Staffing, staffing, staffing! Seems like we just can’t get away from this topic, can we? Nursing home staffing continues to make headlines, and recent court cases remind us why it matters. While federal staffing requirements have changed, providers still have an obligation to meet the needs of their residents. And as recent litigation demonstrates, staffing decisions can have consequences that extend well beyond a regulatory citation.

According to a recent article in McKnight’s Long-Term Care News, a Pennsylvania appeals court overturned a $19 million verdict involving the death of a nursing home resident. The case involved allegations of inadequate care, including pressure injuries. The original jury awarded $4 million in compensatory damages and $15 million in punitive damages. However, the appeals court determined that the management companies could not be held directly liable under the legal theory presented. The court also ordered a new trial to determine compensatory damages against the nursing home’s operators.

Sounds like a victory for the providers, right? Well, not necessarily. The court did not dismiss the underlying claims against the nursing home’s operators. Instead, it addressed how liability and damages should be determined. The case is a reminder that ownership, management responsibilities and resident care obligations can become complicated when litigation occurs.

Meanwhile, the Center for Medicare Advocacy recently reported on lawsuits involving nursing home staffing in Massachusetts, California and Michigan. State attorneys general have challenged nursing home operators over allegations of inadequate staffing. These cases place particular emphasis on resident acuity. In other words, staffing decisions should reflect the actual care needs of the residents, not simply the number of people living in the community.

Federal regulations already require nursing homes to consider resident assessments, diagnoses, acuity and staff competencies when making staffing decisions. Therefore, the annual community assessment plays an important role. The question isn’t just whether you have enough staff on the schedule. Do you have staff with the appropriate skills to meet your residents’ needs?

At the end of the day, what does your community assessment tell you? Have your residents’ needs changed? Are you experiencing more complex medical conditions, increased dependence or additional behavioral challenges? If so, have your staffing patterns changed to reflect those needs?

Bottom line, take another look at your staffing practices. Review your community assessment and talk to your staff. Are they able to provide the care your residents need? Do they have the training, resources and support necessary to do their jobs? You may find that your current staffing practices meet those needs. However, if not, now may be the time to discuss what needs to change.

Stay well and stay informed!