Hi, I’m Jordan Rau, a senior correspondent at KFF Health News. I report on medical quality, cost, and patient safety in the U.S. healthcare system. You can contact me at JRau@kff.org.
By Jordan Rau
Dementia can rob people of so much more than memories. It can muddle their ability to assess threats and atrophy their impulse control. Jointly, these changes can stoke an understudied danger in long-term care facilities: violent altercations between residents.
KFF Health News first examined this problem two years ago in an article about a Montana memory care facility. One resident there pushed another resident in the dining room, and he died days later from the injury. Over three more years the resident hit and verbally abused others, and groped female residents, according to facility records filed in a negligence court case that resulted in a verdict for the family. A Cornell researcher told me at the time that “there is a real problem with endemic violence” in long-term care facilities.
This year we decided to take a deeper look. Our investigation, published this week, identified more than 700 instances of resident-on-resident altercations involving verbal, physical, or sexual abuse cited in nursing homes since January 2024.
We found that in the first three months of 2026, such altercations were the most frequent type of abuse, neglect, or exploitation cited by state and federal inspectors in nursing homes. Those outnumbered citations for mistreatment by workers or unsupervised exits from locked facilities.
Our article recounted assault allegations in two private memory care facilities, in Minnesota and Virginia, and a California nursing home:
- Gladys Lynch was fatally shoved by a female resident who had been wandering into her room, going through her stuff, and using her bathroom, according to a lawsuit brought by her family as well as a police report and Minnesota inspection records.
- Linda Twiddy had to undergo three surgeries and a month in rehabilitation after being kicked by a fellow resident in 2024, according to the lawsuit her family brought, which was settled last month. Her son said she never walked again. She died earlier this year.
- Attilio Cecchetto died two days after being attacked by the roommate his California nursing home assigned: a felon with dementia who was highly agitated by loud noises — like the noises Cecchetto regularly made mumbling and yelling because of his own dementia, according to a state investigative report and a lawsuit filed by his widow and sons. The nursing home had relocated the roommate, Sam Ato Timaloa, seven other times in the prior four months.
Cecchetto’s nursing home and Twiddy’s assisted living facility denied negligence, and Lynch’s facility asked the state to reconsider its finding of neglect.
There’s limited research on the national prevalence of resident-to-resident altercations. But Cornell researchers studied 14 assisted living facilities in New York state and estimated 1 in 7 residents experienced aggression within a month, including verbal, physical, or sexual acts.
They also examined 10 nursing homes in the state and estimated 1 in 5 residents experienced an altercation in a month. Researchers have found that assailants are disproportionately likely to have dementia.
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