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Nursing Home Staffing

By Maureen Kroll, RN, MN, JD

On January 1, 2003 a law was enacted that required all nursing homes participating in Medicare and Medicaid to begin posting staffing information. The regulations required the home to post in a clearly visible place the number of nursing staff on duty each shift. The staff must be those directly responsible for resident care. The numbers should not include social workers, recreation therapists, or physical therapy aides. The law does not require each unit to post their staffing levels. In fact, the consumer must determine the actual staffing on the unit versus the posted staffing levels. In addition, the nursing home is not required to post the number of residents in the unit at the time the list is posted.

To help determine the appropriate staffing ratios, guidelines are utilized. The NCCNHR recommends one (1) direct caregiver to five (5) residents on the day shift, one (1) direct caregiver to ten (10) residents on the evening shift, and one (1) direct caregiver to fifteen (15) residents on the night shift.

The facilities must post the staffing levels, but the consumer must monitor the accuracy of the number. If the consumer believes the staffing ratios are wrong, a complaint can be filed with the State Survey Agency.

Nothing is more important than the welfare of your family member. The cost of care for someone in a nursing home is exorbitant. These facilities must be made accountable for the promise they make to their residents.

Service Area

Attorney Maureen Kroll provides services in Westmoreland County, PA, including the communities of Greensburg, Irwin, Jeannette, Ligonier, Mt. Pleasant, North Huntingdon, Latrobe, and Scottdale.


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