Nursing Home Neglect Deposition Questions: 50 Cross-Examination Questions for DONs, CNAs & Administrators

Nursing home neglect cases are won or lost in the deposition room. By the time you get to trial, the facility has usually retained sophisticated defense counsel, polished their witnesses, and rehearsed a sanitized version of the resident's last weeks. The deposition is where you strip that away — but only if you know which questions force real admissions from the Director of Nursing, CNAs, administrator, and medical director.

This guide provides 50 specific cross-examination questions organized by witness role, plus a 10-question outline for proving understaffing. Every question here has been used to produce admissions that moved cases from defense-favorable to seven-figure settlements.

Before the deposition: what you must have in hand

Do not depose any nursing home witness without the following records already in your file:

• Complete MDS 3.0 assessments (all quarterly, annual, and significant change assessments)
• All care plans (initial, quarterly, and revised)
• Treatment Administration Records (TARs) and Medication Administration Records (MARs)
• CNA flow sheets and ADL documentation (every shift)
• Braden Scale assessments (on admission, quarterly, and after any skin event)
• Incident reports (falls, skin tears, elopements, med errors)
• State survey reports (CMS Form 2567) for the prior 3 years, with F-tag deficiencies
• Staffing schedules and punch records for the residency period
• Payroll-Based Journal (PBJ) data submitted to CMS
• Wound care consult notes and wound measurements (L x W x D, undermining, tunneling)

Questions for the Director of Nursing (DON)

The DON is the facility's clinical gatekeeper. They sign off on the care plans, supervise the nursing staff, and are responsible for implementing the policies that CMS requires. Go after their knowledge of the specific resident and their compliance with facility policy.

1. What is the name of each nursing assessment your facility uses to evaluate pressure ulcer risk on admission?
2. What Braden Scale score triggers a pressure ulcer prevention care plan in your facility?
3. A Braden score of 12 or below — does your facility's policy require a turning and repositioning schedule every two hours?
4. Show me in Ms. [Resident]'s chart where each Braden assessment was performed. Were they performed on the schedule required by your policy?
5. Who at your facility is responsible for ensuring that the MDS coordinator accurately codes Section M (skin conditions)?
6. If an MDS coded "no pressure ulcers present" but the nursing notes from the same week document a Stage II ulcer — what does that tell you?
7. What is the definition of a Stage I pressure ulcer per the National Pressure Injury Advisory Panel (NPIAP)?
8. What is the definition of a Stage IV pressure ulcer, and does your facility's policy require immediate notification of the attending physician when one is discovered?
9. Does your facility consider an unstageable or deep tissue injury to be a reportable event under state regulations?
10. When a new pressure ulcer develops in-house — not present on admission — what documentation does your facility require to establish whether it was avoidable?
11. In the six months before Ms. [Resident]'s admission, how many F-tag deficiencies did your facility receive on CMS surveys related to F-686 (skin integrity)?
12. How many F-tag deficiencies related to F-689 (accidents and supervision)?
13. Did you personally sign off on any plans of correction submitted to the state in response to those deficiencies?
14. What was your facility's nurse-to-resident ratio on the 7a-3p shift on the date of Ms. [Resident]'s fall?

Questions for the CNA (Certified Nursing Assistant)

The CNA knows what actually happened at the bedside. They're usually nervous, often young, and frequently undertrained on the legal significance of their documentation. Be respectful but specific. They will almost always concede things the DON and administrator will not.

15. Were you assigned to Ms. [Resident] on [date]?
16. How many other residents were you also assigned to care for on that shift?
17. Of those residents, how many required two-person assistance for transfers?
18. How many were on fall precautions or bed/chair alarms?
19. How often were you expected to reposition Ms. [Resident] per her care plan?
20. Every two hours — walk me through what that looks like when you have 14 residents and three of them need two-person transfers.
21. When you completed the ADL flow sheet indicating you turned Ms. [Resident] at 10 a.m., 12 p.m., and 2 p.m. — did you actually turn her at each of those times, or did you document at the end of your shift?
22. Did anyone at your facility ever train you on the difference between "documenting what you did" versus "documenting what was supposed to happen"?
23. If you could not get to a resident on the repositioning schedule, what were you expected to do?
24. Were you ever instructed — formally or informally — to complete the ADL documentation even if you didn't have time to perform every task?
25. When did you first notice redness or skin breakdown on Ms. [Resident]'s sacrum?
26. What did you do when you noticed it? Whom did you notify?
27. Is there a written entry in the chart from that day reflecting your report to the nurse?
28. How many times in the week before Ms. [Resident]'s hospitalization did you work a double shift (16+ hours)?

Questions for the Administrator

The administrator is the corporate decision-maker. They control budgets, staffing levels, and ultimately what the building can and cannot do. Go after the business decisions that produced the neglect.

29. As administrator, are you responsible for ensuring the facility meets the minimum staffing requirements under 42 CFR 483.35?
30. What were your budgeted nursing hours per resident day (HPRD) for Q1 of [year]?
31. What were your actual nursing hours per resident day in that quarter?
32. When your HPRD fell below budget, did you request additional staffing from the parent company?
33. Does your facility use agency nursing, and what percentage of shifts in the relevant period were filled by agency CNAs?
34. Does your facility's quality assurance committee review falls and pressure ulcers quarterly?
35. What was the facility's pressure ulcer incidence rate (in-house acquired) in the quarter Ms. [Resident] was admitted?
36. How does that compare to the state and national averages reported on Care Compare?
37. What was your facility's star rating on Care Compare in the quarter of admission?
38. Did the parent company or REIT set a census target or occupancy goal that affected your ability to decline admissions?
39. Were any residents admitted during that quarter whose acuity exceeded the facility's staffing plan?

Questions for the Medical Director

Under 42 CFR 483.70(h), every nursing facility must have a medical director responsible for implementing resident care policies and coordinating medical care. They are often the most under-deposed witness in nursing home cases — and the one with the most to lose.

40. As medical director, are you responsible for overseeing the clinical care provided in this facility?
41. How many hours per month are you physically present in the building?
42. How many residents are in this facility, and how many of them are your personal patients?
43. When was the last in-service you personally led on pressure ulcer prevention?
44. Did you review Ms. [Resident]'s care plan at any point during her stay?
45. Did you review the facility's most recent survey citations related to F-686 (skin) or F-689 (supervision)?
46. If a resident develops a Stage III or IV pressure ulcer in-house, does your facility's policy require you to be notified?
47. Were you notified about Ms. [Resident]'s Stage IV sacral ulcer? When?
48. Do you have a signed medical director agreement specifying your duties and hours?
49. How much did this facility pay you in the year Ms. [Resident] was a resident?
50. Are you the medical director of any other nursing homes owned by the same parent entity?

The 10-question outline for proving understaffing

Understaffing is the root cause in roughly 80% of nursing home neglect cases we see. The following ten questions, posed to the administrator and DON in sequence, build an evidentiary record that supports a direct corporate negligence claim in addition to negligence per se under state nursing home statutes.

1. What is your facility's policy on minimum nursing staffing by shift?
2. What data source do you use to determine whether you met that minimum on any given day?
3. What is your Payroll-Based Journal (PBJ) staffing data for [relevant quarter]?
4. On how many days in that quarter did your facility fall below 3.0 HPRD total nurse staffing?
5. On how many days did RN staffing fall below the state-mandated minimum?
6. Who at the corporate level receives your staffing shortfall reports?
7. What action, if any, does the corporate office take when a shortfall is reported?
8. Have you ever been denied permission to hire agency staff to meet the minimum?
9. Has anyone at corporate ever set a labor budget that you believed was inadequate for the census and acuity of your building?
10. Did any resident incident report in the relevant quarter attribute the incident to inadequate staffing?

How Courtroom AI catches nursing home deposition inconsistencies live

Nursing home depositions are document-intensive. The DON or MDS coordinator will reference MDS sections, Braden scores, F-tags, and RAI dates at a pace that even experienced attorneys can't track while also preparing the next question. That's where real-time AI analysis has become a force multiplier.

Our nursing_home specialty keyword pack — which we rolled out this month — recognizes the domain-specific vocabulary that general legal AI misses. During a live deposition, Courtroom AI flags:

• Braden Scale inconsistencies. When a witness says "her Braden was 14" but the chart entry from the same date shows 9, the tool surfaces the contradiction with both source citations.
• MDS-to-chart mismatches. If Section M of the MDS codes "no Stage II ulcers present" but nursing notes from the same assessment window document a Stage II, the AI flags it as a reportable RAI inaccuracy.
• F-tag deflection patterns. Administrators often minimize prior F-tag deficiencies ("that was corrected"). The AI cross-checks their answer against prior survey reports you've uploaded.
• Staffing arithmetic contradictions. When the DON states ratios inconsistent with the facility's actual PBJ data, the AI surfaces the math.
• Wound staging drift. A wound documented as Stage II in Monday's note but described as "abrasion" in Wednesday's — flagged with exact dates and page references.

The goal isn't to replace your judgment. It's to make sure you never leave an admission on the table because the witness moved past it three questions ago.

Common mistakes in nursing home depositions

• Not deposing the CNA first. The CNA is the most honest witness in the building, and the most important to depose early. Some firms wait until after the DON — by which time defense counsel has coached the CNA on what to say.
• Skipping the medical director. Medical directors often have contractual obligations they cannot explain on the record, and their absence from in-service education is devastating to the defense.
• Not anchoring questions to specific documents. "Was she turned every two hours?" is a terrible question. "On this ADL flow sheet, for the 7a-3p shift on March 4, who documented repositioning at 10 a.m.?" is a great question.
• Failing to get PBJ and staffing schedules before depositions. Without those, you can't cross-examine on staffing at all.

Related reading

• How to Daubert Challenge an Expert Witness in 2026 — methodology attacks and Rule 702 fundamentals
• How AI Analyzes a Two-Hour Deposition in Real Time
• Medical Malpractice Discovery Checklist
• How AI Catches Expert Witness Inconsistencies