$3,100,000Pressure sore death
$2,333,000Fall involving traumatic brain injury
$1,500,000Bedsore settlement
$1,499,000Dementia patient injury
$1,250,000Repeated fall injuries

Understaffing in Nursing Homes

Understaffing in nursing homes has become a national problem. To meet all residents’ needs, nursing homes must meet nurse staffing standards and the minimum staffing levels set out by federal law.

Nursing home residents are the first to suffer when a nursing care home is understaffed, with poor quality care, and nursing home abuse and neglect.

Do you believe your loved one was a victim of nursing home abuse and neglect due to low nurse staffing levels? If so, the personal injury attorneys at Nursing Home Law Center can help determine if you have a case and guide you through the process.

Call our experienced nursing home abuse lawyers toll-free at (800) 926-7565 for a free legal case review to explore your legal options.


Nursing homes provide a wide range of health and personal care services, including 24-hour supervision, assistance with activities of daily living, general well-being, medication management, rehabilitation, and meals.

It’s essential to employ nursing staff, including a registered nurse and a licensed nurse, to ensure adequate staffing. However, assisted-living facilities sometimes have difficulty recruiting and retaining staff members, leading to an understaffed nursing home.

Skilled Nursing Facilities Serving Nursing Home Residents

As people age, their healthcare needs often change due to an increase in chronic conditions, a decline in overall health, or simply the need for more help with activities of daily living which means moving from their home into a skilled nursing facility (SNF).

SNFs provide around-the-clock nursing care and support for nursing home residents living with medical problems to allow them to continue living with human dignity. They also offer various services, such as physical therapy, occupational therapy, and speech therapy. Qualified staff members will enable nursing home residents to access professional medical advice and prevent elder abuse.

In addition, SNFs typically have a social worker on staff to help residents and their families with the transition and connect them with community resources.

A nursing facility staffing roster indicates the time each nursing staff is scheduled to work within 24 hours, with standards set by the Centers for Medicare and Medicaid Services (CMS).

According to Medicare, eight hours is the minimum time nursing staff should provide residents daily care, which means nurse staffing levels and staff turnover have to be enough to provide adequate resident care.

Nursing Home Residents Affected by Understaffing in Assisted Living Facilities

Nursing home residents are vulnerable. They are often elderly, sick, unable to care for themselves, and susceptible to abuse and nursing home neglect.

There are many signs of elder abuse and care home neglect. These can include physical symptoms, such as bruises or broken bones, or psychological cues, such as anxiety or depression.

Poor treatment of nursing home residents can be linked to inadequate nurse staffing levels. A study of Pennsylvania nursing homes showed that a for-profit nursing home chain had staffing levels that were, on average, lower than those of non-profit and government-owned nursing homes.

Nursing home owners are struggling to find enough certified nursing assistants and other healthcare workers to care for an aging population due to the lack of overtime pay and difficult working conditions that employees face, which leaves nursing care homes with a high staff turnover, and poor quality care for the nursing home residents.

In addition, the lack of competent staff, such as certified nursing assistants, is a big problem in a medical care organization such as a nursing facility.

Nursing Home Abuse Caused by Understaffing in Nursing Homes

Many types of elder abuse can occur in nursing homes. The most common type of nursing home abuse is physical, including hitting, slapping, shoving, grabbing, or other physical force. Types of elder abuse include sexual, emotional, and financial abuse.

The Affordable Care Act of 2010 was designed to improve the quality of patient care in the nursing home industry. Having enough staff members, including minimum nurse-to-nursing home resident ratios, is critical for providing adequate care and preventing elder abuse in nursing homes.

On a busy day, the actual nurse staffing levels of an average facility may have a ratio of one nursing staff member for every ten residents, which can drop down to as low as one staff member for every fifteen residents.

Nursing home owners should maintain optimal nurse staffing standards to ensure nursing home abuse and other human dignity violations don’t occur.

Understaffing Consequences for Nursing Facilities Residents Who Are Unable to Move

Patients who cannot move independently risk complications if nursing homes are understaffed. Also, understaffing can increase the risk of falls and other injuries for residents who cannot move.

When a nursing facility’s actual nurse staffing levels fall below the recommended ratio by the nursing home industry, its residents are the first to suffer. Some typical results of neglect in an understaffed medical care organization:


Bedsores can be avoided if the nursing staff takes the necessary precautions. If bedsores appear or worsen, it is clear that the facility provided poor or negligent treatment.

Bedsores, also known as pressure ulcers or decubitus ulcers, can be avoided if staff members follow the appropriate preventative measures. The patients are more likely to develop pressure ulcers, or bedsores, due to remaining in the same position for too long.

Residents should avoid being sedentary for long periods to prevent lesions. Every few hours, residents should be encouraged to move around and change positions. Still, for many in nursing homes, help is needed to get back into their chairs and beds, which might be difficult if the facility does not have the minimum nurse ratios.

Doctors evaluate bedsores to determine their stage of development. The phases of bedsores are as follows:

  • Stage 1: Skin is not broken in this instance. You might see purple, blue, or red blotches depending on your skin tone. The discoloration could also be warm or swollen.
  • Stage 2: A skin-deep ulcer is revealed when the skin cracks. You might see fluid-filled blister pockets at this stage.
  • Stage 3: The ulcer penetrates the skin more deeply, damaging the fat layer as it does so. It looks like a crater at this stage.
  • Stage 4: The infection spreads to the skin’s deeper layers, such as bone and muscles.
  • Unstageable: To get rid of an eschar—a dark, hard plaque—that might be inside the sore, the patient would need further imaging or surgery.

Lack Of Hygiene

Residents of nursing homes are at risk for major infections due to unhygienic conditions, which can result in extended hospital admissions, incapacity, and higher medical costs. However, according to federal law, nursing homes and assisted living facilities that accept Medicare must maintain cleanliness and hygienic conditions.

Poor hygiene is a vital sign of nursing home resident neglect in nursing homes all around the country. Understaffing in a nursing home is a chronic problem, and overworked nursing staff (many times without overtime pay) are liable for elder abuse or unsanitary and unhealthy conditions.

Nursing homes’ immoral neglect and carelessness frequently reach the level of negligence, opening the door to a successful lawsuit filed against the nursing home chain by appalled family members. Call our specialized lawyers for a free legal case review if your loved one has suffered abuse due to inadequate nursing home staffing ratios.

Malnutrition and Dehydration

Residents may also suffer from malnutrition or dehydration because they do not receive enough to eat and drink.

Weight loss is the first noticeable symptom of malnutrition in nursing homes. Speak with staff about your concerns if you see that a loved one has lost weight too fast since moving into a nursing home.

Residents of nursing homes who are undernourished may also have trouble chewing their meals or stop eating altogether.

Seniors with Parkinson’s disease and Alzheimer’s frequently lack thirst and won’t drink even when needed. Since many people suffering from these conditions might be unable to communicate if something is wrong, it is crucial to know the symptoms of dehydration.

Depending on the degree of their condition, those malnourished will exhibit a range of symptoms, from moderate to life-threatening.

All of these complications can be extremely serious and even life-threatening. Therefore, nursing homes must be optimally staffed to protect all residents, especially immobile ones. Nursing homes may be held responsible for any damages resulting from failing to provide this quality of care, including taking action to avoid nursing home abuse.

Why Are Nursing Homes Understaffed?

The issue of understaffing in nursing homes is not new. However, many have suffered abuse or were neglected as a consequence.

Labor Costs Implications on Understaffing in Nursing Homes

Labor costs are a significant driver of operating expenses in nursing homes. In 2015, nursing homes spent an average of $36.63 per day per patient on care, representing 42 percent of their total operating expenses (Nursing Home Compare, 2018).

The median annual salary for a registered nurse working in a nursing home was $60,000 in 2018, while the median yearly wage for a licensed practical nurse or licensed vocational nurse was $43,500 (Bureau of Labor Statistics, 2017).

As the baby-boomer population ages and the demand for nursing homes increases, the labor cost will likely continue to be a significant driver of operating expenses in nursing homes, impacting staffing levels.

Lack of Overtime Pay and Exhaustion in Nursing Homes

The Fair Labor Standards Act (FLSA) requires that covered and nonexempt workers are paid at least the federal minimum wage for all hours worked, plus time and one-half their regular hourly pay rate for hours worked beyond 40 in a workweek.

Some states have enacted minimum wage laws that set a higher minimum wage rate than the federal rate. Covered workers must be paid the higher state minimum wage in these states.

Working in nursing home facilities can be a very demanding and challenging job. The staff is often overworked and underpaid, which is one of the primary roots of understaffing in nursing homes.

A nursing facility with competent staff, such as a doctor and a licensed nurse, can provide professional medical advice and good quality health care and prevent nursing home abuse.

If you suspect your loved one has been suffering due to an understaffed facility, contact our experienced attorneys for a free legal case review.

Examples of Average Settlement Amounts for Nursing Home Abuse Cases Resulting From Understaffing in Nursing Homes

The average settlement amount in a nursing home abuse case can vary depending on the severity of the elder abuse, the injuries sustained, and other factors.

Here are some examples of average settlement amounts in cases where the abuse was caused by understaffing in nursing homes:

  • $2.75 million: Settlement reached in a lawsuit against the skilled nursing facility for negligence that resulted in a patient’s death suit. It was alleged that the facility was understaffed and staff members were not adequately trained.
  • $1.5 million: In this lawsuit, the assisted living facility’s negligence caused the death of a patient. The case was based on a lack of staff with improper training of the employees that provided the residents’ services.
  • $325,000: Financial compensation for a nursing home resident who died due to negligence at a care home. The complaint stated that the center was understaffed.
  • $290,000: The plaintiffs received a settlement in a negligence lawsuit filed against a skilled nursing facility. The claim said that the facility had insufficient staffing and those working were not adequately trained.
  • $270,000: A case involving an assisted living facility was resolved in a settlement. The relatives of the deceased claimed that the facility was understaffed, which resulted in the death of their loved one.

Contact our lawyers for a free legal case review if you find your loved one neglected due to understaffing in nursing homes.

Hiring a Lawyer to Pu rsue a Nursing Home Abuse Case Caused by Understaffing in a Nursing Facility

Were you or a loved one victims of nursing home abuse because there were not enough personnel to provide the services to all residents? Contact an experienced nursing home abuse lawyer immediately for legal assistance with a free legal case review.

Nursing home abuse can result in severe injuries and even death, and the responsible parties must be held accountable.

The abuse and neglect attorneys at Nursing Home Law Center are dedicated to offering legal help to the victims and their family members to recover the financial compensation they deserve for the harm caused by understaffing. Call our legal help phone number toll-free at (800) 926-7565 or use the contact form for a free legal case review.

Our nursing home abuse lawyers operate on a contingency fee basis, so you don’t have to pay us unless we win your case.


Understaffing in Nursing Homes FAQs

Our nursing home abuse lawyers understand that many families have unanswered questions about understaffing in nursing homes and its impact on many nursing facility residents.

Understaffing in Nursing Homes FAQs

What is the Best Way to Remedy Understaffing in Nursing?

One way to fix the understaffing in nursing homes is by hiring enough nurses and certified nursing assistants or reassigning some nurses from other units.

Another way to increase the number of nurses working in nursing care homes is to offer incentives to nurses willing to work overtime or take on additional responsibilities.

It's also essential to improve the working conditions for caregivers in nursing homes by providing better pay and benefits or increasing the number of breaks and days off.

Attaining staffing levels that are safe and adequate is tenable in every nursing care home if the will is there.

Why is Understaffing in Nursing Homes A Widespread Problem?

Why nursing homes are understaffed is a multi-layered answer. There are many causes of understaffing in nursing homes. One common cause is budget cuts.

When a nursing facility faces financial difficulties, it may reduce its staff to save money, leading to staff members working longer hours and fatigue and burnout.

Labor costs in skilled nursing facilities are the primary driver of expenses compared to other costs such as medications, food, and other supplies.

Other understaffing causes can include an unexpected increase in patient census, staff turnover, and high absenteeism.

Why are Nursing Homes Understaffed and How Can We Prevent the Problem?

One way to prevent understaffing in nursing homes is to offer competitive pay and benefits to attract and retain qualified workers.

Additionally, nursing care homes should provide adequate training for all staff members to ensure that employees provide the best possible care for residents.

Nursing home centers should develop policies and procedures to help ensure that staffing levels are adequate, including setting minimum staffing levels and implementing strategies for calling in additional staff when needed.

While there is no silver bullet for addressing the nursing home staffing crisis, research suggests that facility-level interventions can improve staffing levels and resident outcomes.

You can report an understaffed nursing home. To do so, contact your state's long-term care ombudsman or the local office of the Administration on Aging. You can also file a complaint with CMS.

What Are the Implications of Staff Shortages on Patient Care?

There are several ways in which understaffing can negatively affect patient care.

There are simply insufficient nursing staff members to provide resident care. Consequently, many residents do not receive the level or frequency of care they need leading to a decline in their well-being.

Similarly, the caregiver's limited time with each patient may resort to unnecessary force when handling them, especially when a patient resists care or becomes combative.

Additionally, understaffing can lead to staff members feeling overworked and stressed, impacting the quality of care they provide and their job satisfaction and retention rates.

Understaffing can also make it more challenging to maintain a clean and safe environment, putting nursing home residents at risk for infection or other complications.

How Do I Ensure Sufficient Staffing at My Parent’s Nursing Home?

The Centers for Medicare and Medicaid Services provides an online Nursing Home Compare Tool that offers up-to-date information, facts, and figures on every nursing facility nationwide.

You can find the resident-to-caregiver ratio for the target nursing facility and compare that number to other nursing home facilities in the local and national regions.


Nursing Home State Laws

Nursing home abuse lawsuits must be pursued according to the laws set forth by the state where the facility is located. In this section, our attorneys have compiled the relevant laws, regulations and local organizations for each state so you can get an idea of how the law impacts your situation. Should you decide to move forward with a case, you will also find information about locating an experienced attorney who can assist your family.

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