Infections in Nursing Homes | Can You Sue?

Illness develops inside the facility when basic safeguards fail.

These outbreaks come from common staff failures, equipment problems, and facility conditions that federal rules require the facility to control.

The risk factors below repeat across most claims, and the ones that drive most preventable harm include the following:

• Understaffing and rushed care: When staff are short, hand hygiene is skipped, cleaning is rushed, and isolation collapses, all recognized common causes of nursing home neglect claims.
• Poor hand hygiene: Healthcare workers spread MRSA, norovirus, and C. difficile through direct contact when hand hygiene is skipped. Proper hand hygiene reduces infection spread in nursing homes.
• Inadequate environmental cleaning: Environmental cleaning is crucial to prevent infection spread. Strict protocols for environmental cleaning can stop the spread of C. difficile and norovirus.
• Failed isolation and outbreak control: When an infected person is not isolated, the spread reaches residents at greater risk, often showing up as fever, intense scratching, or sudden behavior change. Residents with infections should use appropriate isolation precautions to prevent outbreaks.
• Indwelling catheter and device use: Shared medical equipment, catheters, IV lines, and feeding tubes give bacteria a direct entry path and a route for secondary infection.
• Inappropriate antibiotic use: Antibiotic misuse drives resistance. Multidrug-resistant organisms thrive in nursing homes when infection-control protocols fail.
• Inadequate staff training: Staff who are not trained on standard precautions, transmission-based precautions, and isolation procedures cannot follow them.

Common nursing home infections often develop because residents are medically vulnerable and depend on facility staff to prevent, identify, and treat illness before it becomes severe.

Older residents may have weakened immune systems, chronic wounds, diabetes, swallowing problems, mobility limitations, catheters, feeding tubes, or other medical devices that increase the risk of bacterial infections, viral illness, and serious complications.

Infections can also spread more easily in long-term care facilities because residents live in close contact, share caregivers, and often require hands-on assistance with toileting, bathing, meals, wound care, and medication.

When staff fail to follow infection-control protocols, recognize warning signs, clean shared equipment, isolate sick residents, or notify medical providers promptly, a preventable infection may progress into hospitalization, sepsis, permanent decline, or death.

The most common infections in nursing homes include:

• Urinary tract infections: Urinary tract infections are among the most frequent infections seen in long-term care facilities, especially among residents with catheters, incontinence, dehydration, diabetes, or limited mobility. A UTI may affect the bladder, kidneys, or other parts of the urinary tract and can cause fever, pain, confusion, weakness, falls, or behavioral changes in older adults. Escherichia coli is one of the most common bacteria involved in urinary tract infections, and poor catheter care or delayed treatment can allow the infection to spread.
• Pneumonia and respiratory infections: Respiratory infections can include pneumonia, influenza, COVID-19, bronchitis, and other illnesses affecting the lungs and airways. Pneumonia is a leading cause of serious illness and death among older adults in nursing homes, especially residents with swallowing difficulties, weak cough reflexes, immobility, chronic lung disease, or recent hospitalization. Facilities may be liable when staff fail to monitor symptoms, follow vaccination policies, prevent aspiration risks, or respond to breathing problems in a timely manner.
• C. difficile, norovirus, and gastrointestinal infections: Gastrointestinal infections and diarrheal diseases can spread quickly in nursing homes when hand hygiene, isolation, cleaning, and outbreak-control procedures fail. C. difficile infections often follow antibiotic use and can cause severe diarrhea, dehydration, abdominal pain, fever, and dangerous complications. Norovirus outbreaks can spread rapidly through contaminated surfaces, shared spaces, food handling, or staff contact, placing frail residents at risk of dehydration and hospitalization.
• Skin infections and soft tissue infections: Skin infections and soft tissue infections may develop when cuts, wounds, surgical sites, pressure ulcers, or fragile skin are not cleaned, monitored, and treated properly. Residents with diabetes, poor circulation, limited mobility, or weakened immune systems face greater risk of chronic wound infections and diabetic wound infections. When nursing home staff fail to inspect skin, change dressings, reposition immobile residents, or report worsening wounds, a localized infection may spread into deeper tissue or the bloodstream.
• Infected pressure ulcers: Pressure ulcers develop when prolonged pressure reduces blood flow to skin and underlying tissue, most often in residents who cannot reposition themselves. Infected pressure ulcers can become painful, deep, and medically dangerous when staff fail to turn residents, keep skin clean and dry, provide proper nutrition, or treat early wounds. Severe pressure ulcer infections may lead to cellulitis, osteomyelitis, sepsis, hospitalization, or wrongful death.
• MRSA and other staph infections: Staph infections can spread through direct contact, contaminated surfaces, open wounds, shared equipment, or poor hygiene practices. Methicillin resistant staphylococcus aureus, commonly known as MRSA, is especially concerning because it is resistant to many commonly used antibiotics and may be harder to treat. MRSA and other antibiotic-resistant infections can cause skin abscesses, wound infections, pneumonia, bloodstream infections, and severe complications in medically fragile residents.

These infections are not automatically proof of negligence, but they should prompt careful review when they develop after admission, spread among multiple residents, worsen despite warning signs, or follow repeated failures in hygiene, isolation, wound care, catheter care, monitoring, or staffing.

A negligence claim often depends on whether the facility recognized the resident’s risk factors, followed the care plan, complied with infection-control rules, and responded appropriately once symptoms appeared.

Most healthcare associated infections in nursing homes trace back to a small set of staff actions that can be standardized, trained, and audited.

When the facility follows them consistently, the rate of preventable harm drops sharply.

The core measures every certified facility should follow include:

• Standard hand hygiene: All staff should wash hands or use alcohol-based sanitizer before and after every resident contact.
• Isolation protocols: Residents with confirmed or suspected illness should be placed in single rooms or grouped isolation with dedicated PPE.
• Environmental cleaning: High-touch surfaces, shared equipment, and resident rooms should be cleaned and disinfected daily and after each contamination event.
• Antibiotic stewardship: Antibiotics should be prescribed only when a lab test confirms infection, not on symptoms alone, to limit resistance. Differentiating between true infections and colonization helps avoid antibiotic overprescription.
• Vaccination programs: Vaccination programs are essential for preventing outbreaks. The facility should track influenza, pneumococcal, and COVID-19 vaccination status for both residents and staff. High vaccination rates are essential to mitigate infection risks in nursing homes.
• Surveillance and reporting: When several residents develop similar symptoms, the cases should be tracked, documented, and reported to the medical director within 24 hours.

These measures work only when the facility has enough trained staff on the floor to follow them.

When the records show that staff skipped or rushed these basic measures, the resulting illness may support an infection negligence claim.

A nursing home owes its residents specific infection control duties under both federal regulation and Ohio statute.

Federal regulation, enforced by the Department of Health and Human Services, sets the baseline standard for any facility that participates in Medicare or Medicaid.

Ohio law gives residents specific legal rights inside the facility that they can enforce in civil court.

A facility that breaches either source can be held liable for the resulting infections among nursing home residents.

Federal Nursing Home Reform Act

The federal Nursing Home Reform Act and the implementing regulations at 42 CFR Section 483.80 require every certified nursing home to establish and maintain an infection prevention and control program (IPCP).

Key federal requirements include:

• Infection prevention and surveillance: Facilities must maintain systems for identifying infections, tracking outbreaks, and implementing appropriate control measures.
• Designated Infection Preventionist: Nursing homes must designate a qualified Infection Preventionist responsible for overseeing infection-control efforts and monitoring compliance.
• Written infection-control policies: Facilities must establish and follow procedures addressing hand hygiene, isolation precautions, environmental cleaning, antibiotic stewardship, and outbreak response.
• Vaccination programs: Policies must address recommended immunizations for residents and staff, including influenza and other communicable diseases.
• Reporting and response obligations: Nursing homes must respond promptly to suspected outbreaks and maintain records documenting infection-control activities.

CMS surveyors evaluate compliance with these requirements during inspections. Violations are commonly cited under F880, the federal deficiency tag for infection-control failures.

Repeated or serious violations may result in fines, corrective action plans, reduced CMS ratings, loss of Medicare or Medicaid participation, or other enforcement actions.

Ohio Nursing Home Residents’ Bill of Rights

Ohio Revised Code Section 3721.13 gives residents legal rights that matter directly in these cases.

Among the rights this statute protects, the ones that matter most include:

• Safe and clean living environment: A resident has the right to live in a facility that addresses environmental hazards, including unsanitary conditions, broken sanitation infrastructure, and inadequate cleaning.
• Adequate medical and nursing care: A resident with a known exposure risk, an indwelling catheter, a feeding tube, or open wounds should receive care that matches those documented needs.
• Protection from neglect: Ignoring symptoms, delaying medical evaluation, or leaving wound care unattended may support a neglect claim.
• Right to be informed about medical condition: Residents and their authorized representatives have the right to know about diagnosed conditions, the treatment plan, and any related changes.

The same Ohio statute also imposes affirmative duties on the facility. Nursing homes must train staff on infection prevention protocols.

Residents have the right to protection from infectious diseases. Both Ohio and federal law protect this right.

When long term care facilities fail to meet these standards, the facility may be held liable.

A resident who develops serious illness as a result can recover hospitalization costs, pain and suffering, and other damages.

When a nursing home resident develops a serious illness, such as developing infectious gastroenteritis or sepsis from an untreated wound, both medical action and careful preservation of records are required.

After a serious illness, the family members should focus on the resident’s medical condition and the records that show whether staff followed the facility’s prevention plan.

The most useful early steps preserve the facts before the facility’s account becomes the only version in the chart.

With that in mind, the steps that best protect both the resident and any later claim are:

1. Get prompt medical evaluation: Confirm the resident was evaluated by physicians and other health care providers, tested for the suspected illness, and started on appropriate treatment.
2. Ask when the illness was identified: Confirm when symptoms were first observed, who reported them, when the physician was notified, and when treatment began.
3. Request medical and compliance records: Ask for the medical record, surveillance log, care plan, physician orders, nursing notes, and staffing logs.
4. Document the room and conditions: Photograph the bathroom, bed area, shared spaces, hand hygiene supplies, available PPE used around infected patients, and any visible cleanliness failures.
5. Note staff statements: Record what each staff member said about the illness, when the family members were notified, and whether the explanation changed.
6. Report unresolved safety concerns: If the resident remains at risk, contact the Ohio Department of Health or the Long-Term Care Ombudsman.
7. Speak with a nursing home abuse lawyer: A lawyer can determine whether the preventive safety measures actually in place support a nursing home negligence claim.

Preventable infections occur in the nursing home setting when the facility knew about the resident’s exposure risk but failed to follow the prevention plan or the care plan.

Most facilities operating in Ohio carry a legal duty under both federal infection-control regulations and Ohio resident-rights law, and the claim usually rests on showing where staff failed under both.

A claim depends on whether the records show a foreseeable risk, a broken safety rule, and an injury that followed from that failure.

Shown through those records, the failure breaks down into the four elements of a negligence claim:

• Duty: The facility owed the resident a duty of care under the admission relationship, federal safety regulations, and Ohio resident rights law.
• Breach: Breach involves missed hand hygiene, no isolation, ignored surveillance findings, or failure to recognize symptoms. Infection control plans must prioritize isolating infected residents. Failure to isolate is one of the most common breach findings in these claims.
• Causation: Causation asks whether the illness would have been avoided, or its severity reduced, if the facility had followed the prevention plan and the care plan.
• Damages: Damages may include hospitalization, surgery, IV antibiotic therapy, rehabilitation costs, chronic pain, permanent loss of function, relocation to another healthcare facility, and wrongful death damages in fatal cases.

When the records show that the illness was preventable, the family may be able to file an abuse claim under Ohio law.

A negligence claim starts with collecting evidence that connects the resident’s known exposure risk to the facility’s failure and the injuries that followed.

The facility controls most of the relevant records, so families should request copies as soon as a serious illness is identified.

The strongest claims compare the written prevention plan against what staff actually did during the period leading up to the illness.

That comparison draws on several records the facility keeps, and the ones that matter most include the following:

• Prevention plan and infection control practices: The written plan, policies, procedures, surveillance logs, and outbreak response records show whether the program existed in practice or only on paper.
• Care plan and risk assessment: These records show whether the resident’s specific exposure risks were identified, monitored, and addressed.
• Medical records and clinical timeline: Hospital records, lab results, imaging, surgical notes, and discharge instructions connect the illness to the harm.
• Staffing logs and assignment sheets: Staffing records show whether enough nurses and certified nursing assistants were on duty when the illness developed.
• Training and competency records: These files show whether staff were trained on standard precautions, transmission-based precautions, isolation procedures, and antibiotic stewardship.
• Prior surveys, citations, and complaints: Prior deficiencies, family complaints, and Ohio Department of Health findings may show that the facility knew about the danger before the loved one’s illness.
• Photographs and witness accounts: Documentation of unsanitary conditions, missed hand hygiene, broken sanitation infrastructure, or missing PPE supplies supports the broader compliance failure.

Government Inspection Citations Under F880

Among the records that support an infection negligence claim, F880 citations carry the most weight. They document a federal finding that the facility failed its infection-control duty.

F880 is the federal deficiency code that CMS inspectors record when a facility fails the infection-control rules at 42 CFR Section 483.80.

F880 is one of the most frequently cited deficiencies nationally, with roughly 41% of facilities receiving at least one F880 citation across a two-year period.

According to a 2020 study published in the Journal of the American Medical Directors Association, over 98% of F880 citations involve more than minimal harm to residents.

This means most are scored at a severity level that put a resident at actual risk of injury or illness.

A facility’s F880 history, prior complaints, and Ohio Department of Health inspection findings often show that the same problems existed before a resident’s illness developed.

Prior deficiencies may be directly relevant to the negligence claim.

Damages depend on the severity, the treatment required, and whether the records show the harm should have been prevented or recognized earlier.

Facilities that fail to control outbreaks face damages claims for the full medical and personal cost of the resulting harm to a vulnerable elderly population.

The strongest damages proof comes from hospital records, lab results, imaging, surgery notes, rehabilitation plans, and documentation showing how the resident’s function changed after the illness.

Depending on the severe complications, hospitalized patients and their families may recover damages in these cases that often include the following:

• Emergency medical care: Hospital admission, IV antibiotic therapy, diagnostic testing, surgical drainage or debridement, ICU care, and specialist follow-up may be part of the claim.
• Rehabilitation and long-term care: Physical therapy, wound care, skilled nursing care, and assistive devices may be recoverable when the illness changes the resident’s function.
• Pain and loss of function: Damages may account for chronic pain, reduced independence, fear of recurrence, and limits on basic daily activities.
• Relocation or future care: A serious illness may require transfer to another healthcare facility when the original facility cannot safely manage care or has lost the family’s trust.
• Wrongful death damages: A family may file a nursing home wrongful death claim under Ohio Revised Code Section 2125.02 when a loved one dies from a preventable illness.

Case value depends on the severity, prior illness history, staffing records, facility inspection history, ignored safeguards, and whether the records support holding the facility liable.

Preventable infections can have devastating consequences for elderly residents living in nursing facilities, assisted living facilities, and skilled nursing facilities.

A urinary tract infection, pneumonia, infected pressure ulcer, or gastrointestinal illness may begin with subtle symptoms but can quickly progress into sepsis, hospitalization, permanent decline, or death when warning signs are missed or infection-control protocols are not followed.

Determining whether a facility acted appropriately often requires a careful review of medical records, staffing levels, care plans, infection-control policies, and government inspection findings.

Zoll & Kranz represents residents and families harmed by preventable infections in nursing facilities, assisted living facilities, and skilled nursing facilities throughout the Toledo area.

Our firm investigates whether staff followed required infection-prevention procedures, responded appropriately to symptoms, maintained adequate supervision, and complied with federal and Ohio standards designed to protect vulnerable residents from avoidable harm.

If your loved one developed a serious infection after admission to a nursing facility, assisted living facility, or skilled nursing facility, you may have grounds to pursue a claim for the resulting injuries.

Contact Zoll & Kranz today for a free, no-obligation consultation with an experienced Toledo nursing home abuse lawyer.

You can also use the chat feature on this page to discuss your situation and learn whether you may have a nursing home negligence claim.