Understaffing in Nursing Homes
This page has been written, edited, and reviewed by a team of legal writers following our comprehensive editorial guidelines. This page was approved by Founding Partner, Terry Crouppen who has more than 40 years of legal experience as a personal injury attorney. Our last modified date shows when this page was last reviewed.
This page has been written, edited, and reviewed by a team of legal writers following our comprehensive editorial guidelines. This page was approved by Founding Partner, Terry Crouppen who has more than 40 years of legal experience as a personal injury attorney. Our last modified date shows when this page was last reviewed.
- Last Modified:
- May 9, 2025
If you believe your loved one was harmed by nursing home understaffing, you’re not alone—and you’re not powerless. At Brown & Crouppen, P.C., we understand how devastating it can be to suspect neglect or abuse. With over 40 years of experience and a deep commitment to justice, our team will guide you through your legal options and help protect the safety and dignity of those you care about most.
Main Causes of Understaffing in Nursing Homes
Many factors contribute to chronic understaffing in nursing homes. A nationwide shortage of nurses and caregivers, especially Certified Nursing Assistants, or CNAs, has strained many facilities’ ability to maintain safe and effective staffing levels. Low pay, high stress, and demanding workloads make it difficult for some organizations to retain qualified workers.
Some facilities may deliberately operate with reduced staff to cut costs and increase profits. Others may struggle to meet staffing targets due to budget limitations, mismanagement, or lack of regulatory enforcement. A combination of these issues often creates dangerously low staffing levels.
When nursing homes are understaffed, caregivers are stretched thin. This increases the likelihood of missed medications, delayed hygiene care, and neglected needs, often with devastating consequences.
The Link Between Understaffing and Nursing Home Neglect and Abuse
When nursing homes lack sufficient staff, they usually fail to meet every resident’s basic needs. Overworked caregivers may be forced to rush tasks, skip steps, or overlook key signs of distress. This environment creates serious risks, including both unintentional neglect and, sometimes, outright abuse.
Residents who are not adequately helped may suffer from untreated medical conditions, missed meals or medications, or a lack of hygiene assistance. In extreme cases, stress and burnout among staff can contribute to harmful behavior, including verbal or physical abuse.
Warning signs that your loved one may be experiencing abuse or neglect from understaffing include the following:
- Unexplained injuries, such as bruises or cuts
- Poor hygiene, including unwashed hair or soiled clothing
- Declining health, particularly from missed medications or untreated conditions
- Emotional withdrawal, such as fearfulness or sudden mood changes
No one deserves to suffer in silence. If you notice any of these signs, it’s critical to speak up and seek help.
“The advice I would give to someone who has a loved one in a nursing home facility whom they suspect has been harmed is to call a lawyer. Let the lawyer determine whether or not it is something they need help with. Because sometimes you just don't know, and I'd rather err on the side of you calling. It's always free to call us and have us give you our best analysis of what's going on and how to handle that situation.”
Missouri Regulations on Nursing Home Staffing Levels
Missouri law requires nursing homes to provide sufficient staffing so that residents receive appropriate care. The state mandates minimum staffing levels based on the number of residents and the type of care needed. However, advocates have raised concerns that these minimums are outdated and do not meet current standards for safety and well-being.
When facilities fail to meet these staffing requirements, they can face fines, corrective action plans, and, sometimes, suspension or revocation of their operating licenses. Unfortunately, oversight is often inconsistent, and many facilities continue operating despite repeated violations.
These regulations protect vulnerable residents and ensure their basic needs are met. Adequate staffing is essential for daily care and maintaining residents’ dignity, health, and safety in long-term care environments.
Missouri's Ongoing Crisis: Nursing Home Staffing in the News
Staffing shortages in Missouri nursing homes are not just a local issue. They are part of a larger, troubling pattern that has gained national attention. From pandemic-era challenges to ongoing labor disputes and policy debates, the headlines underscore a crisis with deep roots and real consequences for residents.
Staffing Challenges During and After the Pandemic
The COVID-19 pandemic placed an unprecedented strain on long-term care facilities. It exposed and often worsened existing staffing weaknesses. Missouri nursing homes were particularly hard-hit. Many frontline workers became ill, were quarantined, or left the profession entirely due to burnout and unsafe conditions. Those who remained were left to manage overwhelming workloads.
Even after the height of the pandemic, many Missouri nursing homes have struggled to return to pre-pandemic staffing levels. Recruitment remains challenging, and retention is even more difficult given the high-pressure nature of the work and low compensation. This prolonged strain has caused ongoing gaps in care, increasing the risk of harm to residents.
Recent Stories From Missouri
Multiple reports have highlighted the severe staffing shortfalls facing Missouri’s nursing homes. A 2025 Missouri Independent article revealed that the state ranks among the worst in the nation for nursing home staffing, prompting urgent calls for reform from families, health care workers, and advocates. The article also detailed how many facilities fail to meet basic staffing levels, leaving residents vulnerable to neglect and harm.
Organizations such as VOYCE St. Louis have documented the persistent problems at several Missouri facilities, including instances where residents were left unattended for hours or suffered preventable injuries due to a lack of available staff. SEIU Healthcare Missouri continues to advocate for stronger staffing laws and better working conditions to help stabilize the workforce and protect residents.
These stories reflect a system under pressure and highlight the importance of holding facilities accountable when they fail to meet their obligations.
Missouri's Poor Rankings and Federal Standards
Missouri’s nursing homes have consistently ranked among the lowest in the nation for staffing and quality of care. According to a 2023 Missouri Independent article that cited a report by AARP, Missouri ranked 47th in nursing home safety and quality. A 2023 report by the Long Term Care Community Coalition noted that Missouri nursing home residents receive approximately three hours of care daily, below the national average and the recommended minimum.
The federal Centers for Medicare & Medicaid Services has proposed a minimum staffing standard of 3.48 hours per resident per day, including at least 0.55 hours from registered nurses. Missouri’s current staffing levels do not meet these proposed federal standards, highlighting a critical need for improvement to ensure the safety and well-being of nursing home residents.
Steps To Take If You Suspect Understaffing Is Harming Your Loved One
If you believe your loved one is suffering because of understaffing in a nursing home, you should act quickly and document your concerns. Start by observing and recording signs of neglect or abuse, such as unclean conditions, medication errors, unexplained injuries, or emotional changes.
Communicate your concerns to the facility’s management and request a written care plan if one is not already provided. You can also file a complaint with the Missouri Department of Health and Senior Services, which oversees the state’s long-term care facilities.
If you feel that the facility is not taking your concerns seriously or that your loved one remains at risk, it may be time to consider legal action. Speaking with a qualified nursing home abuse attorney can help you understand your rights and explore the best path forward.
How Brown & Crouppen Attorneys Advocate for Families Affected by Understaffing
Navigating a nursing home understaffing claim can be overwhelming, but you do not have to proceed alone. Our attorneys are dedicated to helping families uncover the truth, hold negligent facilities accountable, and secure the justice their loved ones deserve.
With over 40 years of experience and a proven track record of achieving life-changing results, our legal team understands what it takes to investigate complex nursing home cases. We work with medical experts, review facility records, and pursue every available legal avenue to build a strong case on your behalf.
Our results and commitment to our clients set us apart. Our attorneys know the St. Louis court system and statutes of limitation, understand families’ challenges, and treat each case with the respect and care it deserves. We believe everyone is entitled to exceptional legal representation, regardless of their background or financial situation. That is why we work on a contingency fee basis—if you don’t get paid, we don’t get paid.
If your loved one has suffered from nursing home understaffing, we are here to listen, support, and fight for you.
Speak With Brown & Crouppen About Nursing Home Understaffing Concerns
Understaffing in nursing homes can have serious consequences for residents and their families. If you believe your loved one has been affected by inadequate staffing in nursing, now is the time to take action. Brown & Crouppen Law Firm is here to explain your legal options and determine the best course of action.
To speak with a trusted nursing home abuse attorney, contact us online or at 800-536-4357. We are ready to stand by your side and fight for the care your loved one deserves.
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