How Much Staff Must A Nursing Home Have?

Nearly 1.4 million people are cared for in nursing homes.  As reported by PBS news according to federal records, since 2014, health inspectors have cited numerous nursing homes for having too few nurses. In fact this past year federal data, analyzed by Kaiser Health News, show that numerous nursing homes have fewer nurses and caretaking staff than what was previously reported to the government.  On the worst-staffed days at an average facility, the data shows, on-duty personnel cared for nearly twice as many residents as they did when the staffing roster was fullest.  Medicare previously had been rating each facility’s staffing levels based on the homes’ own unverified reports, making it possible to game the system.  Of the more than 14,000 nursing homes submitting payroll records, 7 in 10 had lower staffing using the new method, with a 12 percent average decrease, the data shows. Lower staffing can unfortunately lead to health code violations and patient neglect.

Given these troubling numbers if you or a loved one are about to come under the care of a nursing home – whether it is for a permanent or short term stay – you may have concerns if there are any standards for nursing home staffing they must follow.  There are, under the Nursing Home Reform Act, otherwise known as the Omnibus Budget Reconciliation Act of 1987 (OBRA), 42 CFR 483, et. seq.  According to § 483.35 a nursing home must have sufficient nursing staff with appropriate competencies and skill sets to provide nursing and related services, to assure resident safety, and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident as determined by resident assessments and individual plans of care.

§483.35(a) of the Act requires a nursing home to provide sufficient numbers of licensed nurses and other nursing personal – including but not limited to nurse aides – on a 24 hour basis to provide nursing care to all residents in accordance with resident care plans. §483.35(b) requires the nursing home to use the services of a registered nurse for at least 8 consecutive hours a day, 7 days a week. §483.35(c) requires the home to ensure its nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents’ needs.

You can also find information about staffing at the nursing home. §483.5(g) of the Act requires the nursing home to post staffing information on a daily basis at the beginning of each shift in a prominent place readily accessible to residents and visitors.  Specifically the home must post the total number and actual hours worked by registered nurses, licensed practical nurses or licensed vocational nurses and certified nurse aides.  The nursing home must also post the resident census (the number of residents in the nursing home).  The nursing home must maintain the posted daily nursing staffing data for a minimum of 18 months, or as required by State law, whichever is greater.

Unfortunately there are not specific numbered requirements set out in the Act on staffing.  What constitutes sufficient staff then?  It will depend on the size of the nursing home, number of residents there, and the time the nursing staff is able to spend with each resident.  If residents are being neglected and not treated this will be a strong sign of understaffing at the nursing home.

The attorneys at the Thistle Law Firm are experienced at handling nursing home malpractice claims.  If you feel a loved one or member of your family was seriously harmed or died due to neglectful care and understaffing at a nursing home the attorneys at the Thistle Law Firm are here to take your call at 215-568-6800.

Leave a Comment