Understaffed Nursing Homes Cause a Decline in Senior Care

Understaffed Nursing Homes Cause a Decline in Senior Care
May 19, 2023

As the baby boomer generation ages, the demand for senior care has never been higher. Unfortunately, the number of available caregivers and nurses in nursing homes and long-term care facilities has not kept up with the demand, leading to understaffing issues.

As a leading nursing home abuse law firm, Hinkle Law has seen firsthand the devastating effects that understaffing can have on the quality of care that seniors receive in nursing homes. It's no secret that many nursing homes are chronically understaffed, with too few nurses and aides to provide adequate care to residents. But what many people may not realize is just how dire the consequences of understaffing can be.

86% Of Nursing Homes in the US are Understaffed

Currently, 86 percent of nursing homes in the U.S are experiencing moderate to severe staffing shortages and 96 percent are struggling to hire additional staff, according to the American Health Care Association’s (AHCA) State of the Nursing Home Industry survey.

Consequences of Understaffed Nursing Homes

Understaffed Nursing Homes Cause a Decline in Senior Care

Understaffed nursing homes can cause a wide range of issues that impact the quality of care and the well-being of the residents. Here are some of the most significant issues that understaffing can cause:

Elder Neglect

Elder neglect caused by understaffed nursing homes refers to situations where elderly residents in nursing homes do not receive the appropriate level of care and attention due to a lack of sufficient staff. When there are not enough staff members to attend to the needs of all residents, it can lead to a variety of issues that can impact the health and well-being of elderly residents.

Examples of nursing home neglect caused by understaffing can include:

  • Neglect of basic needs: Elderly residents may not receive adequate food, water, or hygiene care due to understaffing. This can lead to malnutrition, dehydration, and the development of bedsores.
  • Medical neglect: When there is nursing home understaffing, nurses may not be able to keep up with residents' medical needs, such as administering medications or monitoring chronic conditions.
  • Lack of social interaction: Elderly residents in nursing homes often rely on staff for social interaction and activities. When there are not enough staff members, residents may not receive the attention and social interaction they need, which can lead to feelings of loneliness and depression.
  • Increased risk of accidents: Understaffed nursing homes may not have enough staff to help residents move around safely or assist them with daily tasks. This can increase the risk of falls and other accidents.

 Elder Abuse

Elder abuse caused by understaffed nursing homes refers to situations where nursing home residents suffer harm or neglect as a result of inadequate staffing levels. When a nursing home is understaffed, the caregivers and staff may be unable to provide the necessary care and attention that residents require, which can result in serious harm to elderly residents.

Elder abuse can take many forms, including:

  • physical abuse
  • emotional abuse
  • financial exploitation
  • neglect
  • and abandonment.

Understaffed nursing homes are particularly susceptible to neglect, as staff members may not have enough time or resources to ensure that residents receive adequate:

  • food
  • water
  • medication
  • and other basic needs.

This can lead to serious health problems, such as dehydration, malnutrition, bedsores, and infections.

Medication Errors

An understaffed facility can also lead to medication errors, as staff members may not have enough time to properly administer medications or monitor residents for adverse reactions. This can lead to serious health problems or even death in some cases.

Falls and Injuries

When there are not enough staff members to assist residents with mobility and other activities, the risk of falls and injuries increases. This can be especially dangerous for residents with mobility issues, cognitive impairment, or other health conditions.

Emotional Distress

Understaffing can also cause emotional distress for residents, as they may not receive the emotional support and attention they need. This can lead to feelings of isolation, loneliness, and depression, which can negatively impact their overall well-being.

Burnout and High Turnover Rates

Finally, understaffing can lead to burnout and high turnover rates among nursing home staff. When staff members are overworked and underpaid, they may become disillusioned with their jobs and leave for greener pastures. This can create a vicious cycle of understaffing, as nursing homes struggle to find and retain qualified staff members.

Understaffed Nursing Homes Are Especially Dangerous for Immobile Residents

Understaffing in nursing facilities can have severe consequences for immobile residents who may require extensive assistance with daily activities such as bathing, dressing, and toileting. Here are some of the consequences of understaffing in nursing homes for immobile residents:

Increased Risk of Falls

Immobility can increase the risk of falls, and understaffing can exacerbate this risk. Staff members may not have the time or resources to assist residents with mobility, such as helping them to stand up or walk, which can result in falls and serious injuries.

Increased Risk of Infections

Immobility can also increase the risk of infections, such as urinary tract infections, pneumonia, or skin infections. Understaffing can make it challenging for staff members to maintain a clean and hygienic environment, increasing the risk of infections spreading.

Social Isolation

Immobility can also lead to social isolation, as residents may have limited mobility or may not be able to participate in social activities without assistance. Understaffing can exacerbate this isolation, as staff members may not have the time to provide residents with the necessary social stimulation or to facilitate social activities.

Why Are Nursing Homes Understaffed?

There are several reasons why nursing homes may be understaffed. Here are some of the most common reasons:

Cost Cutting

One of the most significant reasons for understaffing in nursing homes is cost-cutting. facilities may try to reduce their expenses by reducing the cost of labor, meaning fewer workers. This can be especially true for nursing homes that are struggling financially or have limited funding.

High Turnover Rates

Another reason for understaffing in nursing homes is high turnover rates among staff members. Nursing home jobs can be physically and emotionally demanding, and the pay and benefits may not always be competitive. This can lead to burnout and high turnover rates, which can make it challenging for nursing facilities to maintain adequate staffing levels.

Staffing Challenges

Nursing facilities may also struggle to attract and retain qualified staff members due to staffing challenges. For example, nursing homes in rural areas or low-income neighborhoods may have a harder time attracting qualified staff members. Additionally, nursing homes may struggle to find staff members with specialized skills, such as those needed to care for residents with dementia or other complex medical conditions.

Demographic Shifts

As the population ages, the demand for nursing home care is increasing. This can create staffing challenges, as nursing homes may not be able to keep up with the demand for care. Additionally, the COVID-19 pandemic has highlighted the challenges of providing care in nursing homes, which may make some staff members reluctant to work in these facilities.


Nursing homes are subject to strict regulations that govern the number and type of staff members they must employ. However, some nursing facilities may try to skirt these regulations by reducing the number of staff members they employ or by hiring staff members with less training or experience.

Additional Statistics on Understaffed Nursing Homes

  • In a survey conducted by the American Association of Retired Persons (AARP), 47% of nursing home staff reported that they were often too rushed to provide the quality of care they would like to give.
  • The AARP survey also found that 40% of nursing staff reported that they did not have enough time to adequately clean and sanitize residents' rooms and common areas.
  • The Centers for Medicare and Medicaid Services (CMS) reported that in 2019, approximately one in five nursing homes (20%) had a staffing level that was rated as "below average" or "much below average."
  • CMS also reported that in 2019, approximately 25% of nursing homes had been cited for deficiencies related to staffing levels and quality of care.
  • A study by the University of California, San Francisco found that understaffing in nursing homes is associated with increased rates of falls, pressure ulcers, and urinary tract infections among residents.
  • The same study found that understaffing is also associated with increased rates of hospitalization and death among nursing home residents.

Ways To Prevent Nursing Home Staff Shortages

Preventing understaffing in nursing homes is essential to ensure that residents receive the high-quality care they need and deserve. Here are some steps that can be taken to prevent understaffing:

Increase Funding

One of the most effective ways to prevent understaffing in nursing homes is to increase funding. This can include increasing Medicaid reimbursement rates, which can help nursing homes to afford to hire more staff members. Additionally, governments can provide grants or subsidies to nursing homes to help them cover the costs of hiring additional staff.

Improve Staffing Standards

Another way to prevent understaffing in nursing homes is to improve staffing standards. This can include setting minimum staffing requirements for nursing homes or implementing staffing ratios that ensure that residents receive the care they need. Additionally, nursing homes can implement policies that encourage staff retention, such as offering competitive wages and benefits, providing opportunities for professional development, and creating a positive work environment.

Address Demographic Shifts

As the population ages, the demand for nursing home care is increasing. To prevent understaffing, nursing homes must adapt to these demographic shifts by increasing their capacity, developing new care models, and exploring alternative staffing models.

Streamline Regulations

Nursing homes are subject to strict regulations that can make it challenging to hire and retain staff members. By streamlining these regulations, nursing homes can make it easier to hire and retain qualified staff members.

Utilize Technology

Technology can be an effective tool for preventing understaffing in nursing homes. For example, electronic health records can help staff members to coordinate care more effectively, while telehealth technology can enable nursing homes to access specialist care remotely.

Questions To Ask Nursing Homes About Staff to Resident Ratio

Here are some questions you can ask nursing homes about their staff-to-resident ratio:

  • What is your current staff-to-resident ratio?
  • What is the average number of residents assigned to each staff member during different times of the day?
  • How do you determine the appropriate staff-to-resident ratio for your facility?
  • Do you have a plan in place to ensure that staffing levels remain consistent even during times of high demand or turnover?
  • How do you address staffing shortages or call-outs to ensure that residents continue to receive the care they need?
  • Can you provide examples of how you prioritize resident care and safety when determining staffing levels?
  • How do you train and support your staff to ensure they are able to provide high-quality care to residents?
  • Do you conduct regular evaluations of your staffing levels to ensure that they are meeting the needs of your residents?
  • Can you provide me with any data or reports that demonstrate your staffing levels and their impact on resident care?
  • Have you received any complaints or citations related to understaffing, and if so, how have you addressed these concerns?


What can families do if they suspect their loved one's nursing home is understaffed?

If families suspect their loved one's nursing home is understaffed, they can speak with the nursing home administration to voice their concerns. Additionally, families can contact their state's ombudsman program, which is designed to advocate for residents in nursing home facilities.

What are some signs that a nursing home is understaffed?

Some signs that a nursing home may be understaffed include residents not receiving the necessary care or services, staff members appearing overworked or stressed, residents appearing neglected or unclean, and long wait times for assistance or care.

What Should I Do If My Loved One Was Harmed Due To Staffing Shortages At the Nursing Home?

If you suspect that your loved one has been harmed due to staffing shortages at a nursing home, there are several steps you can take:

Report The Incident To The Nursing Home Administration

Notify the nursing home administration immediately of your concerns and request an investigation into the matter. Make sure to document your concerns and any communication with the nursing home administration.

File a Complaint With Your State's Regulatory Agency

If you are unsatisfied with the nursing home administration's response, you can file a complaint with your state's regulatory agency. This agency is responsible for overseeing nursing homes and ensuring that they comply with state and federal regulations.

Consult With a Nursing Home Abuse Lawyer

If your loved one has been harmed due to staffing shortages at a nursing home, you may be able to file a lawsuit against the facility. An experienced nursing home abuse lawyer can help you determine whether you have a viable case and what your legal options are.

Consider Moving Your Loved One To a Different Facility

If you are concerned about your loved one's safety and well-being at the nursing home, you may want to consider moving them to a different facility that has adequate staffing levels and a good track record of resident care.

Contact Hinkle Law Firm

While being proactive to improve the staffing issues at nursing homes is the best way to increaser resident care, sometimes it's not enough, and legal action is needed. Contact us today for a FREE consultation if your loved one was harmed due to staffing shortages in their nursing home.

Have you been personally injured or while receiving healthcare?

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