Choosing a Nursing Home? Watch Out for These Top 3 Red Flags

As the population ages, the demand for nursing homes and other long-term care facilities continues to grow. Roughly 4 million Americans use some form of long-term care each year, and experts predict that nearly 70% of adults over age 65 will need long-term care services at some point in their lives.

Unfortunately, nursing home abuse and neglect remain serious problems across the country. While many facilities provide excellent care, others put profits ahead of residents, leading to preventable injuries, medication errors, poor living conditions, and even abuse.

Choosing the right nursing home can feel overwhelming. The good news is that many warning signs reveal themselves long before a loved one moves in if you know what to look for.

Abuse and Neglect Remain a Nationwide Problem

Nursing homes that accept Medicare or Medicaid (which includes most facilities) must comply with strict federal regulations designed to protect residents’ health, safety, and dignity.

Despite these requirements, investigations by the Office of Inspector General (OIG) have repeatedly uncovered troubling practices throughout the industry.

Common issues include:

• chronic understaffing,
• inadequate employee training,
• medication errors,
• preventable injuries,
• poor supervision,
• and failures to properly investigate complaints.

In March 2026, the OIG reported that some nursing homes improperly diagnosed residents with schizophrenia in order to administer antipsychotic medications.

Investigators found evidence that certain facilities were using these medications to manage resident behavior and improve quality metrics rather than provide appropriate medical care.¹

Read the report highlights here

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Did You Know?

Nursing homes cited for abuse will have an icon showing a white hand inside a red circle next to their name on Medicare.gov.

 

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How to Tell When a Nursing Home Isn’t Safe

For many families, choosing a nursing home is one of the most important decisions they’ll ever make.

The challenge is that most facilities look good during a scheduled tour. The lobby is clean. The staff are friendly. The administrator knows exactly what to say.

The real question is what happens when the tour ends.

Here are three red flags that deserve closer attention.

#1: They Seem More Interested in Selling Than Answering Questions

A quality nursing home should welcome questions from prospective residents and their families.

After all, you’re trusting them with someone’s health, safety, and daily care.

Be cautious if a facility:

• Pressures you to make a decision quickly
• Avoids questions about staffing levels
• Won’t discuss inspection reports or deficiencies
• Gives vague answers about resident care
• Focuses heavily on amenities while avoiding medical-care questions

Many families make the mistake of evaluating a nursing home like they would an apartment complex or hotel. A beautiful building is nice, but it tells you very little about the quality of care residents receive.

A nursing home tour should feel more like an interview than a sales presentation.

How to Spot It During Your First Visit

• Staff seem annoyed by detailed questions
• Administrators cannot provide clear information
• You feel rushed through the tour
• They discourage you from comparing other facilities
• Questions about staffing receive vague answers

If a facility becomes defensive when you ask reasonable questions, consider it a warning sign.

#2: The Facility Looks Fine, But the Residents Don’t

This is one of the most important things families overlook.

Many nursing homes invest heavily in landscaping, common areas, and attractive lobbies. While appearance matters, the residents themselves often provide the clearest picture of what daily life is actually like inside the facility.

As you tour, pay attention to the people living there.

Do residents appear engaged and cared for? Or do they seem neglected and forgotten?

How to Spot It During Your First Visit

• Residents appear unclean or poorly groomed
• Multiple residents are left unattended
• Call lights go unanswered
• Residents appear withdrawn, distressed, or fearful
• Staff interactions seem rushed or impersonal

One neglected resident may be an isolated issue. Several residents showing signs of poor care may indicate a systemic problem.

The condition of the residents will tell you far more than the condition of the building.

#3: They Don’t Want Family Around

One of the strongest protections against nursing home abuse and neglect is family involvement.

Facilities that provide quality care generally welcome family participation because they understand residents benefit from strong support systems.

Facilities that seem to discourage family involvement deserve closer scrutiny.

How to Spot It During Your Research

• Online reviews mention poor communication
• Visitor policies seem unnecessarily restrictive
• Staff become uncomfortable when discussing visitation
• They discourage unannounced visits
• Family complaints appear repeatedly in reviews

While facilities may establish reasonable visitor procedures, families should never feel like they are being treated as an inconvenience.

A nursing home should view family members as partners in care, not obstacles.

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Did You Know?

You can use Medicare’s Care Compare tool to review staffing levels, inspection reports, quality ratings, and abuse citations for Medicare-certified nursing homes in your area.

 

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Do Your Homework Before Signing Anything

Choosing a nursing home is too important to base on a single tour.

Before making a final decision:

• Check Medicare Care Compare ratings
• Review state inspection reports
• Read recent online reviews
• Visit multiple times and at different hours
• Ask about staffing ratios and turnover
• Review abuse citations and serious deficiencies
• Talk to residents and family members when possible

Many problems only become visible when you look beyond the marketing materials.

A little extra research today may help prevent a heartbreaking situation tomorrow.

If You Suspect Abuse or Neglect, Trust Your Instincts

Even families who do everything right can discover problems after a loved one moves into a facility.

Warning signs may include:

• Unexplained bruises or injuries
• Sudden weight loss or dehydration
• Poor hygiene
• Untreated medical conditions
• Emotional withdrawal
• Fearfulness around certain staff members
• Frequent falls
• Medication errors

If something feels wrong, don’t ignore it.

Ask questions. Document your concerns. Speak with your loved one whenever possible. In many cases, family members are the first people to recognize that abuse or neglect may be occurring.

Nursing Home Neglect in Texas? Call Shaw.

Nursing home abuse cases can be difficult to uncover because facilities control the records, witnesses, and information families need to understand what happened. Fortunately, you don’t have to navigate this alone.

If you or a loved one suffered abuse or neglect in a Texas nursing home, you could be entitled to compensation for things like:

• Medical Expenses
• Pain and Suffering
• Emotional Distress
• Relocation Costs
• Rehabilitation Expenses
• Wrongful Death Damages
• And More

We’ll help you find out for free.

Call Shaw at 800-862-1260 today or use our live chat to schedule your free consultation with an experienced nursing home abuse attorney in Texas. No fees, no obligations, just straightforward legal guidance from a firm that puts clients first.

We look forward to serving you.

 

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¹OIG’s Nursing Home Misdiagnosis Full Report (March 2026)