Rights in a nursing home are not suggestions: they are enforceable laws. When facilities ignore them residents face real risks, from lost property and financial exploitation to preventable injury. Use this guide to spot violations quickly and take focused action.
1) Nursing Homes Cannot Seize Control of a Resident’s Finances
Residents control their own funds unless they voluntarily designate a representative or a court appoints one. If a facility agrees to hold resident funds, it must safeguard them, keep them separate from operating accounts, provide accounting, and allow access to statements on request under federal resident‑rights rules.
Warning signs of financial exploitation by a nursing home:
- Pressure to sign “convenience” forms that hand over financial control
- Delays or refusals when you ask for balances or transaction histories
- Unexplained withdrawals or balance discrepancies in the resident’s account.
Records to request: Any “trust” account policy, the resident’s fund ledger, and written authorization showing who may access funds.
What to do next: Put concerns in writing to the Administrator. If money is missing or access is blocked, escalate to the Arizona Department of Health Services complaint process and consult legal counsel.
2) Nursing Homes Cannot Disregard or Mishandle a Resident’s Personal Belongings
Residents at nursing homes will frequently complain that their private belongings have gone missing. While it’s true that items are misplaced, family members should be on the lookout for any signs that property was stolen by someone within the nursing home. Facilities must respect and reasonably protect personal property. Residents have the right to retain and use personal possessions to the extent space permits. Misappropriation or exploitation of resident property is prohibited.
Warning signs of theft or mishandling of personal belongings in a nursing home:
- Frequent “lost” items like electronics (including cell phones), glasses, hearing aids, or clothing
- Multiple residents reporting similar missing items (hearing aids, glasses, dentures, clothing) without facility investigation.
- No process for investigating missing property exists at the nursing home
- No secure storage or sign‑in/out process for valuables the facility agrees to hold.
Records to request: Admission inventory, loss reports, laundry tags and logs, and any reimbursement policy.
What to do next: Ask for a written investigation outcome and reimbursement decision. Keep receipts and photos of all valuables that your loved one keeps with them at the facility.
3) Nursing Homes Cannot Tolerate Physical, Sexual, or Emotional Abuse or Neglect
Facilities must prevent abuse and neglect, train staff, monitor for risk, and act immediately when concerns arise. Federal rules prohibit abuse, neglect, exploitation, and involuntary seclusion in a nursing home.
Warning Signs:
- Unexplained injuries, sudden weight loss, dehydration, or untreated bedsores
- Medication irregularities or drastic behavior changes around specific staff
- Intentional isolation, humiliation, threats, or mocking (including on social media)
Records to request: Incident reports, wound charts, medication administration records, and proof that the physician and family were notified.
What to do next: If safety is at risk, call 911. If your loved one is at risk of future abuse and neglect, remove them from the nursing home. It’s important to document any incidents in writing to the nursing home administrator. Report abuse and neglect to ADHS and Adult Protective Services. Then contact an attorney experienced in long‑term care cases to find out if you have legal recourse.
4) Nursing Homes Cannot Exclude Residents From Medical Decisions Involving Their Own Care
Residents have the right to be informed, participate in care, consent to or refuse treatment, and have their advance directives and medical wishes honored by the nursing home. Residents also have the right to access their medical records. CMS surveyor guidance (Appendix PP) further explains facility obligations in these areas. Some nursing home residents may be unable to understand or agree to their care plans without the assistance of their medical guardian or family caretaker. In all other cases, the resident must be involved in decisions affecting their own health.
Warning signs that your loved one is being left out of their care decisions:
- The resident voices concern about undergoing treatment they didn’t agree to. Or, the resident voices concerns about their care plan.
- New medications, diet changes, or stopping of treatment without explanation
- Missed physician notifications after a fall, fever, confusion, or wound change
- Barriers to getting copies of the care plan or medical records
Records to request: Current care plan, physician orders, nursing notes showing status changes and notifications, and any advance directives on file.
What to do next: Request a care‑plan meeting in writing and ask for documented follow‑ups with timelines. Involve the nursing home resident in correspondence and meetings.
5) Nursing Homes Cannot Discriminate in Admission or Care
Facilities must provide equal access to quality care and cannot discriminate based on protected characteristics. Federal resident‑rights rules include equal access requirements, and Section 1557 of the Affordable Care Act prohibits discrimination in federally funded health programs.
Warning signs that discrimination is occurring in a nursing home:
- Different rules, access, or tone for some residents compared to others
- Refusals to provide reasonable accommodations without explanation
Be especially vigilant if your loved one is in a protected class (race, color, national origin, religion, sex including sexual orientation and gender identity, age, or disability). Watch for patterns like delayed care, denial of interpreters or accommodations, or different rules compared with other residents.
Records to request: Admission criteria, grievance policies, and the facility’s written response to your complaint.
What to do next: Document specifics and dates. File a grievance internally with the nursing home administrator and with state and federal agencies if needed.
6) Nursing Homes Cannot Use Physical or Chemical Restraints for Convenience
Chemical restraints refer to the use of medications (usually psychotropic drugs) that are given to control a resident’s behavior, restrict their movement, or sedate them. In some circumstances, these drugs are necessary for the safety or the well-being of the resident. However, chemical restraints may only be used to treat a medical symptom with proper orders, monitoring, and regular reassessment. Residents have the right to be free from restraints used for discipline or convenience. Detailed CMS guidance appears at F604 (physical restraints) and F605 (chemical restraints) in Appendix PP (CMS State Operations Manual, Appendix PP).
Warning signs that chemical restraints are being misused in a nursing home:
- “As‑needed” sedatives without a clear clinical plan or necessity
- New or increased sedating medications (for example antipsychotics, benzodiazepines, sedative‑hypnotics) without a documented medical symptom, care‑plan update, or monitoring plan
- No updates to the care plan after restraint use
Records to request: Physician orders for restraints or sedating medications, monitoring logs, and reassessment notes tied to the care plan.
What to do next: Ask for alternatives focused on safety such as supervision, therapy, or environmental changes. If restraints persist without medical necessity, escalate your concerns.
If you suspect a violation of your loved one’s rights
- Act on safety first. Call 911 if someone is in immediate danger.
- Move your loved one away from the nursing home if you are not comfortable with the quality of care they are receiving.
- Capture the facts. Keep a dated log, take photos, and note who you spoke with and when.
- Escalate in writing. Send concerns to the Administrator and Director of Nursing and request a written response with corrective steps.
- Use oversight channels in Arizona. File a complaint with the Arizona Department of Health Services (ADHS complaint portal), report abuse or neglect to Adult Protective Services (DES APS).
- Pursue ongoing prevention and oversight. Check facility history and review staffing and inspection trends at AZNursingHomeCompare.com. Form a nursing home family group with other families at the facility. Family groups allow advocates for all residents to compare notes and spot trends.
How Solomon & Relihan helps
We are Arizona’s only law firm 100% dedicated to fighting nursing home abuse and neglect. Our expertise allows us to investigate whether a facility met the accepted standard of care by reviewing records, comparing risk assessments with physician orders, consulting medical experts, and identifying systemic failures like understaffing or poor handoffs.
Our team has the knowledge, resources, and expertise to help you build the case for accountability.
Call (602) 387‑3000 or contact us for a free, confidential evaluation.