Understaffing in Nursing Homes

Nursing homes should be staffed appropriately to meet all residents' needs. When a nursing home is understaffed, residents may not receive the quality care they need and may be subjected to abuse.

Do you believe that your loved one was a victim of nursing home abuse due to understaffing? If so, the nursing home abuse attorneys at Nursing Home Law Center can help you 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, medication management, rehabilitation, and providing meals.

It's essential to employ a registered nurse and a licensed nurse in a nursing facility to ensure adequate staffing. However, a nursing home may have difficulty recruiting and retaining staff members in some cases.

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 residents living with medical problems. They also offer various services, such as physical therapy, occupational therapy, and speech therapy. Qualified staff members will enable the nursing home residents to access professional medical advice.

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 home facility staffing roster indicates the amount of time each nursing staff member is scheduled to work within 24 hours, with standards set by the Centers for Medicare and Medicaid Services. According to Medicare, eight hours is the minimum amount of time nursing home staff should provide care to residents each day.

Nursing Home Residents Affected by Understaffing in Assisted Living Facilities

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

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

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

The nursing home industry is struggling to find enough workers to care for an aging population due to the low pay and difficult working conditions that nursing home employees face.

In addition, the lack of competent staff, such as certified nursing assistants, is a big problem in nursing homes.

Nursing Home Abuse Caused by Understaffing in Nursing Homes

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

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

On a busy day, 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 staffing levels to ensure nursing home abuse doesn't occur.

Understaffing Consequences for Nursing Facilities Residents Who Are Unable to Move

Patients who cannot move independently are at risk for several complications if nursing homes are understaffed.

The patients are more likely to develop pressure ulcers, or bedsores, due to remaining in the same position for too long.

They may also suffer from malnutrition or dehydration because they cannot get to the bathroom or get enough to eat and drink.

Also, understaffing can increase the risk of falls and other injuries for residents who cannot move.

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.

Labor Costs Implications on Staffing in Nursing Homes

The cost of labor is a significant driver of nursing home operating costs. In 2015, nursing homes spent an average of $36.63 per day per patient on labor, 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 salary 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 home care increases, the cost of labor is likely to continue to be a significant driver of nursing home operating costs impacting staffing levels.

Pay for Overtime Hours and Exhaustion in Nursing Facilities

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.

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

Examples of Average Settlement Amounts For Nursing Home Abuse Cases Resulting From Understaffing in Nursing Facilities

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 facilities:

  • $2.75 million: Settlement reached in a lawsuit against the skilled nursing facility for negligence that resulted in the death of a patient. The lawsuit alleged that the facility was understaffed and that the staff members were not properly 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 nursing 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 stated that the facility had insufficient staffing and those who were 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..
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.

What is the Best Way to Remedy Understaffing in Nursing?

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

Another way to increase the number of nurses working in nursing homes is to offer incentives to nurses willing to work overtime hours 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 home if the will is there.

Why Are Nursing Homes Understaffed?

There are many causes of understaffing in nursing homes. One common cause is budget cuts.

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

Labor costs in 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.

How Can We Prevent Nursing Home Understaffing?

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

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

Nursing homes should develop policies and procedures to help ensure that staffing levels are adequate, including setting minimum staffing levels and implementing procedures 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 nurse 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 the Centers for Medicare & Medicaid Services (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 not enough nursing home staff members to provide all of the necessary 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 can 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 There is Sufficient Staffing at My Parent’s Nursing Home?

The Centers for Medicare and Medicaid Services (CMS) 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 home and compare that number to other facilities in the local and national regions.

Hiring a Lawyer to Pursue 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 nursing home residents? Contact an experienced nursing home abuse lawyer immediately for legal assistance.

Nursing home abuse can result in serious 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 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.


Client Reviews

Jonathan did a great job helping my family navigate through a lengthy lawsuit involving my grandmother's death in a nursing home. Through every step of the case, Jonathan kept my family informed of the progression of the case. Although our case eventually settled at a mediation, I really was impressed at how well prepared Jonathan was to take the case to trial. Lisa
After I read Jonathan’s Nursing Home Blog, I decided to hire him to look into my wife’s treatment at a local nursing home. Jonathan did a great job explaining the process and the laws that apply to nursing homes. I immediately felt at ease and was glad to have him on my side. Though the lawsuit process was at times frustrating, Jonathan reassured me, particularly at my deposition. I really felt like Jonathan cared about my wife’s best interests, and I think that came across to the lawyers for the nursing home. Eric