This is the first clinical case-control study detailing clinical outcomes and evaluating risk factors of persons suffering severe physical abuse. Of elderly trauma victims, those who are physically abused have more-severe injuries than their nonabused counterparts. More research is needed to better evaluate risk factors of physical abuse and effective interventions.

Better screening that connects victims of abuse with community services, police action, and alternative residential options is important in reducing the risk of revictimization and connecting individuals with resources that can improve their safety at home, regardless of whether it is in the community or a residential facility.

Background: Studies have demonstrated that measures of lower quality of care and associated adverse health effects are more prevalent in for-profit nursing homes compared to not-for-profit facilities. However, these studies omit persons who receive care in the community setting, and exclusively focus on isolated clinical signs that may obscure the true effect size, since these clinical signs rarely occur in isolation. Objective: In this study, we use the Clinical Signs of Neglect Scale (CSNS), which is an aggregate measure of clinical signs of neglect and substandard care, to evaluate the association of residence type on health outcomes among individuals living in both private community residences and for-profit and not-for-profit long-term care facilities. Methods: In a multicenter, retrospective data analysis of 1,149 patients identified from an inpatient hospital registry, we assessed the relationship between residence type (community dwelling, not-for-profit, and for-profit facilities) and clinical signs of neglect. Adjusted parameter estimates and 95% CIs were estimated with linear regression in 3 models using different reference groups. Results: The most serious clinical signs were consistently more prevalent among residents of for-profit facilities, as were measures of poor institutional quality. Relative to low-functioning community-dwelling patients, the mean difference in CSNS scores was higher among patients residing in not-for-profit facilities by 1.99 (p = 0.012) and 3.55 (p ≤ 0.001) among patients in for-profit facilities. In a separate model, the mean difference in CSNS scores among patients living in for-profit facilities compared to not-for-profit facilities was 1.90 (p = 0.035). Conclusions: Using an aggregate measure, our findings support prior studies demonstrating an association between residence type and adverse health outcomes for disabled elderly.