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Horton Law Firm Blog When Neglect Does Not Add Up: Nursing Home Understaffing

When Neglect Does Not Add Up: Nursing Home Understaffing

Staffing in a nursing home is a matter of math.  Do the math to add up the profits for understaffing.  Do the math to subtract the costs to those who are injured. Math will tell you whether there are enough minutes in the day.  In my opinion, a jury is a variable to plug into the mathematical equation of understaffing to make sure that providing bad care does not pay.The primary caregiver of residents at nursing homes, meaning the one who performs most of if not all the tasks needed to take proper care of the resident, is a certified nursing assistant (“CNA”). To understand how understaffing occurs consider that a CNA typically works an 7.5-hour shift, but with two 15 minute breaks and a 30-minute meal, the CNA only has 6.5 hours of actual time to care for the residents. This allows for 390 minutes for resident care in each shift. Now consider the minutes required for a CNA to complete the responsibilities and tasks that he or she may have on a single shift when responsible for 9 residents (unfortunately CNAs are commonly responsible for 12 to 15 residents on a shift):

4 showers to give (60 min.)
5 baths (75 min.)
5 incontinent residents to clean/change (25 min.)
One catheter to empty (5 min.)
Document on the resident care charts throughout shift (25 min.)
Change 9 bed sheets and make up beds (40 min.)
Turn/reposition 4 bed-ridden residents every 2 hours (60 min.)
Set up 6 meals (25 min.)
Toilet 4 to 6 residents 2 times a shift (60 min.)
Shave/groom/hygiene all residents (135 min.)

Therefore, a CNA with only 9 residents would need approximately 510 minutes to complete these tasks to adequately care for the residents. Yet, the CNA only works for a total of 390 minutes. Thus, the CNA would need 120 more minutes, or two additional hours of non-stop work, to perform the resident care responsibilities. This is if the CNA works diligently during the 390 minutes. However, many CNAs work a double shift at the facility or have another job at another nursing home, hold down two jobs due to low wages- resulting in many days of sixteen-hour workdays, and often work six or seven days per week. Meaning these 390 minutes are likely to be less than productive.

So, what happens?  The people who work as a CNA are given an impossible task.  It is like rolling the dice, day after day.  Experience tells you that it is just a matter of time before someone suffers from the neglect.  It is why it is important for folks to understand the math of understaffing.

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