Understaffing in Florida Nursing Homes, Assisted Living Facilities, Group Homes, & Adult Day Care Centers

The Dangers of Understaffing

Understaffing in nursing homes, assisted living facilities, group homes, and adult day care centers poses a serious threat to the health, safety, and well-being of residents. While state and federal regulations impose minimum staffing requirements on nursing homes and assisted living facilities, they often fail to adhere to them, leading to dire resident outcomes. Further, mere compliance with minimum staffing numbers is rarely sufficient to meet the needs of facility residents, an objective that facilities are obligated to achieve.

Why Facilities Are Understaffed

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There are several reasons why nursing homes, assisted living facilities, group homes, or adult day care centers might be understaffed.

• Cutting Costs. Staff is one of the most expensive components of operating a nursing home, assisted living facility, group home, or adult day care center. Competent staff increases operational costs. Many facilities believe that reducing staff can help save costs and increase profits. However, the opposite is usually true as decreased staffing levels often increase liability exposure when residents are abused and/or neglected.

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• Poor Staff Reliability. Facilities with low staff morale and/or incompetent staff might experience high call-out and/or no-call, no-show rates. When staff members do not show up for work, the facility is at risk of being understaffed. This is further compounded when the facility is already staffed to state-imposed minimums (without considering the needs of the residents). Regardless, nursing homes, assisted living facilities, group homes, and adult day care centers are responsible for ensuring sufficient staff to meet the needs of their residents every day.

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• Low Pay, High Turnover. Nursing homes, assisted living facilities, group homes, and adult day care centers often compete for qualified staff. Paying at or above market rate helps to ensure that facilities not only have sufficient staff to meet the needs of the residents, but that facilities also have qualified staff to meet the needs of the residents. In some instances, failing to pay market wages leads to high turnover rates and understaffing. This, in turn, increases liability exposure when residents are the victims of understaffed facilities.

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• Poor Management. Facilities run by disorganized or unqualified administrators or other management personnel often experience high turnover at every level, including nursing, aides, and support staff. These management failures often trickle down to resident care with devastating consequences..

Dire Outcomes Associated with Understaffing

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Understaffing can lead to serious, preventable harm. Below are just some of the consequences of understaffing:

• Insufficient Monitoring: Inadequate staffing levels result in compromised resident monitoring. Inadequate monitoring leads to delays in recognizing and addressing resident health issues. In these circumstances, changes in condition often go unnoticed, and residents are deprived of critical medical care.

• Increase in Traumatic Injuries: Understaffing also leads to more traumatic injuries. For example, residents who can no longer wait for assistance might be compelled to get out of bed without assistance (when assistance is otherwise required) and try to walk to the bathroom. This unnecessarily increases the risks of falls, fractures, and head injuries.

• Inadequate Care and Treatment: When residents are deprived of necessary care and treatment, they are left to suffer. This is compounded by the fact that some individuals in nursing homes, assisted living facilities, group homes, and adult day care centers are non-verbal--unable to speak up, get a nurse’s attention, identify the source of pain, explain a recent fall, and/or tell a family member what’s wrong. When a facility is understaffed, physicians’ orders are overlooked, treatments are wrongfully withheld, and medications are not administered or are done so in error (see Medication Errors). In addition, residents who require turning and repositioning to avoid bed sores/pressure ulcers do not get the attention they need. These residents then develop bedsores/pressure ulcers that go unnoticed for far too long. This is unacceptable.

• Malnutrition/Dehydration: When facilities are understaffed, residents who require assistance with feeding begin to suffer from malnutrition and/or dehydration. This leads to a host of cascading problems, all of which could have been prevented with proper staffing.

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• Neglect and Poor Hygiene: Understaffed facilities simply cannot meet the basic needs of residents, including assistance with personal hygiene. Neglect in these essential areas can lead to preventable illnesses, infections, and deterioration of residents’ overall health.

• Preventable Infections and Illnesses: Understaffing may lead to lapses in infection control measures, contributing to the spread of infections within healthcare facilities.

• Emotional and Social Isolation: Understaffing often limits the time staff can spend engaging with residents on a personal level, leading to social isolation and emotional distress. Loneliness and lack of social interaction can contribute to depression, anxiety, and a diminished overall sense of well-being.

• Overwhelmed Staff: Staff members who do show up for work experience burnout and become resentful that they are working too hard for too little. Negative attitudes have the potential to manifest into abusive behaviors. This can have severe consequences for the physical and emotional well-being of residents under their care.

Contact FIDJ for a Free Case Review

If you or your loved one was injured at the hands of a nursing home, assisted living facility, group home, or adult day care center, contact the experienced attorneys at FIDJ for a FREE case review.