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Institutional abuse is the maltreatment of a person (often children or older adults) from a system of power.[1] This can range from acts similar to home-based child abuse, such as neglect, physical and sexual abuse, and hunger, to the effects of assistance programs working below acceptable service standards, or relying on harsh or unfair ways to modify behavior. Institutional abuse occurs within emergency care facilities such as foster homes, group homes, kinship care homes, and pre-adoptive homes. Children who are placed in this type of out of home care are typically in the custody of the state. The maltreatment is usually caused by an employee of the facility.