By a Nursing Home Abuse Lawyer in Pennsylvania & New Jersey
Nursing home abuse, neglect and accidents like fall accidents are a sad, unfortunate reality in Pennsylvania’s nursing homes. Many problems in nursing homes throughout Pennsylvania start and end with staff. Common issues include staffing deficiencies or failure to provide sufficient hours of care per each resident.
The problem is that the quality of care in Pennsylvania’s nursing homes is in line with the rest of the nation. This means that quality nursing home care across the nation is suffering.
Related: Abuse in Pennsylvania Nursing Homes – What is the Law?
One of the main issues which leads to nursing home accidents, injuries and abuse is failure to provide enough hours of care per each resident in a 24 hour period, and the most common cause of the problem is a shortage of staff, or failing to hire enough nurses and nurse aides. The reality is that many nursing homes, even non-profit ones, are faced with financial strains which lead to cutting staff hours. This explains why nursing homes across the nation have been under fire for poor quality of care. Despite Pennsylvania law, which sets a bare minimum, nursing homes in this state often fail to provide adequate care. This results in serious injuries for our most vulnerable citizens, the elderly.
The Commonwealth of Pennsylvania regulates both profit and non-profit nursing homes. One of the regulations found in section 211.12 of the Program Standards for Long-Term Care Nursing Facilities sets minimum staff requirements for nursing homes. See below for the full text of section 211.12. Under this law, nursing homes in PA must provide a minimum of:
- at least 2.7 hours of general nursing care provided in each 24-hour period per resident,
- at least 1 nursing staff employee per every 20 nursing home residents, and
- at least 2 nursing service employees must be on duty.
Nursing Home Staffing Deficiencies
Multiple research studies have shown the impact of staffing shortages on quality of resident care. One study examined 90 nursing homes in Northeastern Pennsylvania (i.e., the Philadelphia suburban area), and found an association between the quality of care and a reduction in nurse staffing levels. See the journal, Applied Nursing Research, Nurse staffing levels and quality of care in Northeastern Pennsylvania nursing homes, August 2005.
An earlier study in 2000, Nursing Home Staffing and Its Relationship to Deficiencies (Journals of Gerontology, Series B) analyzed nursing home deficiency citations and found that nursing homes with fewer nursing staff employees (registered nurses and certified nurse aides) had higher numbers of citations, especially ones for poor quality of care.
Pennsylvania & New Jersey Nursing Home Abuse Lawyers
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Pennsylvania Nursing Home Staffing Laws & Requirements (current as of October 2014)
§ 211.12. Nursing services.
(a) The facility shall provide services by sufficient numbers of personnel on a 24-hour basis to provide nursing care to meet the needs of all residents.
(b) There shall be a full-time director of nursing services who shall be a qualified licensed registered nurse.
(c) The director of nursing services shall have, in writing, administrative authority, responsibility and accountability for the functions and activities of the nursing services staff, and shall serve only one facility in this capacity.
(d) The director of nursing services shall be responsible for:
(1) Standards of accepted nursing practice.
(2) Nursing policy and procedure manuals.
(3) Methods for coordination of nursing services with other resident services.
(4) Recommendations for the number and levels of nursing personnel to be employed.
(5) General supervision, guidance and assistance for a resident in implementing the resident’s personal health program to assure that preventive measures, treatments, medications, diet and other health services prescribed are properly carried out and recorded.
(e) The facility shall designate a registered nurse who is responsible for overseeing total nursing activities within the facility on each tour of duty each day of the week.
(f) In addition to the director of nursing services, the following daily professional staff shall be available.
(1) The following minimum nursing staff ratios are required:
| Census | Day | Evening | Night |
| 59 and under | 1 RN | 1 RN | 1 RN or 1 LPN |
| 60/150 | 1 RN | 1 RN | 1 RN |
| 151/250 | 1 RN and 1 LPN | 1 RN and 1 LPN | 1 RN and 1 LPN |
| 251/500 | 2 RNs | 2 RNs | 2 RNs |
| 501/1,000 | 4 RNs | 3 RNs | 3 RNs |
| 1,001/Upward | 8 RNs | 6 RNs | 6 RNs |
(2) When the facility designates an LPN as a nurse who is responsible for overseeing total nursing activities within the facility on the night tour of duty in facilities with a census of 59 or under, a registered nurse shall be on call and located within a 30-minute drive of the facility.
(g) There shall be at least one nursing staff employe on duty per 20 residents.
(h) At least two nursing service personnel shall be on duty.
(i) A minimum number of general nursing care hours shall be provided for each 24-hour period. The total number of hours of general nursing care provided in each 24-hour period shall, when totaled for the entire facility, be a minimum of 2.7 hours of direct resident care for each resident.
(j) Nursing personnel shall be provided on each resident floor.
(k) Weekly time schedules shall be maintained and shall indicate the number and classification of nursing personnel, including relief personnel, who worked on each tour of duty on each nursing unit.
(l) The Department may require an increase in the number of nursing personnel from the minimum requirements if specific situations in the facility—including, but not limited to, the physical or mental condition of residents, quality of nursing care administered, the location of residents, the location of the nursing station and location of the facility—indicate the departures as necessary for the welfare, health and safety of the residents.