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When Your Loved One Leaves Their Nursing Home: Elopement from Skilled Nursing Facilities

By: Joshua H.K. Levy, Anapol Weiss Associate

With the current heat wave affecting much of the United States, including Philadelphia and many parts of Pennsylvania, staying safe from the heat is extremely important. While you may think that your loved one staying at a nursing home is safe inside, unfortunately, that is not always the case. Nursing home residents may sometimes experience “elopement” from their nursing home, encountering the dangers of the surrounding environment unassisted and unsupervised.

What is Elopement?

“Elopement” occurs when a resident leaves the premises or safe area without authorization and/or the necessary supervision. Nursing homes are required by Federal Regulations to provide adequate supervision to prevent accidents such as this and to ensure that the area is free from hazards. However, just because these nursing homes are required to do that does not mean that they always do. In fact, the average nursing home in the United States has seven (7) violations of minimum health standards every year.

The nursing home should have procedures to prevent residents from simply walking out, but these can easily fail. Sometimes, this occurs when a nursing home does not have enough staff members on duty, and a resident can walk right out, as any precautions set up to keep residents inside will only work if there is someone to enforce those policies.

Risk factors

A nursing home must identify residents who are at high risk for elopement so that they can be sure to prevent them from leaving the building.

The nursing home residents most at risk for elopement from the nursing home are the ones with some form of temporary or long-term mental impairment, such as dementia or Alzheimer’s disease, and who are able to walk or use a wheelchair independently. Residents attempting to leave their nursing home may not always know where they are and may not realize the danger involved in attempting to leave the nursing home.

Residents who have made comments about wanting to go home or have previously attempted to leave the nursing home are also considered a higher risk for elopement.

Residents are also at higher risk for elopement when they are placed in a new environment or have a change in medication. These changes can lead to a resident attempting to return to a familiar room or location without realizing that they are accidentally leaving the nursing home entirely due to their poor perception or memory.


When a nursing home allows a resident to wander away from the facility, that resident can get seriously injured. Nursing home residents are there precisely because they need some form of nursing care, ranging from rehabilitation services to supervision and oftentimes including assistance with daily living activities such as eating and going to the bathroom. Many nursing home residents need assistance with walking, and even if they can physically walk, they still may not be able to notice hazards in their path.

Outside of the nursing home they stay in, residents will not be receiving this necessary care, and will be exposed to the elements in a dangerous, unfamiliar environment. Common issues such as uneven sidewalks will be much more likely to cause them to fall, and an elderly nursing home resident is much more likely to suffer serious injuries and broken bones from a fall.

In times of extreme temperatures, nursing home residents are at an even greater risk outside. With summer temperatures, heatstroke and heat exhaustion can set in quickly and could require immediate attention. Nursing home residents are prime examples of the individuals most at risk for heatstroke. People who are over 65 years old with certain health conditions, such as heart or lung disease, or who are on certain medications, such as vasoconstrictors and beta blockers, are at increased risk of heatstroke.

Even worse, heatstroke can cause confusion, so a resident who has wandered from the nursing home will be in even less of a condition to find their way back.

An investigation by the Washington Post revealed that more than 2,000 people have wandered away from assisted living and memory care facilities since 2018. Very often, these already frail individuals who require nursing assistance may succumb to the elements when left outside in extreme temperatures for too long. That same Washington Post investigation found that almost 100 of those residents who left the facilities died and that negligence was often involved.

Due to the numerous risks exacerbated by the hot temperatures, it is imperative that nursing home residents remain in their nursing home and that any trips out of the nursing home are properly supervised.

What To Do

If your loved one has left their nursing home unsupervised, it will take a review of the nursing home’s policies, procedures, staffing records, and event reports to determine specifically what failures allowed that elopement.

Starting this investigation early is critical as witnesses’ memories of the event may fade quickly and certain communications (such as emails) may be set to automatically delete after a certain amount of time, so that any communications or admissions about the incident could be lost.

Importantly, while a resident’s personal factors can increase their risk for elopement, the top contributing factors for elopement are systemic issues at the nursing home itself, specifically breakdowns in team communication and patient assessment.

The nursing home and staff may try to shift the blame onto the resident, but ultimately the nursing home is responsible for enacting ways to prevent residents from leaving unsupervised. These methods can include secure doors and windows, wander management bracelets, an up-to-date plan for elopement, and assessments of the nursing home residents to be aware of their risks.

If you or a loved one has suffered injuries after an elopement incident, contact us today at (215) 929-8822 or for a free consultation. Our attorneys have extensive experience in nursing home, assisted living facility, and personal care facility litigation.