The COVID-19 pandemic exposed dangerous staffing shortages in nursing homes and other long-term care facilities that resulted in the deaths of more than 200,000 residents and workers. In response, the Biden administration proposed a new federal nursing home staffing mandate that would increase transparency and boost staffing requirements for Medicare- and Medicaid-certified facilities and require that an RN be on staff 24 hours per day. The proposed rule represented a significant departure from longstanding federal staffing standards.

Soon after the federal nursing home staffing mandate was issued, nursing home groups, including the American Health Care Association, challenged it, claiming the rule was unrealistic due to workforce shortages and the cost to long-term care facilities. In April, a federal judge struck down the national staffing mandate for nursing homes, ruling that the Centers for Medicare & Medicaid Services (CMS) had exceeded its authority and that only Congress could enact a nursing home staffing mandate. Nonetheless, lawmakers continue to push for federal nursing home staffing mandates that would establish minimum standards for staffing levels in long term-care facilities.

While the current state of federal laws regarding nursing home staff mandates remains in flux, Ohio law requires that long-term care facilities have sufficient direct-care personnel on staff during each shift to meet the needs of residents in a timely and appropriate manner. For example, under Ohio law:

• Nursing homes have direct care requirements per resident per day, which can be met by a combination of nurse aids, registered nurses, and licensed practical nurses.
• A registered nurse (RN) must be on call when one is not on duty.
• The facility must designate an acting director of nursing when the regular director is unavailable (such as when they are on vacation or unavailable due to illness).
• Long-term care facilities must maintain staff who are competent in their assigned roles, and must conduct assessments of individual resident needs and acuity to determine appropriate staffing levels.

Because many Ohio long-term care facilities participate in Medicare and Medicaid programs, they must also comply with applicable federal nursing home staffing mandates.

Why Are Nursing Home Staffing Mandates Important?

Ensuring proper staffing levels in nursing homes and long-term care facilities is critical to the well-being of residents. Having adequate nursing staff ensures residents receive timely assistance with medication administration, mobility needs, nutrition, and personal hygiene from properly trained staff.

Adequate staffing enables caregivers to provide personalized attention, which benefits residents by allowing them to engage in conversation and social activities and receive necessary emotional support, thereby preventing depression and feelings of isolation.

Proper staffing levels also prevent caregiver burnout, fatigue, and turnover, which is widespread in the industry. When staff members feel properly supported, they provide better care and are more likely to stay in their jobs, ensuring better continuity of care and improved outcomes for residents.

What is the Required Nurse-to-Patient Ratio in Long-Term Care Facilities in Ohio?

Ohio law requires that each nursing home provide “sufficient direct care staff on each shift to meet the needs of the residents in an appropriate and timely manner.” Ohio nursing homes are required to provide a minimum daily average of 2.5 hours of direct care per resident per day. This can be divided between nurse aides, registered nurses, and licensed practical nurses.

Are Ohio Nursing Homes Understaffed?

Substantial evidence suggests that nursing homes and long-term care facilities in Ohio are experiencing staffing shortages and are unable to provide care at the levels many experts believe are required for optimal resident outcomes. According to AARP Ohio, more than 35% of Ohio nursing homes report staffing shortages, which is higher than the national average.

How to Protect Your Loved One from Nursing Home Understaffing

While nursing home understaffing remains an ongoing concern, you can protect your loved one from injuries caused by nursing home understaffing by being proactive when researching nursing homes and long-term care facilities, and remaining vigilant once your loved one has been admitted.

• Consult Medicare’s Care Compare to research nursing home staffing levels and compare them to national averages.
• Ask direct questions about staffing levels during tours and meetings, such as “What is the CNA-to-patient ratio?” “Is there an RN on-site 24/7?” and “How does the facility handle staff absences or shortages—do they use overtime, agency staff, or float staff from other units?”
• Once your loved one has been admitted, visit frequently and at different times of day, and be on the lookout for signs of nursing home neglect.
• Build relationships with nursing home staff.
• Know your loved one’s rights and what to do if you believe your loved one’s needs are not being met.

Was a Loved One Injured in a Nursing Home? Contact Robenalt Law Today.

Robenalt Law has offices in Cleveland and Columbus, and handles nursing home abuse and neglect claims throughout Ohio and nationwide.

Call our Cleveland office at (216) 223-7535 or our Columbus office at (614) 695-3800 or contact us online to schedule a free, confidential, no-obligation appointment to discuss your situation and how we can help.