Nursing Homes Critically Understaffed: What It Means for Your Loved One

senior woman nursing home

July 18, 2018

Ellis Law Corporation

Nursing Home

Over a million elders reside in our nation’s skilled nursing facilities, where seniors rely on hired personnel to help them dress, bathe, eat and get their medications. When nursing homes are short-staffed, essential tasks get overlooked and avoidable injury ensues.

When staff are overwhelmed and overburdened, it’s the nursing home residents who suffer with bedsore-related infections, fall-related injuries, missed medications and unhygienic conditions.

Nursing homes overstating staffing levels

A recent analysis of payroll records in 14,000 Medicare-assisted facilities shows that the majority had over-reported their actual staffing numbers to the government, in effect, gaming the system. As reported by the New York Times, “payroll records provide the strongest evidence that over the last decade, the government’s 5-star rating system for nursing homes often exaggerated staffing levels and rarely identified the periods of thin staffing that were common.”

Kaiser Health News evaluated the payroll data, finding alarming fluctuations in day-to-day nursing home staff levels. Facilities that earned 5-star ratings in the Medicare system for high staff to patient ratios had serious shortcomings. One facility – on its lowest days — had only one staff member for 18 residents.

Medicare has never outlined a mandatory staff to resident ratio. Instead, it asks nursing homes to make thoughtful staffing plans based on resident population and needs. It does, however, require a registered nurse to be on the premises for at least 8 hours a day. As several studies have highlighted, facilities that are critically understaffed have a history of health code violations — an important gauge of quality.

Understaffing leads to nursing home neglect

Nursing homes that are understaffed and scrambling to care for residents struggle with high turnover rates, and predictably, increased reports of elder neglect. Countless facilities in California and across the country have huge staff fluctuations, leaving large numbers of residents at serious risk. When basic needs are not met, and patients don’t receive the attention and time they need, the ramifications can be devastating.

Understaffed nursing homes is a critical issue that endangers the welfare of residents.

Lack of adequate care can lead to the following problems:

  • Serious conditions go undetected and untreated
  • Residents are unsupervised and more likely to fall and get injured
  • Lack of personal care and hygiene
  • Development of pressure sores/bed sores
  • Weight loss, dehydration and malnutrition
  • Anxiety and depression from lack of social interaction
  • Inadequate medical care

Any one of these issues can have a detrimental effect on the physical and emotional health of nursing home residents, and in worst-case scenarios, can even lead to death.

California nursing home neglect attorneys

When inadequate staffing causes neglect and injury, the law affords protections. If you’re concerned that your loved one isn’t receiving proper care in an assisted-living facility, discuss these concerns with your local ombudsman or Adult Protective Services and reach out to a Los Angeles nursing home neglect attorney at Ellis Law for a free consultation. Headquartered in L.A., our firm takes cases throughout California on a contingency basis. Learn more about your rights by calling 888-654-7056. 

Additional Resources on Understaffed Nursing Homes:

  1. NY Times, It’s Almost Like a Ghost Town.’ Most Nursing Homes Overstated Staffing for Years
  2. NY Times, Staffing Fluctuates at Nursing Homes Around the United States,