The Hidden Crisis in America’s Nursing Homes: What a New Study Says About Staffing and Patient Safety

Par Joseph Ciaccio, Partner and Head of Napoli Shkolnik’s Medical Malpractice and Personal Injury Litigation Departments

A recent étude published in JAMA Internal Medicine has confirmed what families across the country have long feared: staffing shortages in skilled nursing facilities are a patient safety crisis, not just a workforce inconvenience.

Analyzing data from 2018 to 2024, researchers found that while licensed skilled nursing facility beds declined by 2.5 percent between 2019 and 2024, actual operating capacity fell by twice that amount over the same time period, a full 5 percent.

The impact is not evenly distributed. One in four U.S. counties has experienced operating capacity losses of 15 percent or more, with rural communities hit hardest.

Understaffing and the Risk of Harm

Staffing shortfalls create direct and foreseeable risks for vulnerable residents. When there are fewer eyes on a unit, errors occur. Residents go unchecked for hours. Call lights go unanswered. Medications are missed or given incorrectly. Falls that could have been prevented happened because residents were not properly supervised.

These are not hypothetical scenarios. At Napoli Shkolnik, we represent families who have loved ones harmed at nursing home facilities. Inadequate staffing is a common thread running through claims involving:

• Neglect and failure to meet basic care needs
• Preventable falls and fractures
• Medication errors, including wrong doses or missed medications
• Untreated pressure ulcers and infections
• Malnutrition and dehydration

Many facilities with poor inspection records continue to operate below federal and state staffing standards with limited consequences. Families are often unaware that the facility they trusted had already been flagged for deficiencies before their loved one arrived.

What Families Should Watch For

However, steps can be taken to help keep your loved ones safe. Foremost, stay engaged. Warning signs of inadequate staffing include long waits for basic needs, unexplained weight loss, worsening pressure sores, unexplained injuries, or a decline in hygiene or responsiveness.

You can also check a facility’s staffing levels and inspection history through Medicare’s Care Compare tool, which rates nursing homes on a five-star scale and publishes detailed inspection findings. A poor rating or a history of staffing-related citations should raise serious concerns.

Napoli Shkolnik Is Here to Help

Action can be taken. Napoli Shkolnik represents families in nursing home abuse and neglect cases. Our attorneys understand the complexity of these claims and the evidence required to hold facilities accountable. If you believe a loved one has been harmed due to neglect or inadequate staffing, contactez-nous aujourd'hui.