GAO report showed that one in every five nursing homes across the country was found deficient in terms of its care practices. It was also discovered that some of the abuse incidents had been serious enough to put the resident's life in jeopardy. In many cases, abuse was not even reported though it should have been "classified as actual harm or worse. These included such problems as serious avoidable pressure sores, severe weight loss, and multiple falls resulting in broken bones and other injuries" (p. 31). The report also explained what is meant by sufficient staff. According to CMS guidelines, "determination of sufficient staff is to be made based on the staff's ability to provide needed care to residents. The staff must be able to provide residents with sufficient care so they may reach their highest practicable physical, mental, and . . . well being." (Corzine, p. 32) Hawes (2002) found that despite many complaints against the staff in nursing homes, it was found that some of the people employed in such facilities blamed the residents for provoking them and hence thought this justified their abusive behavior. "…many staff viewed resident behaviors as purposive, intentional. Thus, a resident who resisted care or struck out at staff was often viewed as intending to harm the staff or as deliberately "being difficult." Given these views, some staff believed that treating such residents 'roughly' was acceptable, particularly if the staff member had been "startled" by the resident or if, in their view, the resident might hurt the staff member." (p. 10). This showed how inadequate training results in abusive behavior in nursing homes. With nursing staff being unaware of what constitutes abuse, there is always a chance that someone would be hurt or harmed in their care.

The problem of elderly abuse is well documented. Even though there may be a shortage of researches on the subject, there is enough data available through surveys, complaints and federal and state investigations to indicate the high prevalence of neglect...

It is however unfortunate that many of these cases go unreported as elderly are either too frail to understand what is happening or there is no easy way of filing a complaint. But the complaints that have made it to the concerned authorities indicate that some key reasons are responsible for increase in incidents of abuse and neglect. These include shortage of staff which puts the available staff under increased workload and they feel overworked and underpaid, then there is the problem of inadequate training which has also been cited as one of the key causes of abuse and neglect. Ill-trained staff doesn't understand their duties and responsibilities. They are not familiar with various behavioral codes and guidelines and hence treat the residents poorly. The third and another major problem is lack of proper reimbursement from Medicaid which leads to major financial problems for nursing homes. These homes are then unable to pay their staff properly and they can also not provide adequate training. Thus hiring and retaining quality staff becomes a problem which in turn leads to further abuse issues.