What to Do When Your Loved One Is Sexually Assaulted in a Nursing Home

It’s the worst phone call a family can get. Not the one about a fall or a missed medication — the one that says someone hurt your mother, your father, your grandparent in the place you trusted to keep them safe.

Sexual assault in a nursing home is a crime, a profound betrayal, and — almost always — the result of a facility that failed to protect the people in its care. If this has just happened to your family, you don’t need a long lecture. You need to know what to do in the next 24 hours, and what to do in the weeks that follow.

Right Now: The First Steps in the First 24 Hours

1. Call 911

If your loved one is in immediate danger, call 911. Sexual assault is a crime under Tennessee law, and it should be investigated by law enforcement, not by the facility’s internal compliance department.

Some families hesitate because they want to “find out what happened first” or because facility staff has assured them they’re handling it. Don’t wait. Facilities are not neutral investigators. They have liability exposure, they have employees to protect, and they have every incentive to control the narrative. The police don’t.

2. Get an Immediate Medical Exam — Ideally a SANE Exam

A Sexual Assault Nurse Examiner (SANE) is a specially trained nurse who can perform a forensic examination, document injuries, and collect evidence in a way that holds up in both criminal and civil proceedings. Most hospital emergency departments in Tennessee have access to a SANE program or can arrange one.

Time matters. Forensic evidence — DNA, fluids, fiber transfer, injuries — degrades quickly. Within 72 hours is ideal; within 5 days is still useful in many cases. Even outside that window, an exam can document injuries and provide a baseline for treatment.

If your loved one has dementia, mobility issues, or other conditions that complicate consent or transport, the hospital can still help. Tell the intake staff what happened so they bring in the right team.

3. Do Not Bathe, Change Clothes, or Wash Bedding

If you’re the first to discover the assault, preserve everything. Don’t bathe your loved one. Don’t change their clothes or bedding. Don’t clean the room. Anything that has been in contact with the body or the scene may contain forensic evidence — and once it’s destroyed, it’s gone.

If clothing must be changed for medical reasons, place each item in a separate paper bag (not plastic — plastic destroys DNA evidence) and give them to law enforcement.

4. Call Tennessee Adult Protective Services: 1-888-277-8366

Tennessee is a mandatory reporting state. Under Tenn. Code § 71-6-103, anyone who suspects abuse, neglect, or exploitation of an elderly or vulnerable adult must report it. The hotline operates 24/7. Reports can be anonymous. There is no penalty for a good-faith report that turns out to be unfounded; there are penalties for failing to report.

Adult Protective Services will open an investigation independently of the facility. You can file a report online through the state’s adult abuse reporting portal.

5. File a Complaint with the Tennessee Department of Health

The Tennessee Department of Health Division of Health Care Facilities licenses and inspects nursing homes. File a complaint by calling 1-877-287-0010. The Department is required to investigate reports of abuse and can issue citations, fines, and — in serious cases — license revocation.

6. Contact the Long-Term Care Ombudsman

The State Long-Term Care Ombudsman serves as an independent advocate for nursing home residents. Reach the program at 877-236-0013 or through the Tennessee Commission on Aging and Disability. The ombudsman can help mediate immediate safety issues, push for staffing changes, and document the response of the facility.

In the First Few Days: Building the Record

Document Everything

From the moment you suspect or confirm abuse, start a written, dated log:

• Names of every staff member you spoke to and what they said
• Times you arrived at and left the facility
• Photos of any visible injuries, taken with the date stamp on
• Photos of the room, the bed, any soiled items
• Names and contact information of any witnesses — other residents, visitors, staff
• Copies of any incident reports, care plans, or facility communications

Keep multiple copies — one on your phone, one in cloud storage, one printed. Evidence has a way of disappearing once a facility realizes you’re paying attention.

Get Your Loved One’s Medical Records

You’re entitled to copies of your loved one’s medical records under HIPAA. Request them in writing. Pay particular attention to:

• Care plans and any updates around the time of the suspected assault
• Medication administration records (sedatives, anti-anxiety drugs)
• Nursing notes
• Incident reports (some facilities try to keep these out of medical records — request them separately)
• Behavior logs
• Any prior reports of inappropriate behavior by the alleged perpetrator

Consider Moving Your Loved One

If your loved one is still in the same facility as the alleged perpetrator, their immediate safety is the highest priority. Tennessee Department of Health staff and the Long-Term Care Ombudsman can help arrange an emergency transfer if needed. Federal regulations protect residents from retaliatory discharge — meaning the facility cannot kick out a resident or family for making a report.

Recognizing the Signs When You’re Not Sure

Many nursing home sexual assault victims cannot tell their families what happened — because of dementia, stroke, fear, or shame. Look for:

• Physical signs: unexplained bruises around the breasts, inner thighs, or genital area; bleeding or pain in the genital or anal area; torn, stained, or bloody underclothing; sexually transmitted infections diagnosed for the first time in someone who is not sexually active
• Behavioral signs: sudden withdrawal, agitation, or fear of being touched; new fear or avoidance of a specific staff member; sleep disturbances or new nightmares; uncharacteristic crying, rocking, or self-comforting behaviors; fear of being alone with male (or female) caregivers
• Environmental signs: doors closed for unusually long periods during care; staff members repeatedly assigned to the resident outside their usual rotation; a perpetrator who is overly affectionate, controlling, or possessive

A 2022 systematic review in long-term care settings found that sexual abuse is significantly underreported by victims and their families compared to staff-witnessed reports — meaning the actual rates are higher than official statistics suggest.

Who Can Be Held Liable in Tennessee

A successful civil case usually requires showing that the facility, not just the individual perpetrator, had a duty it failed to meet. In nursing home sexual abuse cases, that typically includes one or more of the following theories:

1. Negligent Hiring

If the facility hired a staff member with a known history of abuse, sexual misconduct, or relevant criminal convictions — or failed to perform a background check Tennessee law required — the facility can be liable for the predictable consequences. Tennessee maintains an Abuse Registry that nursing homes are required to check.

2. Negligent Supervision

Facilities have a duty to supervise both staff and residents. When a resident with cognitive impairment is left in a private room with a staff member who has prior complaints, when staffing ratios are dangerously low, or when surveillance and check-in procedures are ignored, the facility may be liable.

3. Negligent Retention

Sometimes a facility receives multiple complaints about a staff member but keeps them on the floor. When a subsequent assault occurs, plaintiffs argue the facility had actual notice and chose to do nothing.

4. Failure to Report

Federal regulations (42 CFR § 483.12) and Tennessee law require nursing homes to report suspected abuse promptly. Facilities that try to handle it internally or who delay reporting can face substantial penalties — and that delay can become a powerful piece of evidence in a civil case.

5. Resident-on-Resident Assault

Sexual assault by another resident is also actionable when the facility knew or should have known of the risk — for example, when a male resident with documented inappropriate sexual behavior was placed unsupervised with a female resident.

For more on what facilities are legally required to do, our nursing home team has covered 10 things nursing homes can’t do — and how to fight back and the rights every nursing home resident has.

What Compensation May Be Available

Civil cases can pursue:

• Medical expenses, including counseling and ongoing treatment
• Pain and suffering, including emotional distress — often the largest category in these cases
• Loss of dignity and quality of life
• Punitive damages in cases of egregious misconduct
• Wrongful death damages if the abuse contributed to or hastened death

Tennessee caps non-economic damages at $750,000 in most cases, increased to $1,000,000 for catastrophic injury under Tenn. Code § 29-39-102. The cap does not apply when the defendant intentionally caused harm or acted with reckless disregard for the safety of others — a category that often fits these cases.

The Filing Deadline Matters

The Tennessee statute of limitations for personal injury is generally one year from the date of the incident under Tenn. Code § 28-3-104. For nursing home cases involving cognitively impaired residents, certain discovery and tolling rules can apply — but never assume you have more time than the basic deadline.

You Are Not Alone — and You Are Not Overreacting

Families in this situation often second-guess themselves. They worry about embarrassing their loved one, about the facility “retaliating,” about whether what they saw really happened. We’ve worked with hundreds of Tennessee families through this. The pattern is almost always the same: what you noticed was real, and the facility’s first instinct was to minimize it.

Reporting is what protects the next resident. Filing a civil case is what changes facility behavior — because the only language some corporate nursing home operators understand is the language of accountability.

The Higgins Firm offers free, confidential consultations for families investigating possible nursing home sexual abuse. We work on a contingency fee — you owe nothing unless we recover compensation. Call us, and we’ll handle the conversations with the facility, the insurer, and any government agencies for you.