Objective To explore current status and factors associated with abuse tendency among caregivers working in nursing homes, and to provide references for developing targeted management strategies to prevent abusive behaviors. Methods From January to May 2024, a convenience sample of 428 caregivers from 13 nursing homes in three provinces were selected. Surveys were conducted using a general information questionnaire, the Caregiver Abuse Screen for the Elderly, the Environment Subscale of the Caring Nurse-Patient Interactions Scale, and the Jefferson Scale of Empathy-Health Professionals. Results A total of 141 caregivers working in nursing homes exhibited abuse tendency, accounting for 32.94%. Factors associated the abuse tendency of caregivers included the institution type, monthly income of the nursing staff, familiarity with laws protecting the rights of older adults, empathy capacity, and caring interaction with residents (all P<0.05). Conclusions Caregivers working in nursing homes have a relatively high tendency towards abuse. Institutional managers should focus on improving the salary of nursing staff, enhancing their professional skills training and legal education, and strengthening caring interactions and empathy capacity to reduce the risk of elder abuse.