Nursing Home Understaffing

Nursing home negligence is surprisingly common. A common cause of many nursing home neglect and nursing home abuse cases is understaffing of nurses, aides, and other care staff. Both large for-profit nursing home providers and mom-and-pop homes are typically reimbursed on a fixed fee basis by Medicare, Medicaid, the VA, and other benefit providers. One sure way for them to increase profits is to skimp on services. Labor is the most expensive cost, so it is an obvious place for owners and administrators to skimp.  

Only one state has nurse-to-patient ratios enforced by law, which require a specific number of nurses based on the patient census. In addition, Medicare regulations establish some requirements for nurse staffing, but they are so generous to the nursing home industry that they actually work against patients who are involved in nursing home neglect and abuse litigation. Since staffing laws and regulations do not protect patients, a nursing home abuse lawyer, like a nursing home abuse lawyer in Cleveland, OH, will look to industry standards to show that staffing was inadequate to meet patients’ needs.

It is well known that when there are inadequate nurses and nurse’s aides, patients are more likely to develop pressure sores, suffer injury due to falls, higher infection rates, and increased risk of delayed diagnosis or delayed treatment of acute medical conditions. In addition, nurses and nurse’s aides who are required to do more than is humanly possible often suffer from depression, burnout, or anger management issues. In this way, poor staffing can lead to elder abuse, including physical assaults on residents.  

When investigating a claim of nursing home abuse or neglect, a nursing home negligence lawyer will want to investigate staffing levels at the nursing facility, rehabilitation center, group home or other facility where residents depend on skilled caregivers to meet their medical needs and activities of daily living. This can be done by comparing the patient census to the employees’ schedule. Further, it is imperative to look at pay sheets and time records to determine whether the nurses and aides who were scheduled actually showed up for work. Call-offs and no-shows are extremely common in this challenging work environment, especially when nurses and aides are required to perform the work of two or three people. A careful audit is required because nursing homes often play games with their numbers to project competent staffing levels.  

Safe staffing goes beyond numbers. Many facilities take care of particularly challenging residents including the elderly, residents with severe behavioral disorders, and residents with severe disabilities such as cerebral palsy. Caregivers for these residents need specialized training to deal with specialized problems that may arise such as application of restraints, difficulty swallowing, risk of wandering which can result in drowning or freezing to death, self-harm or an assault on another resident, and the inability to verbalize signs or symptoms of an acute medical crisis. Nursing homes and group homes may represent that they provide specialized care. Failure to provide specialized care when required by the applicable standard of care or to fulfill representations made by the care facility, can not only furnish a basis for a nursing home negligence lawsuit but also might support a claim for punitive damage award based on false misrepresentations.

If your loved one has been the subject of nursing home abuse or neglect, be sure to consult with a nursing home negligence lawyer who will investigate whether understaffing was a contributing factor.  

Thanks to Mishkind Kulwicki Law for their insight into the problems that come along with understaffed nursing homes.