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A state audit released in October 2025 confirmed what many Tennessee families have long suspected: the system responsible for investigating nursing home complaints and conducting facility inspections is badly broken.
The findings are not minor administrative shortcomings. They represent a years-long failure to protect some of the most vulnerable people in Tennessee — nursing home residents who have no ability to protect themselves.
Last Updated: October 2025
The Tennessee Comptroller’s audit of the Health Facilities Commission examined complaint and inspection data from July 2022 through April 2025. The results were stark.
Complaint investigations:
Facility inspections:
State law requires all Tennessee nursing homes to have a current inspection by December 31, 2026. The audit found that deadline may be unachievable.
Inspections and complaint investigations are the primary mechanism the government uses to identify and correct dangerous conditions inside nursing homes.
When a facility goes years without an inspection, problems compound. Staffing shortages go unaddressed. Residents develop preventable bedsores. Falls go unreported. Infections spread. Staff who should be disciplined continue working.
When complaints sit uninvestigated — some for nearly three years — residents suffer harm with no government response. Facilities receive no corrective directive. Nothing changes.
The audit’s findings that immediate jeopardy complaints were caught in this backlog is particularly serious. An immediate jeopardy complaint involves a situation that caused, or was likely to cause, serious injury, impairment, or death to a resident. These are not paperwork complaints. These are situations where a real person was in serious danger.
The Executive Director of the Health Facilities Commission acknowledged the problem, attributing part of the backlog to conditions inherited from prior administrations and citing a need for additional survey positions.
State lawmakers were less forgiving. One legislator on the oversight committee called the five-year inspection gap unacceptable in direct terms, acknowledging that while the commission may have faced difficult circumstances, there is no justification for that level of delay.
The committee recommended giving the commission four additional years to address the backlog.
Here is what families need to understand: the failure of state regulators to investigate a complaint or inspect a facility does not mean nothing happened. It does not mean a facility was following the rules. It means the state did not check.
If your loved one suffered serious harm in a Tennessee nursing home — bedsores, a fall, an infection, unexplained weight loss, or death — the absence of a recent inspection or a response to a prior complaint may actually be relevant to your legal claim. It speaks directly to what the facility knew, what it should have known, and whether it operated in an environment of accountability.
Evidence in nursing home neglect lawyer in Tennessee cases includes:
A facility that has not been inspected in five years may have deficiencies that have never been documented. A skilled nursing home neglect attorney knows how to investigate beyond what the public record shows — through the discovery process, expert review, and direct analysis of facility-specific records.
1. Get your family member medical attention.
If your loved one has suffered a serious injury, infection, or unexplained decline, medical care comes first. Document everything — emergency room records, hospitalization notes, specialist evaluations.
2. Request the facility’s records.
You have the right to your loved one’s complete medical records and care plan. Request them in writing and keep copies of everything.
3. Note what the facility told you.
If staff gave you explanations for injuries, changes in condition, or incidents, write them down while they are fresh.
4. Do not sign anything the facility presents.
Following a serious incident, some facilities will ask families to sign documents. Do not sign anything without first speaking with an attorney.
5. Contact a nursing home neglect lawyer.
These cases require prompt action. Surveillance footage gets overwritten. Employees leave. Documents get harder to obtain. The sooner an attorney can begin building the evidentiary record, the stronger your case will be.
The federal government requires routine inspections of Medicare and Medicaid certified nursing homes for a reason: nursing home residents are almost entirely dependent on facility staff for their care. They often cannot report problems themselves. They may not have family who visits regularly. They are, by definition, a population that cannot protect itself.
The inspection and complaint investigation system exists to substitute for that protection when family members are not present and residents cannot speak for themselves.
When that system has a backlog of nearly 5,000 uninvestigated complaints — including complaints flagged as potential immediate jeopardy — the protection fails. The residents who depend on it are left without any check on how they are being treated.
Tennessee families deserve better. And families whose loved ones were harmed during this inspection gap have every right to hold facilities accountable through the civil justice system, even when the state did not.
Does it matter that the state never investigated my complaint?
Yes — and no. The failure to investigate means there is no official finding, but it also means there was no corrective action taken against the facility. A civil lawsuit does not require a prior government investigation. We investigate independently, using the discovery process, to build the evidentiary record.
Can I sue a nursing home for neglect even if the facility passed its last inspection?
Yes. Inspections are point-in-time snapshots. A facility can receive acceptable marks on an inspection and still be providing negligent care. Inspections do not cover every resident, every shift, or every incident.
How long do I have to file a nursing home neglect claim in Tennessee?
Generally one year from the date of injury or discovery of negligence under Tennessee’s medical malpractice statute. Do not wait — evidence and witnesses become harder to secure over time.
What does it cost to speak with a lawyer?
Nothing. The Higgins Firm offers free consultations. We do not charge any fee unless we recover compensation for your family.
What types of injuries are most common in nursing home neglect cases?
Bedsores and pressure ulcers, nursing home infections and sepsis, nursing home falls, malnutrition, dehydration, elopement injuries, and medication errors are among the most common. Wrongful death in a nursing home claims arise when neglect leads to a resident’s death.
The Higgins Firm handles serious nursing home neglect and wrongful death cases across Tennessee. We are a litigation-focused firm that takes cases involving significant harm — and we build them to win.
The audit confirms what families have been told for years: the state system designed to protect nursing home residents is not working. When that system fails, the civil justice system is the only accountability mechanism left.
Free consultation. No fee unless we recover for you.
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For more information about Tennessee nursing home inspections and ratings, or to learn how to report a nursing home, visit our related pages.
Home / Blog / Tennessee Audit Reveals Thousands of Unresolved Nursing Home Complaints — What Families Need to Know
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Dedicated legal advocates protecting your loved ones nationwide. When nursing homes break their promise of care, our experienced attorneys fight for the justice your family deserves.