Myth or Fact? How to Tell the Truth About Nursing Home Abuse

When something about your loved one’s care doesn’t add up, here’s the short answer: nursing home abuse can happen in any facility and usually manifests in troubling patterns; unexplained weight loss, persistent bedsores, missed medications, constant falls and bruising, or sudden withdrawal. Document what you see, report it to the Texas Health and Human Services Commission (HHSC) or Adult Protective Services, and consult a Dallas attorney quickly to protect your loved one and preserve evidence. 

At Crowe Arnold & Majors, we understand that no legal outcome can ever undo the pain of losing someone you love or watching them suffer. That’s why our nursing home abuse attorneys do more than just represent you; we stand beside you. We listen. We care. And we fight to deliver the full justice you and your loved ones deserve. Schedule a free consultation today.

Call to Discuss Your Nursing Home Abuse Case

Why Common Misconceptions About Nursing Home Abuse Are Dangerous

Many families assume residents will speak up, staff will document issues, or regulators will catch problems, but in reality, the vast majority of abuse cases stay hidden.  

According to recent studies, 1 in 10 Americans age 60+ have experienced some form of elder abuse—and only 1 in 24 cases get reported. 

Believing these misconceptions about nursing home abuse can: 

• Delay action: Misplaced trust can cause families to overlook small warning signs until they become emergencies. 
• Silence concerns: Myths can make families question their instincts, stopping them from raising issues with staff or regulators. 
• Allow harm to continue: Without scrutiny, neglectful or abusive practices can remain hidden, endangering residents long-term.  

The reality is: many residents suffer in silence because they fear retaliation, feel ashamed, or are physically or cognitively unable to report what’s happening. In Texas, the problem carries particular urgency, as elder abuse escalated from 60,000 cases in 2022 to 83,000 cases in 2023.  

ProPublica’s Nursing Home Inspect database found that 60% of Texas nursing facilities have been cited for at least one serious deficiency causing “immediate jeopardy” during inspections in the last three years.

Common Myths About Nursing Home Abuse

We want to trust the people and institutions caring for our loved ones. It’s comforting to believe that licensed facilities are always safe, that staff are fully trained, and that regulators will catch problems. These assumptions can make us overlook warning signs, second-guess our instincts, or dismiss small red flags, which is exactly why the following myths about abuse are so persistent. 

Myth: “Abuse Only Happens in Poor-Quality Facilities” 

Reality: Abuse and neglect can occur in any facility, from top-tier homes to those with a troubled reputation. A North Texas Nursing Home was fined $1.25 million over a three-year period by the Centers for Medicare & Medicaid Services (CMS). This fine was the third-highest nationwide during that time. The facility faced serious violations, including allegations of sexual assault and other severe infractions. Thinking that only “bad” facilities are unsafe can lull families into a false sense of security. 

Myth: “If There Are No Bruises, There’s No Abuse” 

Reality: Many kinds of abuse leave no visible marks. In fact, emotional abuse is the most prevalent form of elder abuse, affecting approximately 11.6% of older adults globally, resulting in cognitive decline, depression, and premature mortality. Medication errors and neglect can also be potentially fatal if left unchecked. Additionally, financial exploitation is alarmingly common. 

Myth: “Regulators Will Catch Abuse Before It Gets Serious” 

Reality: Government oversight is important, but not perfect. Investigations take time. Some violations remain undetected for long periods, especially if residents or families don’t speak up. A 2017 federal audit found that in 28% of nursing home abuse cases nationwide, including cases in Texas, there was no evidence the incidents had been reported to law enforcement, despite federal and state laws requiring prompt reporting. This shows that even with regulations in place, abuse can persist if it is not reported. 

Myth: “Families Can Always Spot Abuse Right Away” 

Reality: In many cases, abuse or neglect starts subtly. Changes in mood, hygiene, appetite, or daily routine may go unnoticed. In 2022, an 86-year-old man in Texas City, Texas, was hospitalized after slipping out of bed.  His granddaughter, who had installed a camera in his room due to previous concerns, discovered further abuse when reviewing footage. This incident underscores how abuse can begin subtly and escalate unnoticed until significant harm occurs.

<p align=”center”><strong><a href=”tel:214-231-0555″ class=”button”><strong>Call Our Office to Discuss Your Case</strong></a></strong> </p> 

The Facts Families Need to Know

Abuse can happen anywhere, and when it does, Texas nursing home, assisted living, rehab, and long-term care facilities must follow mandatory reporting laws. Staff who suspect abuse, neglect, or exploitation are legally required to report those to the state regulatory agency (HHSC) and, in some cases, to law enforcement.  

Yet, in practice, these reports don’t always happen. Families can’t assume the system will catch everything. They need to watch for subtle changes in their loved one’s health or behavior and be ready to act if something seems off. 

Abuse Happens in All Types of Facilities

No facility is immune. Staffing strain, turnover, or lax training and enforcement affect homes across the board. Even well-regarded nursing homes have been cited for a few deficiencies, even serious ones. For example, one nursing home had among the lowest numbers of deficiencies in Dallas County. Yet, reports include failure to provide adequate ulcer care and satisfactory food. 

Signs of Neglect Go Beyond Physical Injuries

Bruises and broken bones are the most obvious symptoms of physical abuse, whereas the signs of emotional abuse and nursing home neglect can be much more subtle.   

Watch for patterns like: 

• Weight loss, dehydration, malnutrition 
• Bedsores (pressure ulcers) that worsen 
• Unexpected infections 
• Poor hygiene, unsanitary environment 
• Sudden confusion or emotional withdrawal 
• Medication errors 
• Changes in finances (e.g., missing funds or unexplained purchases) 

If you notice these changes, start by documenting them and asking staff or doctors direct questions. Consistent patterns or unresolved concerns may signal neglect that needs to be reported. 

Violations Often Go Unreported or Hidden

Even when serious violations are reported to state regulators, facilities don’t always alert law enforcement, and families may not be told unless their loved one was directly affected. This lack of transparency makes it even harder for families to grasp the true scope of problems inside a facility. 

State and Federal Oversight Have Limits

• At the federal level, minimum staff requirements were created to improve safety. However, in 2025, a Texas court struck down a rule that would’ve required an RN on duty 24/7 and established a legally required staffing ratio in the state, arguing it overstepped regulatory authority.  
• Meanwhile, Texas’s AG has also challenged national rules requiring higher staffing levels, citing concerns that the regulations could force rural facilities to close due to existing nursing shortages and financial constraints. 
• On the state side, the Texas Department of Aging and Disability Services (now folded under HHSC) issues guidance and handles complaints. HHSC recently updated its rules on reporting abuse and neglect, requiring facilities to notify the state’s Complaint and Incident Intake Unit immediately for any suspected or confirmed incidents. The updates also clarify reporting for communicable diseases and provide clear steps for staff, making it easier to track and respond to abuse. Even with the updates, resources are limited and inspections are periodic.

Families Must Stay Vigilant and Ask Questions

It’s natural to worry about jumping to conclusions. A single issue, like weight loss or confusion, can have medical causes unrelated to neglect. Instead of making immediate accusations, stay vigilant: 

• Document what you see. Keep notes, photos, or dates of changes you notice. Patterns over time are more telling than one incident. 
• Ask staff and doctors direct questions. Bring up concerns in a calm, specific way: “I noticed Mom has lost weight—what’s the care plan to address this?” 
• Follow up. If explanations don’t add up or conditions don’t improve, escalate the concern to facility leadership or your loved one’s care team. 
• Know when to report. If serious harm, unsafe conditions, or repeated issues occur, you can file a complaint with Texas HHSC or call law enforcement if it’s urgent. 

How to Protect Your Loved One from Abuse and Neglect

The most important step families can take is to stay involved and informed. Visit often, ask questions about daily routines, care plans, and medications, and build a relationship with staff. Small, consistent check-ins allow you to spot subtle changes early, making it harder for neglect or abuse to go unnoticed.

Common Signs of Nursing Home Abuse

When touring a facility or arriving on the first day, keep an eye out for: 

• Residents crying out from their rooms, with calls going unanswered 
• Withdrawn, confused, or unusually quiet residents 
• Residents appearing dehydrated or malnourished 
• Staff who seem rushed, inattentive, or absent from key areas 
• Disorganized medication storage or irregular medication schedules 
• Missing personal items, money, or other valuables 
• Dirty rooms, unpleasant odors, dim lighting, or poorly maintained common areas 

How to Document and Report Concerns

1. Write it down. Date, time, what you saw or heard, who was present. 
2. Take photos or videos, when possible and lawful. 
3. Request facility records or reports. Document responses (or lack thereof) in writing. 
4. Report to authorities:
   • Texas HHSC (nursing home complaint hotline) 
   • Local Adult Protective Services (APS) 
   • Dallas County long-term care ombudsman 
   • If harm is severe, involve law enforcement 
5. Keep copies of every communication, report, or piece of evidence.

Legal Options for Families in Dallas

If abuse or neglect is confirmed or strongly suspected, families may pursue: 

• Administrative complaints, leading to fines or sanctions 
• Protective orders in extreme cases to prevent further contact 
• Civil lawsuits for negligence, wrongful death, and elder abuse 

An experienced attorney can help you understand which path fits your situation and how to navigate it. 

Call today or request a free, confidential consultation. No fees unless we win.

Why Choose Crowe Arnold & Majors, LLP for Nursing Home Abuse Cases

Suspecting or knowing a loved one’s been harmed is an upsetting situation you don’t have to face alone. An attorney can guide you through every step, explain your rights, and help you understand what’s really happening in a facility.  

Even if you’re unsure you want to file a formal complaint or lawsuit, an experienced lawyer can investigate, gather evidence, and give you clear options. Professional support can make a confusing and emotional situation much more manageable and ensure your loved one’s safety comes first. 

Experience Holding Dallas Facilities Accountable 

At Crowe Arnold & Majors, LLP, our experienced attorneys handle cases against Dallas-area nursing homes involving neglect, bedsores, improper medication, and abuse. We understand the state and federal rules at play and how to build a strong case for your family.  

When you hire our team, you’re not hiring a single attorney; you’re hiring a council of attorneys who collaborate and contribute their own experiences to the case, always seeking to provide the most successful outcome for the clients we represent. We have recovered hundreds of millions in verdicts and settlements. 

How We Support Families During Investigations 

When you work with us, we’ll: 

• Conduct an independent review and investigation. 
• Help you preserve evidence (records, photos, interviews) 
• Guide you through reporting to authorities 
• Advocate for transparency 
• Handle communications to protect the emotional well-being of your loved one. 
• Represent you in court or settlement negotiations 
• Keep you updated and supported at every step 

We aim to carry the burden so families can focus on their family member’s safety. 

Frequently Asked Questions 

We’re here to answer any questions you have about elder abuse in Texas. Consultations are always free of charge. Here are some of the most common questions people ask: 

What’s the most common myth about nursing home abuse? 

The biggest nursing home myth is believing, “If there are no visible injuries, nothing is wrong.” That misconception hides emotional abuse, neglect, and medication errors — all serious and often invisible. 

Can facilities hide violations from families? 

Yes — facilities can hide violations either by failing to record them fully, refusing to share internal reports, delaying responses, or presenting minimal or sanitized explanations. That’s why keeping your own records and asking detailed questions is so important. 

What should I do if I suspect abuse but have no proof? 

Don’t wait. Begin documenting everything you observe. Report your concerns to the proper agencies (HHSC, APS, local ombudsman). Talk to an attorney with experience in nursing home abuse. Attorneys can sometimes obtain internal records via legal process (e.g., subpoenas) and work to build a case on your loved one’s behalf. 

What legal remedy can Texas courts offer if my elder abuse case is successful?  

If your elder abuse case in Texas is successful, courts can award compensatory damages related to the abuse or neglect to cover medical bills, therapy, and pain and suffering. Punitive damages may also be awarded to punish particularly egregious behavior and deter future misconduct. 

If you’ve noticed worrying signs — big or small — don’t dismiss your instincts. The earlier you act, the better your loved one’s chance of safety and justice.  

Our attorneys and staff at Crowe Arnold & Majors, LLP are committed to helping Dallas and North Texas families hold neglectful or abusive nursing homes accountable. Contact us today for a free consultation, and protect your loved one’s dignity, security, and rights.