The Fewer the Staff, the More Danger for Nursing Home Residents

The healthcare system is facing an increasing problem of staff shortages, and that’s especially a problem with nursing homes. The result is fewer people caring for a rising number of older and disabled Americans. Under these conditions, it’s just a matter of time before serious injuries occur because more nursing homes won’t provide residents with the care they need.

Nursing home staff shortages have been an issue for decades, but it became worse during the COVID-19 pandemic. Unsafe conditions, low pay, and unreasonable workloads became more common during the pandemic.

The nursing home staff turnover rate prior to the pandemic was 94%, reports Nurse Journal. During the pandemic, more nursing home staff quit than other healthcare professionals because of unsafe working conditions.

As of June 2022, according to the American Health Care Association, nursing homes still had understaffing levels:

• 87% of nursing homes have moderate or high staffing shortages
• 98% of nursing homes have problems hiring new staff
• 73% of nursing homes might close because of staffing shortages

The staff are the people keeping residents safe. Without these workers, residents will be injured, suffer neglect, and won’t receive proper medical care.

Understaffing is a Chronic Nursing Homes Problem

The Centers for Medicare and Medicaid Services 23 years ago published a study showing that minimum staff-to-patient ratios were needed in nursing homes to keep residents safe and adequately cared for. The study recommended nurses provide each resident with at least 4.1- 4.85 hours of care daily. This time could come from a mix of staff, including certified nursing assistants (CNAs), licensed practical nurses (LPNs), and registered nurses (RNs).

Many nursing homes don’t reach this level, and there are few consequences for their failure unless there’s a documented and reported harmful outcome for residents. Nurses could lose their license if those under their care suffer:

• Bedsores
• Falls
• Hospitalizations
• Emergency room visits
• Deaths

The federal Centers for Medicare & Medicaid Services (CMS) last month issued a final rule on nursing home minimum staffing requirements for facilities being paid by Medicare and Medicaid. They require a minimum of 3.48 hours of nursing care for each resident daily, including time from an RN and a CNA, as well as 24/7 onsite RN services,  according to the American Hospital Association. Facilities have five years to reach this level.

Lack of Staff is a Problem Nursing Homes are Unable or Unwilling to Address

Nursing homes know the dangers of short staffing, but sometimes, they intentionally hire fewer people to lower their labor costs.

About half of nursing homes didn’t meet CMS recommendations for staff numbers 80% or more of the time from April 2017 to March 2018. Payroll data establishes that nursing homes of all types failed to meet CMS recommendations for the average time spent with residents. For-profit nursing homes didn’t meet the lower requirements of many states where they operate.

Hiring and keeping LPNs are less of an issue because they are the highest paid and do far less physical work than other staff. Nursing homes generally pay RNs less than average salaries, and they have better opportunities to advance in other healthcare organizations. CNAs are usually paid lower than the going rate for their work and perform the most physically demanding job in nursing homes.

How Does This Impact Residents?

Many things can go wrong when not enough people work at nursing homes. Given their obligations when caring for residents, nursing homes can commit negligence when they know they fail to fill open positions, and as a result, the following happens:

• Bedbound residents aren’t turned in their beds frequently enough, so they develop bedsores, or they worsen
• Residents who are a fall risk won’t be supervised as they get out of bed or try to move around the facility, then fall and injure themselves
• Residents without proper supervision may be physically or sexually assaulted by another resident or an employee
• Residents may be intentionally given inappropriate medications to sedate them, so they’re less active and require less attention

Overworked staff won’t get all their required work done, or the quality of their work will suffer. This can play out in many ways, including:

• Nurses may make medical errors, so residents are given the wrong medications or the correct ones but with the wrong dosage, potentially causing serious harm
• Staff may forget to secure doors, allowing residents to wander into restricted areas or outside where they can injure themselves
• Residents’ health conditions may worsen because they’re not getting care from a physician or being transported to a hospital due to the lack of attention from staff

Nursing homes are critical to caring for older and disabled Americans. But if they don’t address their fundamental challenges, residents will continue to be injured and become ill because of their negligence.

Speak To a Nursing Home Injury Lawyer Today

Satterley & Kelley, PLLC attorneys will fight for your loved one to obtain the care they need and the compensation for injuries they deserve. We also represent family members of those who died of a nursing home’s negligent care. Call our Louisville office to set up a free initial consultation with an experienced lawyer toll-free at 855-385-9532 or contact us online.