The Consequences of an Understaffed Nursing Home

Legally reviewed by:
Rubin, Glickman, Steinberg & Gifford P.C.
January 21, 2024
nursing home

We move our loved ones into nursing homes to keep them safe, healthy, and well-cared for. In making that emotional and difficult decision, we also trust that the facility we choose will have adequate staffing to meet our beloved family member’s needs. Unfortunately, sometimes that trust is misplaced. Some nursing homes fail to maintain sufficient staffing, with disastrous results. 

Numerous harmful consequences flow from understaffing at a nursing home. Here is an overview of some of the more common ones, the staffing levels nursing homes should have, and how a skilled nursing home negligence lawyer can hold facilities and their management accountable when a resident suffers harm due to understaffing. 

What Happens When Nursing Homes Go Understaffed?

Studies have shown that when staffing drops below minimum levels at nursing homes, the frequency and quality of care residents receive drops, and their health and well-being suffer. Nursing home understaffing leads to, among other potentially life-threatening problems: 

  • Delayed or insufficient medical care
  • Failures to identify health emergencies and other changes in residents’ medical conditions
  • Failures to administer necessary medication or therapies
  • Lack of assistance for residents who need to shower or use the bathroom, leading to unsanitary conditions and falls
  • Isolation of residents leading to mental health declines
  • Assaults and abuse, including sexual violence, against residents by staff or other residents
  • Inadequate nutrition and hydration for residents
  • Equipment failures and uncleanliness that create safety hazards
  • Infectious disease spread among residents and staff

Any of these issues—all the direct consequence of understaffing—can all-too-quickly lead to resident illness and death. Many nursing home residents are already in a vulnerable state of health. Even a slight deficit in the amount of attention and care they receive can result in severe and rapid health declines. 

Nursing Home Staffing Requirements

Given the potential consequences of falling short, all nursing homes should have enough staff to meet the care needs of their residents. For too long, however, insufficient legal requirements existed for what qualified as the minimum acceptable staffing level at a facility. Without strict minimums and aggressive enforcement, many facilities got away with having fewer qualified professionals on staff than were necessary to ensure the health and safety of those in their care. However, since the pandemic and the tragic (and avoidable) losses of life at nursing homes that came with it, that has begun to change. 

The federal Center for Medicaid Services (CMS), in partnership with state-level health agencies, develops staffing regulations for nursing homes. Recently, CMS proposed a regulation setting minimum staffing levels for nursing homes nationwide. It recommends that all facilities have registered nurse (RN) staffing sufficient to provide at least 0.55 hours of service to each resident per day, and nurse aide (NA) staffing to provide at least 2.45 hours per resident day (HPRD). It also recommends that all facilities have an RN on staff 24 hours per day. These are the staffing levels that CMS has determined, after careful study, to be the absolute minimum necessary to keep residents safe and healthy. 

Some states have gone further. In Pennsylvania, for example, new regulations already in effect require 2.87 hours of direct care for each resident per day, rising to 3.2 hours effective July 1, 2024. Soon, state rules will require every Pennsylvania nursing home to have one certified nurse assistant (CNA) per 10 residents during the day, per 11 residents in the evening, and per 15 residents overnight. They must also have one licensed practical nurse (LPN) per 25 residents during the day, per 30 residents in the evening, and per 40 residents overnight; and one RN per 250 residents at all times. 

How a Lawyer Can Help

If you have a loved one who resides in a nursing home, or you reside in one yourself, the facility should have at least the levels of staffing described above. Sometimes, a home will need even more nursing staff than those minimums. Any shortcoming in providing the level of staffing necessary to assure a reasonable level of care puts a nursing home’s population at risk of severe harm. 

Anyone who suspects that a nursing home is not meeting minimum staffing standards should contact a skilled nursing home negligence lawyer right away. Connecting with a knowledgeable attorney first—even before raising concerns with a nursing facility or regulators—safeguards the rights and safety of the resident you care about.  A lawyer can quickly assess the situation, evaluate the risk posed by potential understaffing, take immediate steps to keep a resident safe from harm, and seek compensation for any damages the resident has already suffered. 

The owner, operator, management, or employees of a nursing home may have significant legal and financial liability for any harm that comes to residents as a result of understaffing. By taking timely and appropriate legal action  on a resident’s behalf, a lawyer can often secure payment for: 

  • The cost of transferring the resident to a different facility
  • Medical expenses in treating health conditions caused or worsened by understaffing
  • The resident’s physical pain and emotional suffering
  • The resident’s diminished quality of life

In the tragic event of understaffing leading to the death of a nursing home resident, a lawyer can pursue a wrongful death action on the grieving family’s behalf to secure compensation for their loss. 

Hiring a lawyer to address the potential harm done by an understaffed nursing home is affordable. Nursing home negligence attorneys offer free consultations for residents and their families to explore their rights and options. They represent clients on a contingent fee basis, which means they only get paid if they deliver results. 

Contact a Knowledgeable Nursing Home Negligence Lawyer at Rubin, Glickman, Steinberg & Gifford, P.C., Today

Understaffed nursing homes pose a potentially lethal danger to their residents. Reams of evidence demonstrate that short-staffing leads to tragic, preventable health outcomes for the vulnerable people placed in a facility’s care. Nursing homes should abide by recognized minimum staffing standards, but many still do not, and they should be held accountable.

Rubin, Glickman, Steinberg & Gifford, P.C., can help. We are a team of award-winning lawyers who represent nursing home residents and their families in personal injury claims against facilities in Southeastern Pennsylvania. If you suspect that understaffing at a nursing home in Bucks or Montgomery County has harmed, or may harm, you or your loved one, contact us online or call us at (215) 822-7575 for a free consultation.


Legally reviewed by:
Rubin, Glickman, Steinberg & Gifford P.C.
Pennsylvania Attorney's
January 21, 2024
Established in 1952 by Irwin S. Rubin, Rubin, Glickman, Steinberg & Gifford P.C. boasts over 65 years of experience serving clients throughout Pennsylvania. Renowned for its commitment to ethical representation, the firm has garnered prestigious accolades, including being named the "Best Law Firm" for its outstanding legal defense work by U.S. News & World Report. Their team of seasoned attorneys, recognized as Pennsylvania Super Lawyers and Rising Stars, brings unparalleled expertise to a wide range of legal matters, ensuring exceptional representation for individuals, families, businesses, and organizations.