Fear of retaliation in long-term care

Nobody
Spoke Up

Abuse and neglect can remain hidden when residents, families, care employees, and others are afraid to speak up about what they have witnessed or know.

Illustration by Yuval Caspi depicting a hand over the mouth of an older adult

Fear can allow harm to continue

Abuse and neglect of individuals living in nursing homes and assisted living residences often continue or worsen when residents, families, care employees, and others are afraid to speak up about what they have witnessed or know.

This website was created to:

  • Educate about the fear of retaliation when considering reporting mistreatment;
  • De-stigmatize and alleviate retaliation fears;
  • Contribute to efforts aimed at holding care homes and perpetrators accountable; and
  • Keep mistreatment victims and reporters safe.

Residents. Staff. Families

Nobody Spoke Up: Staff Fear of Retaliation in America’s Nursing Homes

A review of state investigation records documenting staff fear, intimidation, and retaliation in nursing homes.

Read the report →
Cover of the Nobody Spoke Up staff fear of retaliation report
101state investigation reports
100nursing homes
35states represented

Source: June 2026 report. Investigations completed December 2017–November 2025.