Contact: Richard Mollot,, 212-385-0356

June 14, 2023 – When nursing home residents are silenced, the consequences can be dire. Too often, fear of staff retaliation – the fear itself – prevents residents from voicing concerns and from receiving the care and services to which they are entitled. Ultimately, this inaction leads to unnecessary emotional, psychological, and physical harm to vulnerable residents. 

In honor of World Elder Abuse Awareness Day (June 15), LTCCC is releasing a new report, “They Make You Pay”: How Fear of Retaliation Silences Residents in America’s Nursing Homes. This groundbreaking research examines fear of staff retaliation and the consequences of this fear by capturing residents’ experiences in their own words, using 100 government investigation reports on nursing homes from across the country.   

“Fear of retaliation is a pervasive phenomenon that inflicts significant emotional harm on nursing home residents,” said Eilon Caspi, PhD, the principal author of the report. “We hope that this project will encourage the development of awareness campaigns and lead to meaningful policy changes that address this urgent problem.” 

On the NursingHome411 project page, you can access:

  • The report PDF.
  • User-friendly summaries of surveys highlighting the residents’ lived experiences of fear of retaliation or actual retaliation.
  • Excerpts and quotations from the report.
  • A digital archive of the survey and complaint investigations.
  • Video and slides from LTCCC’s webinar on fear of retaliation, featuring Dr. Caspi.

The title of this project, “They Make You Pay,” is inspired by a survey report detailing how fear of retaliation deterred residents at a Florida nursing home from reporting or filing grievances related to poor care. A resident told the surveyor that staff would retaliate against residents by delaying care or sabotaging meals. “They make you pay,” the resident said.

This survey report is one of 100 examined in this project. In each report, we endeavor to highlight the lived experience of residents and show how they are directly impacted by fear of and actual retaliation. We hope that heightening awareness of this phenomenon can result in real changes in policy, practice, and enforcement actions.

Have You Experienced Fear of Retaliation? We want to hear from you. Please share your story with us (anonymously if preferred). Your voices matter and can make a real difference in the lives of current and future nursing home residents