Proving Causation: Linking Neglect to Injury in Nursing Home & Care Facility Cases
November 25, 2025
In nursing home and care facility neglect cases, proving causation is one of the most essential — and most challenged — elements of the case. Families often know their loved one declined because of poor care, but to succeed legally, you must show exactly how the neglect caused the injury.
At LFK Law Practice, P.C., we help families build clear, evidence-backed narratives using timelines, photos, medical documentation, and expert testimony.
Below are the four main categories of evidence used to prove causation — now with authoritative sources included.
Timeline of Deterioration
A timeline organizes the resident’s decline into a clear, chronological story that links lapses in care to worsening symptoms.
A strong timeline includes:
- When symptoms first appeared
- Missed medications
- Delayed responses to call lights
- Documented weight loss, dehydration, or mobility decline
- Dates of increased falls, injuries, or infections
- Gaps or inconsistencies in facility records
Timelines help expose patterns such as:
- Infrequent repositioning → pressure ulcer → infection
- Ignored symptoms → delayed diagnosis → hospitalization
- Staff shortages → skipped care → worsening health
Why it matters:
A timeline shows both foreseeability and the direct trajectory from neglect to injury.
Sources:
- Centers for Medicare & Medicaid Services (CMS) — Resident Assessment & Care Planning Requirements (42 C.F.R. §483.21)
- Agency for Healthcare Research and Quality (AHRQ) — “Falls in Nursing Homes” & “Pressure Injury Prevention”
- U.S. Department of Health and Human Services (HHS) — Long-Term Care Guidelines
Before and After Comparisons
Side-by-side comparisons are powerful because they show how the resident looked before the neglect and how their condition changed after.
Useful “before vs. after” documentation includes:
- Physical appearance and weight
- Cognitive status
- Mobility or independence level
- Skin integrity (bedsores or wounds)
- Emotional or behavioral changes
This evidence may come from:
- Family photos
- Prior medical records
- Facility evaluations
- Therapy progress notes
These comparisons create a persuasive narrative that a decline was not natural aging, but the result of substandard care.
Sources:
- National Institute on Aging — “Signs of Poor Care in Nursing Homes”
- Centers for Disease Control and Prevention (CDC) — “Pressure Ulcers: Statistics & Prevention”
- CMS Quality Measures Manual — Resident functional outcomes
Photographic & Video Evidence
Visual documentation is often the most compelling proof of neglect because it captures what facility records may try to hide.
Types of helpful evidence:
- Photos of wounds, bruising, or poor hygiene
- Images showing unsanitary or unsafe conditions
- Time-stamped photos documenting wound progression
- Surveillance footage from hallways or common areas
- Images taken before hospital transfers
Why photos matter
They verify condition, severity, and timing — and can impeach inaccurate or incomplete facility charting.
Sources:
- Centers for Medicare & Medicaid Services (CMS) — Guidance on Documentation Accuracy (F-Tag 842)
- National Pressure Injury Advisory Panel (NPIAP) — Wound Staging & Visual Documentation Standards
- U.S. Department of Justice — Evidence Preservation Guidelines
Medical Expert Opinions
Medical experts play a critical role in explaining exactly how and why the injury occurred and whether it could have been prevented.
Experts may include:
- Wound-care specialists
- Geriatricians
- Nursing experts
- Neurologists
- Infection-control specialists
Medical experts help establish:
- Whether care met accepted medical standards
- If the injury resulted from neglect versus natural decline
- The expected progression with proper care
- How delays or failures directly worsened the condition
This testimony converts evidence into clear, legally actionable causation.
Sources:
- American Geriatrics Society (AGS) Clinical Practice Guidelines
- National Pressure Injury Advisory Panel (NPIAP) — Clinical Best Practices
- CDC — Infection Control Guidelines
- CMS — Federal Requirements for Quality of Care (42 C.F.R. §483.25)
How LFK Law Practice, P.C. Proves Neglect and Injury
Our firm builds strong cases by:
- Collecting facility incident reports, care plans, and medical charts
- Constructing detailed timelines showing decline
- Gathering photo, video, and digital evidence
- Consulting independent medical and nursing experts
- Showing how proper care would have prevented the injury
- Holding negligent facilities accountable
📞 If you believe a loved one was harmed due to nursing home neglect, contact LFK Law Practice, P.C. today. We help you uncover what really happened — and prove it.
Frequently Asked Questions
How do you prove that nursing home neglect caused an injury?
Proving causation requires showing a clear link between the facility’s actions (or failures) and the resident’s injury. This includes establishing a timeline of deterioration, documenting before-and-after condition changes, collecting photos or videos, and securing medical expert opinions that connect the neglect directly to the harm.
Why is a timeline important in a nursing home neglect case?
A detailed timeline can reveal patterns of missed care, delayed treatment, or worsening symptoms. It helps show that the decline was not natural, but caused by preventable lapses in care.
Can photographs really prove nursing home neglect?
Yes. Photos of wounds, bruising, unsafe conditions, or poor hygiene can be some of the strongest evidence in a neglect case, especially when facility records are incomplete or inaccurate.
Do I need a medical expert to prove neglect?
In most cases, yes. Medical experts can explain how the injury occurred, whether it was preventable, and how the facility’s failures directly led to the resident’s deterioration.
What if the nursing home’s records don’t match what the family saw?
Inconsistencies between charts and family observations often indicate poor documentation or attempts to downplay negligence. Timelines, photos, and expert analysis can expose these gaps and strengthen your claim.
