California nursing homes were originally designed to care for elderly residents with physical impairments. But in recent years, they’ve increasingly become housing for individuals with serious mental illnesses—conditions such as schizophrenia, bipolar disorder, and psychotic disorders. This shift has created a dangerous mismatch between resident needs and facility capabilities, leading to higher rates of abuse, neglect, and trauma for both mentally ill residents and those around them.
This article explores how the influx of psychiatric patients into California nursing homes is fueling abuse, why facilities are often unequipped to handle these cases, and what legal and regulatory reforms are urgently needed.
The Rise of Psychiatric Admissions in Nursing Homes
Nationwide, one in five nursing home residents has been diagnosed with a serious mental illness. In some California facilities, that number is significantly higher. Investigations have found that in certain homes, up to 90% of residents carry diagnoses such as schizophrenia or bipolar disorder.
This trend is driven by several factors:
- Closure of state psychiatric hospitals
- Lack of community-based mental health housing
- Pressure on hospitals to discharge patients quickly
- Financial incentives for nursing homes to accept high-need residents
While nursing homes are legally permitted to admit residents with mental illness, they must meet specific staffing and training requirements. In practice, many do not.
Case Example: North Aurora Care Center
A recent investigation by APM Research Lab and LAist highlighted a disturbing case at North Aurora Care Center, a facility operated by Petersen Health Care. In October 2023, the facility admitted a 28-year-old man with schizophrenia, hypersexual tendencies, and cognitive delay—despite staff objections that they could not meet his needs.
Within 24 hours of arrival, the resident allegedly groped a woman with Down syndrome, attempted to enter another resident’s bed, and wandered into a third woman’s room. Nurses were unaware of the incidents until residents reported them the next morning.
The facility was not certified to house residents with serious mental illness, despite the fact that roughly 70% of its population had such diagnoses. Illinois law requires certification for facilities accepting psychiatric patients, but no record exists of North Aurora—or any other facility in the state—being certified under that law.
Abuse Risks for All Residents
The presence of untreated or poorly managed mental illness in nursing homes increases the risk of abuse in multiple ways:
- Residents with psychiatric conditions may act aggressively or unpredictably.
- Staff may lack training in de-escalation or trauma-informed care.
- Vulnerable residents—especially those with developmental disabilities or dementia—may be targeted.
- Facilities may underreport incidents to avoid regulatory scrutiny.
This creates a volatile environment where abuse is more likely to occur and less likely to be addressed.
Regulatory Failures and Lack of Enforcement
California law requires nursing homes to report suspected abuse and to maintain adequate staffing levels for all residents. However, enforcement is inconsistent. Investigations have revealed:
- Delayed responses to abuse complaints
- Minimal fines that fail to deter misconduct
- Lack of oversight for facilities admitting psychiatric patients
- Absence of specialized training for staff
In 2010, Illinois passed a law requiring certification for nursing homes housing mentally ill residents. California has no equivalent statute, and even in Illinois, enforcement has been virtually nonexistent.
Legal Implications for Families
When abuse occurs in a facility that knowingly accepted residents it could not safely manage, families may have grounds for legal action. Potential claims include:
- Negligence
- Elder abuse (California Welfare and Institutions Code § 15657)
- Violation of resident rights
- Wrongful death (California Code of Civil Procedure § 377.60)
Attorneys may also investigate whether the facility violated licensing regulations or failed to disclose risks during admission.
What Families Can Do
If you suspect abuse linked to mismanaged mental illness in a nursing home:
- Document all incidents and injuries.
- Request medical records and care plans.
- File complaints with the California Department of Public Health and the Long-Term Care Ombudsman.
- Consult an nursing home abuse attorney with experience in psychiatric care litigation.
- Demand transparency from the facility regarding staffing, training, and resident diagnoses.
Policy Recommendations
Experts and advocates recommend several reforms:
- Require certification for facilities housing psychiatric patients
- Mandate specialized training for staff
- Increase funding for community-based mental health housing
- Strengthen abuse reporting and enforcement mechanisms
- Create public databases of facility compliance and incident history
Without these changes, California nursing homes will continue to serve as de facto psychiatric wards—often at the expense of resident safety.
Final Thoughts
The growing presence of serious mental illness in California nursing homes is a public health and legal crisis. Facilities unequipped to manage psychiatric conditions are placing all residents at risk, and regulatory agencies have failed to respond with adequate oversight. Families must remain vigilant, assert their rights, and demand accountability when abuse occurs.
The solution is not to exclude mentally ill individuals from care—but to ensure that care is appropriate, safe, and supported by law. Until then, the cycle of misplacement and harm will continue.
References
- California Welfare and Institutions Code § 15657. (n.d.). Civil actions for elder abuse.
- California Code of Civil Procedure § 377.60. (n.d.). Wrongful death actions.
- Gawthrop, E. (2025, August 7). Abuse rates higher at nursing homes with more mental illness. APM Reports.
- LAist. (2025, August 7). ‘We did not want to take this guy’: Abuse rates higher at nursing homes with more mental illness.
- California Advocates for Nursing Home Reform. (2006). New Report Reveals Widespread Abuse, Broken Oversight in California Nursing Homes.
