Sexual abuse in nursing homes

Legal accuracy check

Chris Schroeder, Esq.

Florida Bar #520381 · D.C. Bar

First published October 5, 2026 · Last checked October 5, 2026

How pages are checked

How claims against a nursing home work

This page covers skilled nursing facilities, nursing homes and other long-term care settings for older adults. A claim against one of them usually asks who was allowed near the resident, what staff were told, and what the facility did next. The institutions hub lists the other kinds of institution we cover.

Federal standards for Medicare and Medicaid facilities

A nursing home that takes Medicare or Medicaid must meet the requirements in 42 CFR Part 483. The definitions section is direct: “Sexual abuse is non-consensual sexual contact of any type with a resident” (42 CFR 483.5). Under 42 CFR 483.12, “the resident has the right to be free from abuse, neglect, misappropriation of resident property, and exploitation.” The facility must have written policies that “prohibit and prevent” abuse and set out how allegations are investigated.

The reporting clock is short. An allegation that involves abuse must be reported to the administrator and to the State Survey Agency “immediately, but not later than 2 hours after the allegation is made,” and the results of the facility’s investigation are due within five working days (42 CFR 483.12(c)). These rules are enforced by the government through inspections and penalties. In a lawsuit, they show what the facility was required to do; how much weight a court gives them depends on the state.

The Elder Justice Act reporting rule

A separate federal statute puts the duty on individuals as well as the facility. Under 42 U.S.C. 1320b-25 (section 1150B of the Social Security Act), every owner, operator, employee, manager, agent and contractor of a long-term care facility that received at least $10,000 in federal funds in the preceding year must report any “reasonable suspicion of a crime” against a resident to federal health officials and to at least one law enforcement agency. Where there is serious bodily injury, the report is due within 2 hours; otherwise within 24 hours. A covered person who fails to report faces a civil penalty of up to $200,000, or up to $300,000 if the failure made the harm worse. The facility may not retaliate against an employee who reports.

Federal auditors have found reports going missing. The HHS Office of Inspector General found in a June 7, 2019 audit (A-01-16-00509) that an estimated one in five high-risk emergency room Medicare claims for nursing home residents in 2016 resulted from potential abuse or neglect, and that facilities “failed to report many of these incidents” as federal rules required.

Negligence and state elder abuse statutes

The main civil claim is negligence under state law: negligent hiring, supervision and retention of staff, and failure to protect a resident from a known risk, including another resident with a history of sexual misconduct. Many states also have an elder abuse statute that adds remedies. California’s Elder Abuse and Dependent Adult Civil Protection Act is one example. It covers people 65 and older (Welf. & Inst. Code 15610.27) and defines physical abuse to include sexual assault (15610.63(e)). Where a plaintiff proves by clear and convincing evidence that a defendant committed the abuse and acted with “recklessness, oppression, fraud, or malice,” the court “shall award to the plaintiff reasonable attorney’s fees and costs,” and a limit on damages that normally applies after the victim’s death is lifted (15657). Against an employer, the plaintiff must also meet the stricter test for holding an employer responsible for punitive damages. Other states set their own definitions and remedies.

Public nursing homes and Section 1983

Some nursing homes are owned by counties or hospital districts. On June 8, 2023, in Health and Hospital Corp. of Marion County v. Talevski, the Supreme Court held, 7 to 2, that two provisions of the Federal Nursing Home Reform Act, on unnecessary restraint and on notice before discharge, give residents rights they can enforce under 42 U.S.C. 1983 against a county-owned home. The Court did not rule on the Act’s other provisions, so whether a resident can sue a public facility under Section 1983 over abuse is decided provision by provision.

Who can be held responsible

The facility and its licensee. The company or public body that holds the license and runs the home is the usual defendant. It is answerable for its own hiring, staffing, supervision and response to complaints.

Owners and management companies. Many homes are run by an operating company with a separate owner or management company above it. Whether those entities can be held liable depends on how much control they had over staffing and care, which is a question of state law and of the evidence.

The person who committed the abuse. A staff member, visitor or other resident can be sued directly. Where the abuser is another resident, the claim against the home asks whether it knew of the risk and failed to act. A criminal case is separate from the civil claim and can run at the same time; see civil and criminal cases.

Abuse by a physician in a care setting is covered on our page about doctors and medical institutions, and abuse of adults with disabilities in community residences on our group homes page. Our guide to adult sexual assault describes the kinds of conduct the law treats as assault. Families can often bring a claim on behalf of a resident who cannot, and can ask to proceed under initials; see filing anonymously.

Deadline and arbitration issues for nursing homes

Arbitration clauses in admission agreements. In 2016 the Centers for Medicare & Medicaid Services banned nursing homes from using arbitration agreements signed before a dispute arose. On November 7, 2016, a federal court in the Northern District of Mississippi blocked that ban, and a final rule published July 18, 2019 (84 FR 34718, effective September 16, 2019) repealed it. The current rule, 42 CFR 483.70(m), allows these agreements with conditions. A facility “must not require” a resident or representative to sign one as a condition of admission or continued care. The agreement must give the right to rescind it “within 30 calendar days of signing it,” must provide for a venue convenient to both sides, and the facility must keep the agreement and any decision for five years.

For sexual assault, federal law now goes further. The Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act of 2021 (9 U.S.C. 402, Public Law 117-90, enacted March 3, 2022) provides that, “at the election of the person alleging” a sexual assault dispute, no predispute arbitration agreement “shall be valid or enforceable” in a case relating to it. The statute defines a sexual assault dispute to include nonconsensual sexual contact “including when the victim lacks capacity to consent” (9 U.S.C. 401), and it says a court, not an arbitrator, decides whether it applies. Keep a copy of every page signed at admission, including pages a relative signed.

Time limits. A claim by an adult follows the state’s adult deadlines. In California, a civil claim for sexual assault of an adult can be brought within 10 years of the last act or three years from discovery, whichever is later (Code Civ. Proc. 340.16(a)), and a window open from January 1, 2026 to December 31, 2027 revives older claims against a private entity alleged to have covered up earlier assaults. If a claim is framed as medical negligence instead, the shorter clock in Code Civ. Proc. 340.5 (three years from injury or one year from discovery, whichever comes first) can be argued. California also stops the clock while a person is “lacking the legal capacity to make decisions” (Code Civ. Proc. 352(a)), but that pause does not apply to claims against a public entity.

Public facilities. A claim against a county or district nursing home usually has to be presented to that body in writing first. In California the deadline is six months (Gov. Code 911.2); the exemption for childhood sexual abuse does not reach claims by adults, and the 2026 to 2027 revival window excludes public entities. The general rules by state are in our statute of limitations reference.

Active litigation involving nursing homes

Nursing home sexual abuse claims are almost always individual suits in state court. We have not found a consolidated proceeding. Each item below is an allegation unless it says a court has ruled.

In the Savannah case, the resident’s sister alleges that the other resident had “a documented history of sexual misconduct” and that the facility did not tell the family, according to WTOC (September 21, 2026). Riverview had not responded to a request for comment or to the lawsuit in court as of that report, so its position is not in the public record we reviewed. No criminal charge was reported.

The case tracker lists the matters we follow. A facility missing from this page is not a sign that no claim exists.

Where to go next

If a resident is in danger now, call 911. Reporting abuse explains how to report to police and to the state agency that inspects nursing homes, and our guide for families covers what relatives can do. How to file a claim walks through what a lawsuit involves, and trauma and healing lists support that does not depend on any lawsuit. If you want a lawyer to look at the dates and the admission paperwork, a free, confidential case review costs nothing and commits you to nothing.

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