Nursing Home Abuse in Missouri – A Comprehensive Guide


Kimberly Dawn Neumann

There are over 34,000 Missouri residents presently living in nursing homes. This may not seem large, but the staffing and infrastructure present in Missouri leaves a lot to be desired. This sadly leads to an increase of nursing home abuse in Missouri.

According to the AARP, Missouri is ranked one of the worst states in several areas of nursing home care. Over 50% of all Missouri caregivers quit within a year, and only 5% of residents live in a 5-star nursing home.

Alarmingly, the state also lands 46th for inadequate staff levels and turnover, seriously illustrating the nation’s current eldercare workforce crisis.

However, there are things you can do to help. That includes learning to spot nursing home abuse signs, knowing how and when to report, and securing legal assistance.

Don’t worry if you’re not sure where to start. This guide will give you the information you need, and if necessary, help you find a nursing home abuse attorney.

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Missouri Nursing Home Resident Rights

Many Missouri nursing home residents and their families don’t realize they have state and federal rights that protect against abuse.

These rights are so powerful that clear violations to them may result in a nursing home abuse lawsuit. Some of the many Missouri resident rights the state guarantees include:

  • The right to treatment that is respectful and recognizes each resident’s individuality
  • The right to a homelike environment, including use and safety of personal belongings
  • The right to choose activities, schedules, healthcare, and providers
  • The right to a reasonable accommodation of needs and preferences
  • The right to welcome or refuse visitors of a resident’s choosing, at any time
  • The right to participate in social, religious, and community activities
  • The right to access personal and medical records
  • The right to manage one’s own financial affairs
  • The right to private and unrestricted communication with any person of their choice
  • The right to freedom from abuse, neglect, and exploitation

In addition to the above rights, a resident has the right to be fully informed of all rules and regulations. This includes receiving a written copy of the complete list of residents’ rights upon move-in.

What is Nursing Home Abuse in Missouri?

The definition of nursing home abuse in Missouri is the intentional infliction of harm to an elderly individual. It holds true whether for physical injury or mental anguish.

Occasionally several types of abuse may occur at the same time. As such, it’s wise to speak with an attorney to determine where your claim fits.

Abuse victims may hide their condition from their loved ones out of shame or fear of retaliation from their caregivers. It’s vital to catch abuse before the situation escalates, putting their lives in danger.

Nursing home abuse may show up in different forms but generally it’s broken down into abuse, exploitation, or neglect.

Physical Abuse and Emotional Abuse

Nursing home physical abuse occurs when a caretaker or fellow resident purposely inflicts bodily injury to a senior adult. This type of abuse may become obvious when signs like sudden bruises, bleeding, broken bones, burns, and swelling appear.

Examples of the kinds of actions that may contribute to physical abuse include:

  • Punching, slapping, kicking
  • Intentional shoving
  • Use of physical or chemical restraints
  • Intentional refusal of resources

It’s not uncommon for caregivers or visitors to try to explain away signs of physical abuse as normal frailty that comes with aging. Therefore, it’s important to be on the lookout for these overt symptoms.

Emotional or psychological abuse, on the other hand, may be tougher to identify. That’s because it’s usually more secretive and doesn’t leave visible marks.

Additionally, many nursing home residents stay quiet about this type of abuse for fear of retaliation.

Nursing home emotional abuse may look like:

  • Humiliation and harassment
  • Intentional embarrassment
  • Isolation from other residents
  • Intimidation
  • Name-calling
  • Blaming for minor offenses

Remember, it’s totally appropriate to call 911 if you feel a nursing home resident is in immediate danger. There should be no tolerance for physical and emotional abuse of the elderly.

Sexual Abuse

Inappropriate physical touching or sexual assault is another form of physical abuse that occurs in nursing homes.

While it may seem unbelievable that this would happen in a nursing home, the elderly are still at risk. This is especially true for women and patients with dementia.

Sometimes the perpetrators are staff, but oftentimes they’re other residents. Whomever the culprit, no nursing home resident should have to deal with unwanted sexual conduct.

Examples of sexual abuse may include:

  • Rape
  • Coercion to perform sexual acts
  • Inappropriate advances
  • Taking and distributing suggestive photos without consent

Torn or stained undergarments, unexplained STDs or sudden personality changes may all indicate sexual nursing home abuse.

Financial Abuse

Financial abuse, which people sometimes refer to as exploitation, is a particularly cruel way to take advantage of the elderly.

Many seniors have spent their entire lives amassing financial assets to help support them in their elder years. This makes them prime targets for extortion and duplicitous practices from nursing home staff. Vulnerable adults with mental disabilities are especially vulnerable to financial abuse from their caretakers.

Examples of exploitation may include:

  • Taking belongings or money from a resident’s room
  • Unauthorized use of a nursing home resident’s credit, debit, or bank card
  • Changing the recipients of a will or life insurance policy

Many seniors don’t even realize someone is siphoning their funds until it’s too late. Especially if they trust their caregivers. As such, finances are an area to be extremely vigilant about monitoring.


Closely related, but not quite the same as other types of abuse is nursing home neglect.

The reason this warrants its own category is that neglect indicates inadequate care or apathy, whereas abuse involves intentional harm.

But whether it’s on-purpose or not, long-term care facilities are responsible for nursing home neglect whenever it occurs. And since many Missouri nursing home facilities are facing extreme staff shortages, residents are at real risk.

Signs of negligence from a Missouri nursing home may include:

  • Failing to provide shelter, food, or clothing
  • Not performing required wound or medical care
  • Leaving residents in bed too long such that persistent bed sores develop
  • Not providing wheelchairs or walkers for residents with mobility issues
  • Refusing to change residents after episodes of incontinence
  • Regularly turning off the call light or ignoring help requests from residents

Every nursing home resident has the right to adequate basic care. And a lack of staff doesn’t bode well for meeting those needs. Nonetheless, there’s no excuse for causing the elderly to suffer, and neglect is a serious offense.

Main Causes of Nursing Home Abuse in Missouri

The main cause of nursing home abuse in Missouri is a lack of trained staff — with Missouri losing about 6,000 nursing care facility workers during the pandemic. It now ranks in last place (51st) for hours of care per patient – about three hours per day.

But there’s another huge issue in that out of 501 accredited Missouri nursing homes, 167 have citations for serious deficiencies.

There are also 453 homes with infection-related issues. And there have been a total of $19.5 million in penalties and fines levied on these homes.

Making matters worse, the Department of Health and Senior Services (DHSS) is egregiously behind on facility inspections. Recent reports state that 1 in 4 Missouri nursing homes hasn’t had a standard inspection in two or more years.

According to ProPublica’s Nursing Home Inspect database, Missouri has among the largest inspection backlogs in the country.

Without proper accountability from regular inspections, the risks for nursing home abuse in Missouri are high.

How to Prevent Further Nursing Home Abuse

Not all nursing homes facilitate abuse, so doing due diligence prior to moving into such a facility is smart. Ask valuable questions like staffing turnover rates and the inspection results before admitting your loved one to a nursing home.

A good place to start is by using the Medicare nursing home comparison tool.

You can also find out results of any licensed Missouri long-term care facility on its last inspection. Results are always available on the DHSS “Show Me Long Term Care in Missouri” site.

However, remember that some facilities may not have had recent inspections so in-person visits are also in order.

Warning Signs of Nursing Home Abuse

One of the best ways to stop nursing home abuse is to spot the warning signs early.

While the symptoms depend on abuse type, here are some of the clues the Department of Justice suggests you should look for:

  • Bruises, black eyes, welts
  • Bleeding, cuts, lacerations
  • Sprains, dislocations, broken bones
  • Unusual changes in sleeping and eating patterns
  • Dramatic weight loss
  • Emotional upset or agitation
  • Personality changes, such as excessive apologizing
  • Depression or anxiety
  • Unexplained disappearance of funds or possessions
  • Untreated bedsores
  • Dirty clothing or undergarments
  • Unsanitary or unclean living conditions

Try to keep lines of communication open if you know someone in a nursing home. This includes calling and checking up in person regularly as well.

Many seniors hesitate to bring up their experiences because they don’t want to cause problems. Some also simply assume mistreatment is normal. Reassure them that they have a right to proper care and are safe to share any concerns. Finally, don’t hesitate to report any suspicions of abuse you observe.

How to Report Nursing Home Abuse in Missouri

There are several steps to take if you suspect incidents of nursing home abuse in Missouri.

The first thing to know is that while anyone can report elder abuse, some individuals are mandatory reporters. These individuals have a legal obligation under Missouri law to report abuse or neglect if they reasonably suspect it.

The list of mandatory reporters includes doctors, dentists, nurses, social workers, clergy, firefighters, psychologists and more.

But even if not on the mandatory reporter list, reporting nursing home abuse is the right thing to do.

Authorities usually suggest that your first step should be bringing evidence of mistreatment to the nursing home’s management. However, owing to staffing shortages, that may not bring a situation to effective resolution. As such, it is wise to also make official reports with state agencies.

Adult Protective Services (APS) through the Missouri DHSS has an online reporting portal available 24/7. APS encourages both mandatory reporters and concerned individuals to use this option.

However, you are also welcome to call the Adult Abuse & Neglect Hotline at 1-800-392-0210. The hotline is open 365 days per year from 7 a.m. to 8 p.m.

Missouri Ombudsman

Another reporting resource to explore is the Missouri Long-Term Care Ombudsman program.

For those who don’t know, an ombudsman serves as an advocate for older adults in long-term care (LTC) accommodations. While the ombudsman office doesn’t have the power to enforce resolutions, they can push management to change their conditions. The Missouri ombudsman office can also independently investigate complaints.

To find a local ombudsman in your area, call 1-800-309-3282. You can also email the main office at [email protected]. Or check out this online DHHS map, which offers direct contact information for all available counties in Missouri.

Information to Include When Reporting Nursing Home Abuse

Be sure to include as much information as possible in your report to facilitate an investigation.

Some details that it may be helpful to gather prior to reporting include:

  • Name and age of victim
  • Name, address, and phone number of the nursing home
  • Your contact information and relationship to the abused
  • Brief description of the suspected abuse, and how you know about it
  • Date or dates of the abusive event
  • Lists of other agencies who you may have contacted (such as law enforcement)
  • Contact information for any witnesses
  • Details about the alleged perpetrator(s) including name, age, physical description, position at the nursing home, and contact info if available

When seeking help with nursing home abuse situations, don’t be afraid to alert as many people as necessary. That includes the facility, law enforcement, APS, an ombudsman volunteer, and a nursing home abuse attorney.

Types of Damages in a Nursing Home Abuse Lawsuit

Beyond reporting to the authorities, when nursing home abuse directly affects you, your case may warrant further civil litigation.

After contacting an attorney, you may choose to file a personal injury lawsuit for yourself or your loved one. The reason to do so would be to seek damages to cover any incurred losses. This is in addition to potential felony charges a perpetrator may receive.

Compensatory and punitive damages make up the two types of damages that may be awarded in a Missouri nursing home abuse claim. Payouts for these types of damages depend on the evidence and your attorney’s skill in proving your case.

Compensatory Damages

Compensatory damages are monetary payments for “actual” damages resulting from the incident. The amount of an award will depend on the proven harm, loss, or injury to the victim.

These may be in the form of economic damages, like medical bills or money lost via financial exploitation. Or they may be non-economic damages like pain and suffering or emotional distress.

Punitive Damages

The idea behind punitive damage awards is to make the financial burden painful for those responsible for the abuse. In this way, punitive damages aren’t meant to make up for losses. Instead they serve as a deterrent against future incidents of abuse.

Missouri caps punitive damages at $500,000 or five-times the net amount of a judgment, but that’s still a hefty punishment. However, there must be clear and convincing evidence that the defendant was acting with malice for this award to stick.

Missouri Statute of Limitations

The statute of limitations for filing a lawsuit alleging personal injury from nursing home abuse in Missouri is five years.

That deadline is markedly longer than most states, but it doesn’t mean you can get complacent. Missed deadlines mean your case will not receive consideration in a court of law.

The statute of limitations is three years for cases of wrongful death, starting from the date of the victim’s passing. In either situation, however, it’s best not to wait so you don’t miss your opportunity to file. Also keep in mind that you stand a better chance of a positive settlement when details are fresh.

LegalASAP Can Help You find a Nursing Home Attorney

Because nursing home abuse in Missouri is a real risk at the moment, getting the right help is key. While there are some terrific state resources, they’re also overextended. Unfortunately, the backlog means you may not get assistance in a timely manner.

The best way to immediately address incidents of nursing home abuse is to get a skilled attorney in your corner.

Specialized nursing home abuse lawyers know the ins-and-outs of the system and can assist you faster. In fact, we can connect you free of charge today with a qualified attorney in our extensive law firm network.

Remember the sooner you get an evaluation, the quicker you or your loved one can move into a better situation. Because no one should have to suffer where they live.

Kimberly Dawn Neumann

Kimberly Dawn Neumann is a multi-published NYC-based magazine and book writer whose work has appeared in a wide variety of publications ranging from Forbes toCosmopolitan. She graduated summa cum laude from the University of Maryland, College of Journalism. For more,, Instagram @dancerscribe, and Twitter @KimberlyNeumann