Scabies in Nursing Homes

Scabies is a disease caused by parasitic mites burrowing into a person’s skin. Scabies can spread quickly from person to person, especially in an environment such as a nursing home. Neglect by nursing home staff can worsen a scabies outbreak and cause life-threatening conditions in residents. If a loved one has contracted scabies in a nursing home, visit for legal help.

Elder skin infection

When a loved one is under the care of a nursing home or long-term care facility, you hope they are in the best hands. But while many residents and their loved ones place immense trust in nursing home staff and administration, too many residents suffer injuries or illness due to neglect and improper protocols. 

One health condition that is too common in nursing homes is a skin disease known as scabies. If a loved one has been affected by nursing home scabies, they may be the victim of neglect by the nursing home administration or its staff. Learn more about scabies in nursing homes and how can help if your loved one has been affected.

What Is Scabies?

Scabies is a contagious skin disease caused by the mite Sarcoptes scabiei, commonly known as the “itch mite.” Female mites of this species burrow into a person’s skin to lay their eggs. The eggs incubate under the skin until they hatch. During incubation, the affected individual’s immune system triggers an allergic reaction to the presence of the mite eggs in the skin. This leads to unpleasant skin inflammation, itching, and potentially more severe symptoms if a scabies infection gets out of control. 

Scabies is particularly dangerous to older adults and immunocompromised individuals. In these cases, a scabies infection can result in a particularly severe form known as “crusted scabies” or “Norwegian scabies,” which causes agonizing symptoms and may be fatal if scabies mites enter an infected individual’s bloodstream.

Scabies is spread from person to person through close physical contact or contact with something an affected individual has touched. In most cases, the scabies mite is too small to be seen by the naked eye, so vulnerable individuals often do not notice the female mite burrowing into their skin. For this reason, it can be difficult to determine if a bedsheet or pillow contains scabies mites or mite eggs.

Nursing homes and care facilities can avoid scabies outbreaks by adhering to strict hygiene protocols in patient rooms. This includes consistently and thoroughly washing all bedsheets and pillows and regularly vacuuming each patient’s room.

What Are the Symptoms of Scabies?

The most common symptom of scabies is persistent itching on the skin at the site of the infection. Once mite eggs have been laid under a person’s skin, the body’s immune system triggers an allergic response that causes constant itching, usually not relieved by scratching. In many scabies infections, the itching is worse at night. This can cause a secondary symptom of sleep deprivation if the consistent itching keeps the person awake. 

Most people with scabies also develop a noticeable rash at the site of the infection. This rash often resembles “hives,” or small reddish bumps that form a thick cluster on the skin. However, scabies rashes can also look like pimples or scaly, flaky patches that resemble eczema. In severe cases of crusted scabies, affected individuals also develop thick crusts across larger portions of their skin caused by a much higher number of mites. 

Consistent scratching of the infection site can also cause sores and scratches to develop across the skin. If untreated, these sores may become infected, especially if the affected individual is elderly or immunocompromised.

What Causes Scabies in Elderly Residents?

Elderly individuals may be at a higher risk of developing scabies than others. Many cases of scabies originate from prolonged exposure to an infected surface, especially a bed or a chair. Elderly individuals are less mobile than younger people and spend more time in a chair or bed. If scabies mites contaminate these surfaces, prolonged contact with an elderly individual’s skin greatly increases the risk of scabies infection.

Because elderly individuals are more likely to have other health issues compromising their immune systems, they are also more likely to develop severe cases of crusted scabies. Individuals suffering from crusted scabies are much more contagious due to the higher quantity of scabies mites in the skin. This means they are more likely to spread the disease to other nursing home residents via physical contact or prolonged contact with physical surfaces.

How Does a Scabies Infestation Spread in a Nursing Home?

Scabies infestations can spread in a nursing home for several reasons. In most nursing home infection outbreaks, scabies mites spread to new hosts via physical surfaces that have direct contact with skin. Bed sheets, mattresses, and pillowcases are commonly responsible for scabies infections, especially if the nursing home circulates bed sheets and blankets across multiple patients. 

Because of the higher presence of immunocompromised patients, nursing homes are more likely to have residents who contract crusted scabies. These individuals are much more contagious due to their skin’s higher number of mites. Exposure to these individuals or surfaces they have touched can cause large-scale scabies outbreaks in nursing homes.

Do Nursing Homes Have Protocols for Scabies Outbreaks?

Nursing homes should have protocols to prevent and control scabies outbreaks, though they may vary from institution to institution. Effective scabies prevention protocols should include both preventative hygiene and effective responses to diagnosed cases. Nursing homes should always thoroughly wash all bedsheets, blankets, mattresses, and other surfaces that come in physical contact with residents’ skin. 

Nursing homes should also be able to diagnose any new case of scabies quickly. Once a resident is found to have scabies, the nursing home must implement a quarantine protocol to minimize physical contact with other residents. Additionally, staff who have been in contact with that patient should not be in contact with other residents.

Can Scabies Be Misdiagnosed by Nursing Home Staff?

Unfortunately, misdiagnosis of scabies can and does happen in nursing homes. Scabies may sometimes be misdiagnosed as another skin disease, such as eczema or allergic dermatitis. Staff may also assume that scabies rashes result from bites from other arthropods, such as spiders or mosquitos. Misdiagnoses delay essential quarantine protocols and exacerbate an outbreak.

Is Scabies a Sign of Nursing Home Neglect?

If your loved one has developed scabies in a nursing home, they may be a victim of nursing home neglect. Staff may have failed to properly clean mattresses and sheets, which can lead to an infection by scabies mites. The nursing home staff may have also misdiagnosed cases of scabies in another patient and failed to implement proper quarantine procedures. 

Many neglect cases occur because of understaffing and other cost-cutting measures taken by nursing home administrators. These cause staff to cut corners and fail to provide a reasonable standard of care. Cleanliness, proper hygiene, and adequate patient monitoring can all be undermined, leading to a scabies outbreak. 

In some cases, extreme neglect forces nursing home residents to remain in one place for an extended period, often in close vicinity to other patients. This type of neglect drastically increases the chances of a scabies outbreak.

Who Is Liable for Scabies in Nursing Homes?

When nursing home scabies outbreaks occur, both individual caregivers and the institution can be held liable if it is found that they violated necessary scabies nursing home protocols. If your loved one was affected by a scabies outbreak in a nursing home, legal experts can help you understand who is liable based on relevant laws and the circumstances of the case.

Can You Sue a nursing home for a scabies infestation?

Yes, a lawsuit may be pursued in the outbreak was caused or worsened by nursing home neglect. In most cases, three types of people can sue a nursing home due to a scabies outbreak resulting from neglect: nursing home residents, the residents’ agents under powers of attorney, and residents’ immediate family members.


What Conditions Are Mistaken for Scabies?

Skin conditions such as eczema, psoriasis, and dermatitis can all be mistaken for scabies. Allergic reactions and insect bites are also common sources of misdiagnoses.

What Does Scabies Look Like?

Scabies most commonly resembles a red rash comprised of bumpy, reddish hives, though it can also take on a scaly or crusty appearance.

How Long Does Scabies Last?

With treatment, scabies lasts up to four weeks.

How Long Can Scabies Mites Live on a Mattress?

Scabies mites can live three or four days on a mattress outside a human host.

Get Help With Nursing Home Scabies

If a loved one has been affected by a scabies outbreak in a nursing home, you should learn your legal options. is an advocacy organization dedicated to preventing injuries and illness in nursing homes and achieving justice for those affected. If you suspect a case of nursing home scabies was caused by neglect, contact us for information and legal help.

Fact Checked

Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.
Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.