Nursing Homes will finally be required to maintain minimum staffing levels – assuming someone is willing to enforce the rules.
by John King
In our expansive nursing home litigation practice, we often hear similar complaints between different clients. But one of the most common complaints we hear usually comes when we start asking clients what life was like at the nursing home shortly before something happened to their loved one.
“The staff were just never around.”
“We asked for help, but no one would come.”
“I visited often and never once did I see nurses stop by and check in.”
Inadequate staffing levels are one of the most common issues plaguing the for-profit nursing home industry. The nursing homes we end up suing most often were set up with the goal of extracting profit from a community, rather than providing effective nursing care. And the easiest way to do that is by cutting the biggest expense in the operating budget: staffing.
Short-staffed nursing homes are such a problem that the federal government ordered the Centers for Medicare and Medicaid Services (CMS) to research the appropriate staffing levels for nursing homes. This ultimately resulted in the publication of amended rules in the Code of Federal Regulations that would require “3.48 staffing hours per resident day” in an attempt to obligate nursing homes to provide enough staff for the level of care their residents need.
The ambition of this approach deserves praise. But the nobility of its aims is matched only by the practical difficulties of meaningful reform. The new CMS rules are being phased in, and it won’t be until 2026 that the rules are fully enforceable.
State laws are another option to ensure minimum staffing laws, but those laws face their own hurdles. For example, Illinois recently passed a law that attempted to implement a state version of the new federal regulations which mandated 2.5 hours of daily direct care for residents. Nursing home workers and labor unions praised the law, but the nursing homes themselves, whose websites often market their hospitality and commitment to servicing residents’ needs, won an appeal in 2023 to delay the fines imposed by that law until January 1, 2025.
Now that these state regulations have some teeth, we hope that nursing homes will raise the standard of their care and meet the looming healthcare crisis of our aging population. But the threat of fines will need time to permeate the market and force bad actors to confront the consequences of their staffing failures. In the meantime, Illinois alone is expected to be short 15,000 registered nurses in 2025.
Nationally, the implementation of minimal staffing levels will present a new dilemma, as the consequences of failing to follow the rules will only be as impactful as the new administration wants them to be. Robert F. Kennedy Jr., the recently appointed head of the Department of Health and Human Services, and the person ultimately responsible for ensuring the new federal rules take effect, recently stated that though the rules “were well intentioned,” they would pose a “disaster.”
It's hard to imagine that such an attitude will translate into better care for nursing home residents.
For now, prospective nursing home residents and their families should take caution when searching for a long-term housing solution. Low staffing levels can translate directly into negligence when residents develop pressure ulcers, fall while unattended, or become sick waiting for medication to be administered.
When searching for a nursing home, ask about staffing levels to ensure that a facility will be able to provide for your loved one. Ask about staff turnover and whether the nursing home is owned or operated by a for-profit corporation. It can be hard to find a location to service long-term care needs when there aren’t many options nearby, but extra diligence when selecting a nursing home can help prevent medical issues later on.
However, in the event that low staffing levels does lead to injury to a loved one, Rosenberg, Eisenberg, and Shactman LLC can help. We have successfully litigated hundreds of cases where a family member was hurt or injured because staff did not respond appropriately to the resident’s needs. If you have questions, please feel free to Contact us for a consultation.
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