Nursing home residents deserve to have enough competent individual care to tend to their daily living, nutritional, social, and emotional needs. Residents who have dementia need even more individual care. Poor staffing levels can mean that residents suffer different types of nursing home abuse and neglect, including:

• Physical abuse. Physical abuse includes kicking, hitting, and slapping; and the use of physical or chemical restraints – because staff members are overworked or stressed, taking their frustrations out on residents.
• Emotional abuse. Overworked staff members may isolate residents, yell at residents, or intimidate residents to try to control them – instead of tending to their needs in a respectful manner.
• N Understaffing prevents nursing homes from caring for the daily living needs of patients. Neglect includes bedsores, malnutrition, dehydration, falls, bladder and bowel difficulties, the failure to recognize stroke symptoms, and many other dangers. Nursing home neglect due to understaffing also includes the failure to give residents their correct medications in the correct dosages, wandering, and elopement (leaving the nursing home facilities without supervision).

Our Knoxville nursing home and abuse lawyers hold nursing homes accountable when understaffing causes residents to suffer injuries or causes them to die. We understand the applicable nursing home staffing laws and the current nursing home industry staffing standards.

The federal nursing home staffing level requirements

The Nursing Home Reform Act sets minimum standards for nursing home care. The law is part of the 1987 Omnibus Budget Reconciliation Act. According to the American Hospital Association, the Centers for Medicare & Medicaid Services (CMS) on April 22 finalized the minimum staffing requirements for nursing homes. The rule (which is not fully phased in and subject to legal challenges) applies to nursing homes that participate in Medicare and Medicaid.

Most nursing homes across the United States and in Tennessee participate with CMS. The rule (if it becomes enforceable) applies to the 1.2 million people who receive services in Medicare and Medicaid-certified Long-Term Care (LTC) facilities each day. Long-term care facilities include nursing homes.

The final rule requires that nursing homes provide at least 3.48 hours of nursing care per resident each day. This care includes “0.55 hours of care from a registered nurse per resident day and at least 2.45 hours of care from a nurse aide per resident day.” Some exemptions do apply.

According to CMS, the minimum nurse staffing standards are necessary due to:

• Non-compliance by a subset of facilities
• The need to create a consistent floor to reduce variability in the minimum floor for nurse-to-resident ratios across states
• The need to support nursing home staff
• Most importantly, to reduce the risk of residents receiving unsafe and low-quality care

CMS is also working to ensure that nursing homes and other long-term facilities have “an RN onsite 24 hours a day, seven days a week, to provide skilled nursing care. “

According to CMS, if the final rule becomes enforceable, LTC facilities may qualify for an exemption. “External circumstances may temporarily prevent a facility from achieving compliance despite the facility’s demonstrated best efforts.” The rule identifies the criteria for exemptions in more detail.

The Tennessee nursing home staffing level requirements

There are state level requirements for nursing homes. The Tennessee Department of Health:

Sets specific licensing requirements and conducts regular inspections to ensure compliance with these standards. Additionally, the department conducts investigations into complaints and reports of potential abuse or neglect in nursing homes. Tennessee also offers resources and support for families and residents to report concerns and seek assistance when needed.

According to State Regs Today, Tennessee has minimum staffing requirements for “the number of licensed and certified nursing staff, including registered nurses, licensed practical nurses, and certified nursing assistants, that must be on duty at all times.” Tennessee also has specific education and training requirements depending on the type of facility.

The law requires that nursing homes in the state have an adequate number of staff members to provide “care as needed.” There are specific staffing requirements for licensed staff (RNs and LPN/LVNs). These professionals should be on staff 24/7, and each professional should provide .4 (hours per resident per day) of “licensed nursing personnel time.” Direct care staff should provide 2 hours per resident per day, which includes .4 of “licensed personnel time and at least 2 nursing personnel on duty each shift.”

If your loved one suffered any type of abuse or neglect while a resident of a nursing home, Banks and Jones has earned the respect of nursing home residents, families, insurance companies, and the legal community for our ability to hold nursing homes accountable. We understand the causes of nursing home abuse and neglect, including not having enough staff members. Call us or fill out our contact form to schedule a free consultation to help your loved one.