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  • Writer's pictureBrian A. Raphan, Esq.

What happens when Nursing Homes and Hospitals reduce staff?


Understaffing in nursing homes and hospitals is a pressing issue that can significantly impact the quality of care provided to patients and residents. 

When these facilities operate with insufficient staff, the repercussions are far-reaching and affect not only the healthcare workers--leaving them overworked, stressed, and short-handed-- but negatively impacts those they care for. Neglect is a by-product of understaffing that can lead to more injuries, poor health, infection, and a host of other medical problems.

Nursing Home Neglect, bedsores
Understaffing leads to neglect

So what actually happens? Imagine you or an elderly parent are in a nursing home and need assistance. When will you get it? Well, during the day a nursing home may have 1 aide for 8-12 patients. A night shift may have as low as 1 aide for 15-20 residents. Why?

One answer is that the majority are privately owned. And that means they need to turn a profit. How much profit is essentially up to the private or corporate owners. The easiest way for them to profit is to cut costs. And that means cutting staff.

Impact on Patient Care

  1. Reduced Quality of Care: With fewer staff members available, the time each caregiver can spend with patients decreases. This can lead to hurried, less thorough care, and critical signs of deterioration may be missed. In nursing homes, residents might experience delays in receiving medications, assistance with daily activities, and emergency response. What happens when two or three patients or nursing home residents need care at the same time? Who gets it?

  2. Increased Risk of Medical Errors: Overworked and fatigued healthcare workers are more prone to making mistakes. This can range from medication errors to incorrect charting, potentially leading to serious health consequences for patients. Ultimately, the patient or residents suffers.

  3. Higher Infection Rates: Proper hygiene practices, including handwashing and regular cleaning, are essential in preventing infections. Understaffed facilities may struggle to maintain these standards, increasing the likelihood of hospital-acquired infections (HAIs). For example, an immobile elder needs to be turned every few hours to prevent decubitus ulcers, commonly called Bedsores, from happening. Otherwise, where there is pressure against the skin and surface, especially around bony areas such as the sacrum, elbows, and buttocks, sores can develop due to decreased blood flow. And they develop quickly. A small red mark can turn into a stage 2 bedsore in a matter of days. And if not medically attended to it can progress to a painfully severe and possibly deadly stage 3 or 4 days later. Problems get even worse if the wound gets infected.

  4. Higher Mortality Rates: Studies have shown a direct correlation between nurse-to-patient ratios and patient outcomes. Inadequate staffing can lead to higher mortality rates, particularly in critical care settings where timely intervention is and quality of care is crucial.

Impact on Healthcare Workers

  1. Burnout and Stress: Continuous understaffing places a significant burden on healthcare workers, leading to high levels of stress and burnout. This not only affects their well-being but also reduces their efficiency and effectiveness at work.

  2. High Turnover Rates: Job dissatisfaction caused by understaffing can result in high turnover rates. This exacerbates the staffing problem, creating a vicious cycle that further strains the remaining staff and compromises patient care.

  3. Increased Risk of Injury: Overworked staff are more likely to experience physical injuries. For example, nurses and aides frequently lift or reposition patients, and doing so without adequate assistance can lead to musculoskeletal injuries.

Broader Implications

  1. Financial Consequences: Understaffing can lead to financial strain on healthcare facilities. Poor patient outcomes and higher infection rates can result in penalties and reduced reimbursements from insurance providers and government programs. Additionally, the costs associated with high turnover, including recruitment and training, can be substantial. Less profit equates to less care.

  2. Reputation and Trust: Consistently poor care due to understaffing can damage the reputation of healthcare facilities. This loss of trust can make it harder to attract both patients and qualified staff, further compounding the problem.


In conclusion, understaffing in nursing homes and hospitals presents serious challenges that can jeopardize patient care and staff well-being. We all know that even under normal circumstances, needs are not always met on a timely basis during a hospital stay or as a nursing home resident.

If you have been a victim of neglect or malpractice at a nursing home or hospital, demand that you get the care you need. Don't be shy or hesitant to speak up.

If you unfortunately have a serious injury, you will likely be able to sue and get the financial compensation you deserve. Feel free to call us to see if you have a case. A free consultation or sending us an email can quickly let you know where you stand.

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