How Often Does Nursing Home Understaffing Lead to Abuse and Neglect?

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One of the most common causes of nursing home abuse and neglect is understaffing. When there aren’t enough nurses, techs, or aides to work on a shift, employees become overworked, tired, and more prone to make a mistake. When a nursing home endures understaffing, it can increase the likelihood that patients will be abused or neglected. Employees might forget to administer medication, leave patients unwashed for days, or even physically abuse patients out of anger.

As the loved one of a nursing home resident, you want to ensure they have the best care possible at all times. California has regulations in place that require 3.5 hours of direct care per day per nursing home resident. If this regulation is violated, you have the right to file a nursing home understaffing lawsuit against the facility where your loved one lives. 

Common Causes of Nursing Home Understaffing

One of the most common causes of nursing home understaffing is intentional actions by the owners. The cost to run a nursing home is high, especially when it comes to retaining quality employees. If owners aren’t willing to pay wages reflective of the experience they are seeking, they will likely deal with a lot of empty positions.

Another intentional action is when nursing homes hide understaffing. Nursing home administrators are required to report problems to the state. Hiding the number of employees on the staff from state agencies, residents, or family members of residents can lead to serious consequences.

Another cause of nursing home understaffing is having a high turnover rate. Employees come and go, but the turnover rate could be high for a number of reasons. For example, the pay might not be good enough, the facility might not be clean, there could be a shortage of trained nurses, and more.

The misconception that employees must work a ton of overtime hours at the nursing home in order to become a respected employee can also lead to understaffing. Having too much overtime available can force employees to find work elsewhere because of high stress levels or exhaustion.

How COVID-19 Has Played a Role in Nursing Home Understaffing

Nursing homes have been dealing with understaffing issues since before the COVID-19 pandemic hit the United States. However, the arrival of the pandemic only exacerbated understaffing issues as evidenced by some nursing home understaffing statistics. The Associated Press reports that close to one-third of all nursing home facilities in the United States have fewer nurses and aides employed than before the start of the pandemic.

Despite the circumstances, the nursing home is responsible for ensuring that there are enough staff members available to provide adequate care to all of the residents. This means that even though there was a pandemic, nursing homes were still required to ensure the appropriate staffing levels were maintained. If they weren’t and residents suffered abuse and neglect, the nursing home could be held liable for those injuries.

What are the Consequences of Nursing Home Understaffing?

When a nursing home is understaffed, the residents can suffer immensely. Below, you will find the consequences of how understaffing contributes to nursing home abuse:

  • Physical abuse
  • Sexual abuse
  • Malnutrition
  • Financial abuse
  • Emotional abuse
  • Improper medication administration
  • Dehydration
  • Death

The above list covers the consequences that nursing home residents can experience. Nursing home employees also suffer from understaffing problems. They can experience psychological problems and health issues due to increased levels of stress. The situation can become worse for the employee if he or she makes a mistake that leads to a resident suffering an injury.

Signs of Nursing Home Abuse

The following are the most common signs of nursing home abuse:

  • Bed injuries/asphyxiation
  • Dehydration
  • Emotionally upset or agitated, extremely withdrawn and non-communicative
  • Falls, fractures or head injuries
  • Infections
  • Instances of wandering/elopement
  • Malnutrition
  • Pressure ulcers (bed sores)
  • Rapid weight loss or weight gain; signs of malnutrition
  • Reluctance to speak when a staff member is present
  • Unexplained or unexpected death of the resident
  • Unexplained injuries such as wounds, cuts, bruises or welts
  • Unsanitary and unclean conditions
  • Sudden or unusual changes in the residents’ behavior (fear of being touched, sucking, biting, rocking)
  • Wanting to be isolated from others
  • Injuries that require hospitalization
  • Any incident causing broken bones
  • Any injury or death that occurs during or after an incident where the resident wandered away from the facility
  • Heavy medication or sedation
  • A resident is injured by another resident
  • The resident is ill often, and the illnesses are not reported in a timely manner to a doctor or the family

What are the 3 Most Common Complaints About Nursing Homes?

The three most common complaints about nursing homes are a lack of social interaction for residents between other residents or family members, a slow response to calls for nurses, and the poor quality of the food served.

What is the Minimum Staffing Level in a Nursing Home?

In California, the following minimum licensed staffing levels are required at all nursing homes:

  • 1-59 beds: 1 RN/LVN 24 hours per day
  • 60-99 beds: 1 DON RN Day Full Time and cannot be in-charge nurse and 1
    RN/LVN 24 hours per day
  • For 100 beds or more: 1 DON RN and 1 RN 24 hours per day
  • Direct care staff must be provided at 3.5 hours per resident per day. California’s requirement used to be 3.2 hours of direct care per day.

California has the following staffing regulations in place based on the time of day:

  • Day: 1LN:20 patients 1 CNA:9 patients
  • Evening: 1 LN:25 patients 1 CNA:10 patients
  • Night: 1 LN:30 patients 1 CNA:15 patients

What are the Types of Elder Abuse?

According to National Council on Aging, there are six types of elder abuse, including:

  • Physical abuse: inflicting pain, bruises, or unexplained falls
  • Sexual abuse: fondling, touching, intercourse or any sexual activity, without consent
  • Emotional abuse: verbal threats, harassment, or knowingly intimidating
  • Negligence
  • Financial exploitation: fraud, missing property and belongings, or forged financial documents
  • Abandonment: intentionally deserting an older adult

Are Nursing Homes Overcrowded?

As of 2019, there were an estimated 1.5 million people living in nursing homes across the country. This number doesn’t necessarily show that nursing homes are overcrowded, but if nursing homes do not have enough employees on the staff, residents can be subjected to abuse and neglect. Nursing homes are required to provide the appropriate staff members for the number of beds at the facility. If they fail to do so, the nursing home could be the subject of a nursing home understaffing lawsuit.

How to Report a Nursing Home for Understaffing in California

If you believe the nursing home where your loved one resides is understaffed, you should file a complaint immediately. You can do so in one of three ways:

  1. Call it in at 800-722-0432
  2. File your complaint on-line at
  3. Mail a copy of your complaint to the California Department of Justice, Office of the Attorney General, Bureau of Medi-Cal Fraud and Elder Abuse, P.O. Box 944255, Sacramento, CA, 94244-2550

Is it Difficult to Sue a Nursing Home?

It is possible for you to file a nursing home understaffing lawsuit if nursing homes ignore the regulations that are in place under California law. A nursing home understaffing lawyer will be able to review your case, explore the evidence available, and provide you with an honest evaluation. It can be difficult to understand the laws and regulations for nursing home staffing levels, which is why it is always in your best interest to consult with an attorney if a loved one has suffered abuse or neglect in a nursing home because of understaffing.

Compensation for Nursing Home Abuse Due to Understaffing

If the nursing home where your loved one resides is understaffed, and they suffered abuse or neglect, you can recover compensation for the following damages:

  • Mental health therapy
  • Medical bills
  • The cost to change caregivers or to move to a different nursing home
  • Physical therapy

How to Prove Nursing Home Negligence

In order for a nursing home understaffing lawsuit to succeed, you will need to prove negligence on the part of the facility. Doing so is not easy, but it’s also not impossible. You will need to have evidence that the nursing home acted negligently when providing or failing to provide your loved one the care they deserved. Evidence that helps prove negligence in a nursing home understaffing lawsuit includes pictures of bruises or injuries, missed daily check-ins, verbal statements from residents and former employees, and medical records.

Seek Legal Counsel for Nursing Home Understaffing Issues Today

Was your loved one abused or neglected living in a California nursing home? If so, it’s imperative that you protect their rights by seeking legal counsel from an experienced nursing home understaffing lawyer. The compassionate team at Berberian Ain LLP will fight vehemently for your loved one’s rights, helping you seek compensation for their injuries, including pain and suffering. Call our office at 818-808-0048, or complete a contact form to schedule a consultation with a member of our team.