A serious problem in nursing homes across the United States is understaffing. Many nursing homes either do not have enough trained people to provide adequate care to residents, or have a deficiency in the number of skilled or trained staff members available. To address this problem, both the Federal and State governments have set forth minimum requirements for nursing homes. Minimums are usually reported as a minimum number of hours of care, rather than as a minimum number of people.
Federal law generally requires that nursing homes have enough staff to meet the needs of the nursing home’s residents, but does not prescribe a specific minimum number of staff.
Federal guidelines do, however, provide recommendations as to the minimum amount of care time residents should get each day. For example, consider the nursing home resident that requires skilled care, such as frequent medical supervision. The federal government recommends that a resident who requires skilled care receive a minimum 246 minutes (4.1 hours) of nursing care each day, consisting of at least 72 minutes (1.2 hours) that are administered by a licensed professional. Of those 72 minutes of licensed professional care, 45 minutes (0.75 hours) should be administered by a registered nurse.
Illinois law requires a minimum number of daily hours of care for each resident, as well. As of January 1, 2013, Illinois residents requiring skilled care were provided with at least 204 minutes (3.4 hours) of nursing care per day, of which 51 minutes (0.9 hours) were to be provided by a licensed professional, meaning a registered nurse (RN), licensed practical nurse (LPN), or a certified nursing assistant (CNA). Of those 51 minutes of licensed professional care, 21 minutes were to be administered by an RN.
These minimums were increased on January 1, 2014, so that residents requiring skilled care now are to receive a minimum of 228 minutes (3.8 hours) of nursing care per day, of which 57 minutes should be from a licensed professional. Of those 57 minutes of licensed professional care, 23 minutes should be administered by an RN. Residents requiring intermediate care (basic nursing care and other restorative services under periodic medical direction) are to receive a minimum of 150 minutes (2.5 hours) of nursing care per day, of which 38 minutes should be from a licensed professional. Of those, 15 minutes should be administered by an RN.
Regrettably, the Illinois staffing requirements do not clearly differentiate between licensed professionals and nursing assistants. This lack of definition has lead to an imbalance in the number of RNs and LPNs on staff versus the number of nursing assistants, with the number of nursing assistants being disproportionately higher than the number of licensed professionals. Such heavy reliance on nurse’s aides can bring about instances of neglect and abuse in the nursing home.
Illinois law also requires that all staff members wear identification badges indicating the staffer’s name, job title, and any licenses he or she may possess. Nursing homes are further required to post the names and job titles of all staff members on duty each shift.
If you are concerned that a nursing home in our state is not performing according to the minimum standards required by law, please contact The Rooth Law Firm at (800) 598-4348 to express your concerns.
Illinois Citizens for Better Care, Minimum Required Staffing
Direct Care Staffing Administrative Code 77(I)(c) Section 300.1230, Joint Committee on Administrative Rules