Staffing Nursing Homes

Nursing Home Staffing Guide

Each day, tons of things swirl around a nursing home. People come and go. Residents fall down. Medical emergencies arise. It can be hard to keep track of what’s going on. Yet, you need to do that. If you don’t, more people will get hurt. The reason residents enter homes is to avoid these problems. To prevent them, staff your home properly.

You’ll need all kinds of workers in the nursing home. Some of them work directly with residents. They make sure guests’ needs are being met. Others work behind the scenes. They make sure everything runs smooth. Together, the entire staff functions to care for each resident. Yet, if one of them fails, the whole group can get in trouble. We want to review staffing guides in nursing homes now. Find out about the perils of understaffed nursing homes here.

What Kinds of People do I Need to Run my Nursing Home? Admin

Before discussing the people you see first at a nursing home, let’s talk about the staffers that keep the facility running. That’s the administration. They set policy. They make procedures. They build the foundation and tone for other workers to do their job. Their duties touch broadly on legal, financial, HR, and quality concerns. Yet, there are some specific boxes you must check for these admin staffers. Take a look at these requirements.

  • States demand that your admin workers have a license.

  • Admin staffers need a bachelor’s/master’s degree. They can have a lesser degree with significant work experience in a like home.

  • State/federal legal knowledge; operational experience; privacy/employment/disability issue mastery.


Care workers provide direct assistance to residents. Nursing homes would fail completely without them. They’re the most important part of a facility. Check out these staff roles. You’ll need them to ensure your home runs smoothly.

  • Registered nurses. You need registered nurses to assess residents. They evaluate and then plan the care of residents. After that, they measure the effects of their work. RNs must be licensed in the state they’re working in. They also need between 2-6 years of schooling.

  • Assistant nurses. Assistant nurses work at the direction of RNs. They assist residents on a day-to-day basis. They help them with eating, dressing, cleaning, etc. Each assistant nurse must obtain certification. They must also receive regular trainings.

  • Dietician. Nursing homes must have a dietician at least on a part-time basis. Federal law requires this. If the person isn’t full time, the home must have a food service director coordinate care with the dietician. The dietician must obtain certification. That can be done through education or through the American Dietetic Association’s Commission on Dietetic Registration.

These staffing profiles are critical to the success of your nursing home. They’re just the minimum though. You might also find that physical therapists, licensed vocational nurses, or licensed practical nurses are necessary too. Which and how many you require depends on the nature of your home and needs of your residents. You should obtain professional advice to help determine your total staffing requirements.

What do Employees do at a Nursing Home?

Of course, the exact duties of nursing home staff depend on the roles. Yet, they’re all tasked with providing a safe environment for residents. However, we can be a bit more specific when identifying their responsibilities. Let’s review their main tasks.


Before residents even walk through the door, home staff should have a plan in place. Nursing home admin should consult with his/her doctors. Then, they need to draft a plan of care. This plan should reduce the risk of injury. Common injuries include bed sores, falls, and malnutrition.


Nurses and other direct care providers need to implement the admin’s plans and procedures. They do this by providing regular checks, prescribing meds, and performing other tasks. The goal here is to ensure that the resident’s needs are being met. Also, you want to verify your plans are being followed. This will also reduce the damage of unexpected risks.


If the unlikely does arise, you need to be ready to act. This involves planning well before injuries happen. You need to install alert and emergency systems. These should notify medical and ambulance services. The damage needs to be kept to a minimum. This can only happen if you have personnel and technology procedures to identify, respond, and fix problems. Of course, you will also need to contact your relevant government or regulatory body to tell them what happened. Most states have laws requiring this disclosure.

Each of these main groups has many tasks within it. These outline the core duties that nursing home workers have. To find out what each employee should do in more detail, contact a legal professional.

Nursing Home Staffing Requirements

We already noted that nursing homes must keep dieticians on staff. At the least, they must consult with them regularly. What other staffing requirements do nursing homes have? It depends. If your home accepts Medicare or Medicaid, you’ll have more obligations. You need an RN on call every day for eight hours a least. Also, a licensed nurse must be working all day, each day. For your nursing aides, you must train them at least 75 hours. Other than that, there aren’t a lot of specifics. You must employ and train staff “To provide sufficient staff and services to attain or maintain the highest possible level of physical, mental, and psychosocial well-being of each resident." Of course, federal law just guarantees a floor of service for residents. States can add to that and they often do. For example, look at some Illinois laws. They add additional staffing burdens to nursing homes.

  • They must have a specific number of nurses. This number almost doubled in 2014. It depends on the size of the home.

  • 3.8 hours of nurse care per resident needing skilled care. 57 of these minutes should be by a licensed nurse. 23 of these minutes should be by a registered nurse.

  • Residents needing intermediate care should receive 2.5 hours of nursing time. 38 of these minutes should be from a licensed nurse. 15 of these minutes must come from a registered nurse.

  • Nursing homes must post the names and titles of nurses working on shift.

  • Nurses must wear ID badges with their names and titles at all times.

This just provides an outline of nursing home staffing requirements. To meet residents’ needs, nursing homes may be required to go beyond these rules. To figure out your staffing demands, seek expert legal counsel.

Nursing Home Staffing Penalties

Understaffing occurs at nursing homes for many reasons. Nurses cost a lot to employ. It can be hard to find qualified staff for nursing homes too. Yet, this has direct effects on care. The kind and quality of treatment suffers. Residents get harmed because of it. They fall over and break bones. They don’t get the right meds. Tons of negative outcomes result due to understaffing. Homes get in trouble as well. They may face fines, shutdowns, and more. Even nurses may receive personnel penalties. To understand what liability your nursing home might have, contact a qualified attorney.

Nursing Home Staffing Resources

Look at these resources on staffing your nursing home.

Learn more about how to better operate your nursing home! Read these pages.

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