Can Short Staffing in Nursing Homes Lead to Abuse and Neglect?

 Posted on November 11, 2024 in Nursing Home Abuse

In July 2024, it was reported that despite a new federal rule setting tighter nursing home staffing standards, just 16 percent of Illinois nursing homes are in full compliance. In fact, in some nursing homes, the time between a patient turning on a "call light" to ask for help and a nurse arriving to provide that help is 45 minutes or longer.

Since many of those calls for help involve a true emergency, the time it takes for a resident to get help is simply unacceptable. In May 2024, the Centers for Medicare and Medicaid Services issued new federal staffing minimum rules to help residents get the care they need.  

The new federal rule aims to reduce the risk of nursing home residents receiving low-quality care – or no care at all. If you have a loved one in an Illinois nursing home and you believe that he or she is being abused or neglected, it is important to speak with an experienced Madison County, IL nursing home abuse attorney from Schwartz Injury Law.  

What is Included in the New Federal Nursing Home Rule?

The new federal nursing home rule mandates that an RN be on site 24 hours per day, 7 days per week, with an exemption from 8 hours per day under specific circumstances. Total nurse staffing standards specify that each facility must provide, at a minimum, 3.48 total nurse staffing hours per resident day, with 0.55 RN staffing hours per resident day and 2.45 Nursing Assistant staffing hours per resident day.

Hours per resident day are staffing hours per resident per day, which is the total number of hours worked by each type of staff divided by the total number of residents. Phase One states that by August 8, 2024, nursing home facilities must meet the requirements for facility assessments while also considering input from residents, their family members, and attorneys.   

Rural facilities and Medicaid-certified nursing facilities have extra time to implement the rule in some situations. Phase Two for all non-rural facilities gives those facilities two years from the date of publication to meet the new nurse staffing requirements, including having an RN on site 24 hours a day, seven days a week.

What Are the Key Takeaways of the Rule?

• Less than 20 percent of all nursing home facilities currently meet all staffing minimums required in the rule.

• Even fewer (11 percent) for-profit facilities meet all the requirements in the rule, while 41 percent of non-profit facilities meet the requirements, and 39 percent of government facilities meet the requirements.  

•  Rural nursing homes are actually as likely to meet the requirements of the rule but will have longer to comply with the new requirements.

• In more than half of all the states across the nation, fewer than one-quarter of facilities meet all staffing requirement minimums. For example, only about 5 percent of nursing home facilities in Arkansas, Tennessee, Texas, and Louisiana currently meet the rule requirements, while more than 50 percent of nursing home facilities in Alaska, North Dakota, Maine, DC, Hawaii, and Oregon currently meet the rule requirements.

Are Illinois Nursing Homes Failing to Comply with Federal Rules?

As of June 2024, only 108 of the 670 nursing homes in Illinois met all the federal rule requirements, although 11 nursing homes failed to provide data. Sixty percent of Illinois nursing homes do not meet the total nurse staffing standard, 41 percent do not meet the RN standard, and 81 percent do not meet the nursing aide standard.

Nursing homes that fail to meet the new requirements will face escalating penalties, including corrective action plans and fines. Termination of a program would be a last resort. Some nursing home administrators say they are not being given sufficient time to add additional nursing staff.

How Does Understaffing in Nursing Homes Lead to Abuse and Neglect?

One of the biggest factors leading to nursing home abuse and neglect is understaffing. When a facility is understaffed, residents are much more likely to receive injuries from falls, bedsores, malnutrition, and dehydration as a result of inadequate attention from staff. Since the staff that is there are likely to feel overwhelmed and underpaid, they are also more likely to abuse or neglect residents.

Understaffing may result from unavoidable factors, including a lack of qualified applicants, or it could be a deliberate choice by nursing home owners, managers, and administrators to save money and increase profits. It can be costly to pay three shifts of employees each and every day, yet when nursing homes are understaffed, meals are not delivered on time, bedridden residents are not helped to the bathroom, and pain medication requests go unanswered.

Nursing homes tend to have a high turnover rate precisely because the staff are overscheduled and overwhelmed by their daily duties. Staffing levels must now be verified through payroll rather than data sent directly by the nursing homes. This prevents false information regarding staffing levels from being reported. The effects of nursing home understaffing include:

• Nursing home residents are dropped while being moved because only one staff member is moving the resident instead of two.

•  Nursing home residents attempt to go to the bathroom on their own because their calls have gone unanswered, leading to serious falls.

• Bedsores are more likely to go unnoticed, becoming infected and painful because of a lack of available staff to move and turn nursing home patients.

• Basic care, including feeding, providing water throughout the day, bathing, and moving, is often simply not done when a nursing home is understaffed.

What Can You Do if You Suspect Nursing Home Abuse or Neglect?

If you suspect your loved one is being abused or neglected while living in an Illinois nursing home facility, you can reach out to an experienced nursing home abuse attorney who can answer your questions and clearly lay out your options. If you suspect your loved one is in immediate danger, do not wait—call 911 and report the abuse. You can also call the statewide 24-hour Adult Protective Services Hotline at 1-866-800-1409 or the Illinois Department of Public Health’s Nursing Home Complaint Hotline at 1-800-252-4343 to report suspected abuse, neglect, or exploitation.  

Contact a Cook County, IL Nursing Home Abuse Lawyer

When you choose a Chicago, IL nursing home attorney from Schwartz Injury Law, you will talk to a real lawyer, never an impersonal intake service. We have extensive knowledge in this area of law and provide exceptionally personalized service to each client. Our nursing home team works collaboratively on every case, leveraging our broad network of professionals with the goal of the most positive outcome. Contact Schwartz Injury Law at 312-535-4625 to schedule your free consultation.