Adequate staffing in nursing homes can mean the difference between proper care and dangerous neglect, yet many facilities in Pennsylvania operate chronically understaffed. When residents do not receive the attention and assistance they need due to insufficient staff, preventable injuries and suffering often follow.
The nursing home abuse lawyers at Rubin, Glickman, Steinberg & Gifford have represented families whose relatives suffered harm due to understaffing at Pennsylvania facilities for over 65 years. We understand how staffing shortages create conditions where negligence thrives, and we hold facilities accountable when inadequate staffing leads to resident injuries.
Pennsylvania’s Nursing Home Staffing Standards
Pennsylvania regulations establish minimum staffing requirements for nursing homes to ensure residents receive safe, adequate care. Licensed nursing homes must maintain sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. While this standard sounds comprehensive, enforcement and interpretation can be inconsistent.
The Centers for Medicare & Medicaid Services (CMS) also sets federal standards for facilities participating in Medicare and Medicaid programs. These regulations require facilities to have sufficient staff with appropriate competencies and skills to meet the needs of all residents. Federal law mandates that a registered nurse serve as director of nursing, a licensed nurse be on duty at least eight consecutive hours seven days per week, and a registered nurse be on duty at least eight consecutive hours per day seven days per week.
Beyond these baseline requirements, the actual number of staff members needed varies based on resident acuity levels, facility size, and resident needs. Facilities must conduct assessments to determine appropriate staffing levels, but many operate at minimum levels regardless of resident conditions. This creates dangerous situations where staff cannot possibly provide adequate attention to all residents who need assistance.
How Understaffing Leads to Resident Harm
When nursing homes fail to maintain adequate staffing, residents face increased risks of multiple types of harm. Falls represent one of the most common consequences of understaffing. Residents who need assistance getting out of bed, using the bathroom, or moving around the facility may attempt these activities independently when staff are unavailable to help. These attempts often result in serious falls causing fractures, head injuries, and other trauma.
Pressure ulcers develop when residents cannot reposition themselves, and staff lack time to turn immobilized residents regularly. These wounds begin as reddened skin areas but can progress to deep tissue damage, infection, and even death when left untreated. Adequate staffing allows regular repositioning, skin checks, and wound care that prevent pressure ulcer development. Understaffed facilities often have multiple residents with preventable pressure sores at various stages.
Medication errors increase dramatically in understaffed facilities. When nurses rush through medication administration to cover too many residents, they may give wrong medications, incorrect doses, or skip doses entirely. These errors can have serious consequences, including adverse drug reactions, ineffective treatment of chronic conditions, and medical emergencies requiring hospitalization.
Dehydration and malnutrition occur when staff lack time to assist residents who need help eating and drinking. Some residents require substantial assistance and encouragement to consume adequate nutrition and fluids. In understaffed facilities, meal trays may be delivered and removed without staff ensuring residents actually ate or drank anything. This leads to weight loss, weakness, confusion, and serious health complications.
Neglect of personal hygiene creates both physical and emotional harm. Residents may go extended periods without bathing, clean clothing, or assistance with toileting. This neglect causes skin breakdown, urinary tract infections, and profound indignity for residents who cannot care for themselves. The emotional impact of sitting in soiled clothing or going days without bathing can be devastating.
Recognizing Signs of Understaffing
Several warning signs may indicate that a facility operates with inadequate staffing levels. If you visit and consistently see call lights illuminated for extended periods, this suggests residents cannot get timely assistance when they need help. Residents left in hallways unattended, particularly those with dementia who may wander, indicate that staff cannot properly supervise vulnerable individuals.
The physical appearance of residents provides important clues. Multiple residents with unkempt hair, dirty clothing, or body odor suggest staff lack time for basic hygiene assistance. Weight loss across multiple residents may indicate that mealtime assistance is inadequate. Pressure ulcers on multiple residents strongly suggest staffing levels cannot support the repositioning and care needs of immobilized residents.
Staff behavior also reveals staffing problems. If nurses and aides appear rushed, stressed, or unable to respond to questions because they are too busy, the facility likely operates understaffed. High staff turnover creates additional problems because inexperienced workers may not know residents’ needs, preferences, or care plans. Frequent use of temporary agency staff rather than regular employees indicates chronic staffing issues.
Holding Facilities Accountable for Understaffing Negligence
Pennsylvania law allows families to pursue civil claims against nursing homes when understaffing causes resident harm. These claims typically involve proving the facility knew or should have known staffing levels were inadequate, the inadequate staffing directly contributed to the resident’s injuries, and the injuries caused compensable damages, including medical expenses, pain and suffering, and potentially wrongful death.
Evidence in understaffing cases includes facility staffing records, state inspection reports noting staffing deficiencies, medical records documenting injuries consistent with neglect, and testimony from staff members about working conditions. We often work with nursing care standards to analyze whether staffing levels meet professional standards for the resident population’s acuity levels.
Facilities frequently defend understaffing claims by arguing they met minimum regulatory requirements or that resident injuries resulted from unavoidable complications of age and illness rather than inadequate care. Strong evidence demonstrating the connection between insufficient staffing and preventable injuries is essential to overcome these defenses. Documentation showing patterns of similar injuries affecting multiple residents strengthens claims that systemic understaffing caused the harm.
Some families fear that reporting understaffing concerns or pursuing legal action may result in retaliation against their relative who remains in the facility. Pennsylvania law prohibits such retaliation, and facilities that engage in retaliatory behavior face additional liability. We take immediate action if facilities threaten or actually retaliate against residents or families who assert their legal rights.
Contact Rubin, Glickman, Steinberg & Gifford About Nursing Home Understaffing
If you believe inadequate staffing contributed to injuries or neglect your relative suffered in a Pennsylvania nursing home, you need attorneys who understand both the regulatory requirements and the practical realities of nursing home care. The personal injury team at Rubin, Glickman, Steinberg & Gifford has recovered millions of dollars for clients in nursing home negligence cases and earned recognition as a “Best Law Firm” by U.S. News & World Report every year since 2010.
We provide compassionate support to families during difficult times while pursuing aggressive legal action against facilities that prioritize profits over resident safety. Our attorneys work on a contingency fee basis, meaning you pay no upfront costs and no attorney fees unless we recover compensation for you. Contact our office today for a free consultation about your nursing home understaffing and negligence concerns.
Rubin, Glickman, Steinberg & Gifford P.C.
Pennsylvania Attorney's
December 15, 2025
