Your mother broke her hip in a fall at the nursing home. Your father developed a Stage 3 pressure wound that became infected. Your grandmother choked during a meal because no one was supervising her. The facility says it was an unfortunate event. But when you look closer, something else comes into focus: there were not enough people working to keep your loved one safe.
Understaffing is not a background condition. It is the root cause of many of the most serious injuries and deaths in nursing homes, assisted living facilities, and group homes across New Jersey.
The Injuries That Understaffing Causes
When a facility does not have enough certified nursing assistants, nurses, and trained caregivers on each shift, the specific failures are predictable and the resulting injuries are serious.
Residents who need help getting to the bathroom try to go alone because no one responds to the call bell. They fall. They break a hip, fracture a wrist, or hit their head. Some of those falls are fatal.
Residents who cannot reposition themselves are not turned on schedule because the aide responsible for them is also responsible for a dozen other people. Pressure injuries develop. They progress from reddened skin to open wounds to deep craters that expose bone. Infection sets in. Sepsis follows.
Residents who need supervision during meals are left to eat alone because there is no one available to monitor them. They choke. They aspirate food into their lungs. They develop aspiration pneumonia, which can be fatal in an elderly person.
Medications are given late or missed entirely because the nurse on duty is covering too many residents. The consequences range from uncontrolled pain to medical emergencies.
These are not theoretical risks. They are the injuries and deaths that families across South Jersey and throughout New Jersey bring to my office.
Why Understaffing Is a Choice, Not an Excuse
Facilities sometimes describe staffing shortages as something beyond their control. But staffing is a budget decision. When a nursing home collects payment for a certain level of care and then does not hire enough people to deliver it, that is a choice. Labor is the largest expense in any long-term care facility, and it is often the first thing cut when ownership prioritizes profit over resident safety.
There have been investigations in New Jersey where facilities were found operating well below required staffing levels while receiving Medicaid and Medicare funding meant for resident care. When a facility accepts that funding and does not staff adequately, the residents pay the price with their health and sometimes their lives.
Information Families Typically Want After a Staffing-Related Injury
If your loved one was seriously injured or died in a nursing home, assisted living, or group home, and you suspect staffing played a role, there are steps you can take to start building a clearer picture.
- Ask the facility how many aides and nurses were on the floor the shift the injury occurred. Ask how many residents each staff member was responsible for. Request this in writing.
- Request the incident report, the care plan, and any logs related to the injury, whether those are repositioning records, fall-prevention protocols, or medication administration records. These documents show whether the facility was following its own plan, and whether anyone was available to carry it out.
- Check the facility’s staffing data at Medicare.gov/care-compare. This publicly available tool shows self-reported staffing levels for certified nursing homes. While it does not tell the full story, it can reveal patterns of low staffing.
- Write down what you observed during visits before and after the injury: how long call bells went unanswered, how many staff were visible, whether your loved one’s basic needs were being met. These observations become important evidence.
A New Jersey attorney who handles nursing home injury and death cases can obtain staffing records, payroll data, and internal documents that families cannot access on their own. If your loved one was hurt or killed in a facility in Burlington, Camden, Gloucester, or anywhere in New Jersey, and understaffing was a factor, those records often tell the story the facility will not.
Frequently Asked Questions About Nursing Home Understaffing
Common signs include call bells going unanswered for extended periods, residents left in soiled clothing, the same resident position every time you visit, meal trays sitting out long after mealtimes, and visibly rushed or unavailable staff. Visiting at different times, especially evenings and weekends, often reveals the most about a facility’s actual staffing levels.
Understaffing is not a valid excuse. It is a staffing decision the facility makes. When a facility does not hire enough people to carry out its own care plans and a resident is injured as a result, the facility may be held accountable for that failure.
The Centers for Medicare and Medicaid Services publishes self-reported staffing data for certified nursing homes at Medicare.gov/care-compare. This gives you a baseline, though it may not reflect actual staffing on any given shift.
Falls resulting in hip fractures, head injuries, and broken bones. Pressure injuries from missed repositioning. Choking and aspiration from unsupervised meals. Medication errors from overworked nurses. Infections from delayed wound care. In serious cases, these injuries lead to hospitalization or death.
Request the incident report, care plan, and staffing information for the shift in question, in writing. Document your own observations from visits. An attorney who handles nursing home injury and death cases in New Jersey can obtain staffing records, payroll data, and internal documents that are not available to families directly.
Schall at Law represents families across New Jersey, including South Jersey, from our Moorestown office.
Related Resources
Were you or a loved one a resident of a nursing home, assisted living, or group home and injured due to failures in care?
Better Call Schall® at 856-310-6782 or send a message through our contact form.
Important: Time limits apply. If this happened recently, contact us promptly.
This post is general information, not legal advice.
