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Understaffing in Nursing Homes

Understaffing in Nursing Homes

Understaffing in nursing homes is becoming a major problem in the state of California. Between 2020 and 2021, over 150 California nursing homes filled out a form for approval to understaff their facilities. So far in 2022, an additional 200+ care facilities have applied for the same approval.

While some of this understaffing can be explained by worker shortages, there is likely also something more sinister at work: intentional understaffing. Keep reading to find out what causes understaffing, why it’s dangerous, and how it can be prevented.

Have you or a loved one experienced abuse or neglect at a nursing home or an assisted living facility? If so, it’s important to act right away.

The Peck Law Group has over 52 years of combined experience in helping victims throughout California. Receive your free case evaluation with one of our nursing home abuse attorneys today by calling toll free 866-999-9085.

The Causes of Nursing Home Understaffing

There’s no doubt that understaffing can result from a lack of applicants to a care facility. However, it’s more common than you think for nursing home owners to purposefully understaff their care facilities.

Typically, this happens for a few reasons:

#1: To Cut Labor Costs

It’s not hard to imagine that fully staffing a nursing home comes at a huge payroll cost. After all, the minimum ideal staffing level in California is 1:8. That means for every 8 patients in the facility, there should be one nurse on the schedule. 

To put this into perspective, let’s say a nursing home houses 40 residents. At the minimum ideal level of staffing, this nursing home would always need 5 members of the nursing staff on-duty. Let’s say these nurses are paid state minimum wage at $15.00 an hour.

This means the daily payroll total for nurses alone in a fully-staffed facility would be $1800 a day.

Now, let’s look at the daily payroll for an understaffed facility. Due to worker shortages, this facility is only able to accommodate one nurse per every 20 patients. The same 40-resident facility now only requires 2 nurses on duty at any given time.

Even if these nurses are paid the same rate of $15.00 an hour, the daily payroll total for nurses only comes to $720.

As you can see, even though patient care might suffer as a result, there’s no denying that nursing home understaffing has a huge impact on payroll costs.

#2: High Rates of Staff Turnover

One of the biggest problems that nursing home understaffing causes is exhaustion. When nursing home staff is forced to complete work that’s meant for multiple people, it puts undue strain on them.

Unfortunately, even with the promise of overtime pay, nursing home staff are often more likely to quit their jobs due to being grossly overworked. Unfortunately, this only perpetuates the ever-worsening problem of nursing home understaffing.

#3: Inaccurate Staffing Reporting

Staffing reporting is an important way that Medicare keeps tabs on nursing homes. This process is intended to make it easy to identify which care facilities are understaffed, and to give a full picture of just how bad the situation is.

However, staffing levels were, at one point, being forwarded directly from nursing homes with no documentation requirements. This made it possible for nursing homes to intentionally send incorrect information.

To fight intentional inaccurate staffing reporting, most states now require staffing levels to be verified by payroll.

The Dangers of Understaffing in Nursing Homes 

Nursing home understaffing has vastly negative effects on many different fronts. For employees of these facilities, it leads to exhaustion, overwhelm, and far too often, employee turnover.

However, for nursing home residents, the problems are far more serious.

When nursing homes fail to adequately staff their facilities, it is the residents who suffer. When too few nurses are on-duty, it means that meals might not get delivered on time, pain medication requests can take longer to be fulfilled, the resident’s needs may be neglected, and more.

The harrowing truth is that nursing home understaffing can be a huge factor in serious injury or even the death of residents.

Aside from day-to-day operations being interrupted, nursing home understaffing also poses an extreme safety risk to residents.

For example, one of the most important jobs of nursing staff in these facilities is helping residents to the bathroom. This role is intended to reduce the risk of patients falling on their way to the bathroom.

Nursing home understaffing means that residents will likely be forced to wait longer periods before receiving help getting to the bathroom. This often leads to residents attempting to make it to the bathroom solo, which results in a larger risk of falling.

Another big risk of nursing home understaffing is new or worsened bed sores.

Some patients in care facilities are bound to their beds and must be turned periodically to keep them comfortable and to avoid painful bed sores. Nursing home understaffing greatly impacts the timeliness and frequency of patients being turned, which can exacerbate bed sores or cause new ones to emerge.

Overall, nursing home understaffing undoubtedly leads to a diminished level of patient care. In fact, it is this problem that has been directly connected with an alarming rate of nursing home neglect cases. The fact of the matter is that it is virtually impossible for understaffed nursing homes to operate at an acceptable capacity.

How to Prevent Understaffing in Nursing Homes

We know the risks that come along with understaffing in nursing homes, so what can be done about it?

The good news is that there are many ways to prevent understaffing in nursing homes while championing adequate and safe patient care for all nursing home residents.

Perhaps the easiest way to combat nursing home understaffing is to make staffing a top priority at nursing home facilities. Directors who demand non-negotiable staff levels complete with a minimum number of CNA’s and nurses are far less likely to have issues with nursing home abuse and neglect.

Paying close attention to when a care facility is staffed is another gravely important detail.

Studies show that nursing home understaffing is more prevalent on weekends, which means that care directors must pay close attention to staffing according to resident needs, not employee desires.

Overall, preventing understaffing in nursing homes has all-around positive impacts on residents. Facilities can enjoy a lesser chance of nursing home abuse charges, lower turnover rates, and are able to offer a higher standard of care as a result.

The Peck Law Group has worked with many people that have been neglected at nursing homes and assisted living facilities due to understaffing. If you or a love one have become a victim of abuse or neglect, contact us today for your free case evaluation with one of our nursing home abuse lawyers.

Nursing Home Abuse & Neglect Attorney Steven Peck

About the Author

Attorney Steven Peck has been practicing law since 1981. A former successful business owner, Mr. Peck initially focused his legal career on business law. Within the first three years, after some colleagues and friend’s parents endured nursing home neglect and elder abuse, he continued his education to begin practicing elder law and nursing home abuse law.


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