEA). Nursing homes in Medicare or Medicaid must also report allegations of abuse, neglect, exploitation or mistreatment to state officials themselves: within 2 hours if abuse or serious bodily injury is involved, and otherwise within 24 hours (42 CFR 483.12(c)(1)).

What rules must a nursing home follow?

Every nursing home in Medicare or Medicaid must meet the federal requirements in 42 CFR Part 483, which are also the basis for its inspections (42 CFR 483.1(b)). Besides the care duties above, residents have the right to be free from abuse, neglect, exploitation and misappropriation of their property (42 CFR 483.12), and a home must have enough nursing staff with the right skills, around the clock, to keep residents safe (42 CFR 483.35).

Breaking a rule doesn’t make a home automatically liable. In Michigan, the model jury instruction on regulations adopted by a state agency tells jurors to weigh a violation as evidence of negligence, together with all the other evidence, and you still have to show the negligence caused the harm (M Civ JI 12.05). The instruction is written for state regulations, so ask a lawyer how the federal rules would be used in your case.

Medicare’s Care Compare rates each nursing home from 1 to 5 stars, including for health inspections and staffing (CMS), and a home must let anyone review its inspection and complaint reports from the past three years (42 CFR 483.10(g)(11)).

Who can be held responsible for elder abuse or neglect?

An elder abuse claim is a kind of personal injury claim. Depending on the facts, it can be brought against:

• The person who caused the harm, often for assault or battery.
• A nursing home or care agency. In Michigan, a facility usually isn’t liable for an employee’s intentional abuse outside the scope of the job, but it can be liable for its own negligence in hiring, training and supervising staff (Zsigo v Hurley Medical Center, 2006), such as hiring someone it knew or should have known was likely to harm people (Hersh v Kentfield Builders, 1971).
• A family member or hired caregiver. In Michigan, a caregiver whose reckless act or failure to act seriously harms a vulnerable adult also commits a crime (MCL 750.145m(c), 750.145n(2)).
• An agent under a power of attorney, a guardian or a conservator who misused their authority.

If a resident was assaulted by an outsider where security was poor, see negligent security claims.

Is a nursing home claim malpractice or ordinary negligence?

In Michigan, the answer can decide whether a claim is filed in time. The state Supreme Court asks whether the claim arose within a professional relationship and whether it raises questions of medical judgment beyond the common knowledge and experience of a jury. If both answers are yes, the malpractice rules apply (Bryant v Oakpointe Villa Nursing Centre, 2004).

In Bryant, a resident with dementia died after slipping between her bed rails and mattress, the day after two nursing assistants found her tangled in her bedding, dangerously close to asphyxiating, and, by their account, told their supervising nurses she was at risk. The claim that the home did nothing after learning of the danger was ordinary negligence: no expert is needed to judge whether it should have taken some corrective action. The claims that it failed to train staff to assess the risk from bed rails, and failed to assess the risk from her bedding arrangement, were malpractice, because they needed expert testimony. Because the line can be hard to draw, the Court advised filing close cases both ways, within the deadlines that apply.

Not sure whether your claim is malpractice or negligence, or how much time is left? Get a free case review. Four quick questions, no cost, no obligation.

What if money or property was taken?

Elder abuse, including financial exploitation, is often committed by someone the older person knows and trusts, such as a family member or caregiver (NCEA). Report it to APS at 855-444-3911, whether it happened to you or to someone else (MDHHS; MCL 400.11a(3)).

Can a nursing home make you use arbitration instead of court?

Admission papers can include an agreement to resolve disputes through binding arbitration, out of court (Legal Information Institute). Under the Federal Arbitration Act, a written arbitration agreement in a contract involving commerce is valid and enforceable, except on grounds that exist for revoking any contract (9 U.S.C. § 2), and a person with a claim of sexual assault or sexual harassment that arose on or after March 3, 2022, can choose court instead (9 U.S.C. § 402(a)). For nursing homes in Medicare or Medicaid, federal rules add protections (42 CFR 483.70(m)):

• The home can’t require the agreement for admission or continued care, and must say explicitly that signing is optional.
• It must be explained in a form and language the resident and representative understand, and provide for a neutral arbitrator both sides agree on and a convenient venue.
• It must allow 30 calendar days to cancel it after signing, and can’t discourage anyone from talking to officials, including inspectors and the ombudsman.

A home also can’t ask for or require a third party, such as a relative, to guarantee payment as a condition of admission or of staying (42 CFR 483.15(a)(3)). If your parent is already in a home, check the admission papers for an arbitration agreement and its date, and ask a lawyer whether it covers your claim.

Who can bring the claim, and what if your loved one died?

If the older person can make their own decisions, the claim, and every decision about it, is theirs. When abuse or neglect causes a death, the family may have a wrongful death claim. See our wrongful death guide, Michigan wrongful death claims and how a settlement is divided.

How long do you have to file an elder abuse claim?

Every state sets deadlines, called statutes of limitations, and they depend on the claim. See injury deadlines in every state.

How do you get the records and keep the evidence?

The care plan, nursing notes and incident reports show what the home knew and did.

• The resident’s right: in a home in Medicare or Medicaid, a resident can see their records within 24 hours of a request, excluding weekends and holidays, and get copies within 2 working days, for a reasonable, cost-based fee. A resident representative, such as an agent under a power of attorney or a guardian, can exercise the rights delegated to them or given to them by a court (42 CFR 483.5; 483.10(b)(3), (7), (g)(2)).
• HIPAA: a provider generally must act on a request within 30 days, with one 30-day extension (45 CFR 164.524(b)(2)). A person with legal authority to make an adult’s health care decisions counts as their personal representative, as does an executor or administrator after a death (45 CFR 164.502(g)(2), (4)).

Keep a dated log and photos of what you see, as Michigan’s Attorney General suggests (Michigan Department of Attorney General), along with bills and the admission papers. Before putting a camera in a resident’s room, ask a lawyer: Michigan makes it a crime to install a recording device in a private place without the consent of the people entitled to privacy there (MCL 750.539d(1)(a)), and LARA considers only photos and recordings obtained lawfully (LARA).

What can an elder abuse claim recover?

Damages can include the reasonable cost of necessary medical care, pain and suffering, mental anguish, fright and shock, and the denial of social pleasure and enjoyments (M Civ JI 50.02, 50.05), but no one can honestly tell you in advance what a claim is worth. If Medicare paid for treatment of the injuries, federal law requires it to be repaid from a settlement or judgment that covers that care (42 U.S.C. § 1395y(b)(2)(B)(ii)). See pain and suffering damages and who gets paid from a settlement.

What to do next

1. Make sure your loved one is safe. In an emergency, call 911. Get medical care for any injury, and ask that it be documented.
2. Report it. In Michigan, call APS at 855-444-3911, and for a nursing home or other health facility, LARA at 800-882-6006. The ombudsman, 866-485-9393, can help a resident raise concerns.
3. Write it down. Keep a dated log and photos, request the records, and find the admission papers.
4. Check the arbitration clock. At a nursing home in Medicare or Medicaid, an arbitration agreement signed in the last 30 days can still be canceled (42 CFR 483.70(m)(3)).
5. Talk to a lawyer before any deadline passes. Get a free case review, or compare Michigan injury lawyers and ask each whether they handle nursing home and elder abuse cases.

What waiting can cost

• The right to sue. In Michigan, a malpractice suit generally must be filed within 2 years, with the 182-day notice sent first, and most negligence suits within 3 (MCL 600.5805(2), (8); 600.2912b(1)).
• An investigation under the federal rules. In most cases, LARA can’t investigate an incident more than 12 months old under federal authority; it may forward it for investigation under state authority instead (LARA).
• The chance to cancel an arbitration agreement at a home in Medicare or Medicaid, which ends 30 calendar days after signing (42 CFR 483.70(m)(3)).
• Evidence. Wounds heal and witnesses move on.

What a good outcome looks like

Your parent is safe, whether the care has been fixed or they’ve moved, and the agencies you called have looked into what happened. If there’s a claim, it’s filed on time, the records show what the home knew and did, and those responsible pay for the harm. If your parent can decide for themselves, they do, with you beside them. From worrying that something is wrong to knowing who to call, what the home owed your parent and how long you have to act.

For other claims involving medical care, browse the medical mistakes and malpractice guides.

Updated September 28, 2026

This guide is general information, not legal advice, and laws change. For advice about your situation, talk to a lawyer licensed in your state. Reading this page or contacting us does not create an attorney-client relationship.