Cogburn Davidson | June 9, 2025 | Nursing Home Abuse
When you trust a facility with a parent or spouse, you justifiably expect qualified caregivers to be there, every hour of every day. Unfortunately, chronic understaffing is one of the biggest threats to resident safety in Nevada and nationwide. At Cogburn Davidson Car Accident & Personal Injury Lawyers, our nursing home abuse lawyers have spent 40 + years uncovering staffing shortfalls, holding negligent owners accountable, and recovering hundreds of millions for vulnerable families. The guide below explains exactly why thin staffing is so dangerous, how to spot it, and what steps to take if your loved one is at risk.
What Counts as “Enough” Staff?
Under federal rules, every nursing home must have “sufficient” nursing personnel to meet resident needs and must post daily staffing numbers under the Payroll-Based Journal (PBJ) system (42 C.F.R. § 483.35).
Nevada adds its own layer, requiring facilities to “maintain adequate staffing ratios at all times” and to develop contingency plans for absences (NAC 449.74558).
Despite these laws, the Centers for Medicare & Medicaid Services (CMS) found that more than half of U.S. homes fell below their self-reported staffing levels at least one day each quarter (CMS PBJ Data Brief, 2019).
How Understaffing Endangers Residents
| Harm | Why It Happens When Staff Are Thin | Key Data Point |
| Falls & Broken Bones | Fewer aides mean delayed toileting assistance and unsupervised transfers. | Facilities in the lowest staffing quintile had 40% more hip fractures than the best-staffed homes (JAMA Network, 2021). |
| Pressure Ulcers | Bed- or chair-bound residents aren’t turned every two hours. | Each additional CNA hour per resident-day cuts pressure ulcer odds by 10% (Characteristics of United States nursing homes with high percentages of stage 2–4 pressure injuries among high-risk nursing home residents with obesity). |
| Infections | Overworked staff skip hand-washing and PPE changes. | Between 2013 and 2017, 82% of all homes received infection-control citations, and repeat offenders were more likely to be understaffed (GAO-20-576R). |
| Malnutrition & Dehydration | Meal assistance is rushed or skipped. | On average, residents in understaffed homes lost 4–6 lbs more per quarter (AARP Public Policy Institute). |
| Chemical or Physical Restraints | Staff use sedatives or restraints to “manage” too many residents. | Homes below 3.5 nursing hours per resident-day had double the antipsychotic use rate (HHS-OIG, 2022). |
Warning Signs Your Loved One’s Facility Is Short-Staffed
- Call lights ring for 15 + minutes before anyone responds
- Residents look unkempt—soiled linens, unchanged clothes, unbrushed hair
- Staff appear rushed, skipping friendly conversation or ignoring questions
- Repeated use of agency (temp) nurses who don’t know residents’ names
- Sudden drop-off in activities, physical therapy sessions, or communal dining
What Federal Investigators Say About Staffing and COVID-19
During the first pandemic year, nursing homes with the lowest registered-nurse (RN) hours recorded nearly twice the COVID-19 death rate of better-staffed facilities (HHS-OIG, 2024). The crisis made one fact unmistakable: staffing levels are a life-or-death variable, not a budget line item.
Steps to Take if You Suspect Dangerous Understaffing
- Document Delays and Conditions. Date-stamped photos, call-light wait times, and written incident logs create a clear record.
- Request the Daily Staffing Sheet. Federal law gives you the right to inspect those numbers.
- Report to State Authorities. Call the ADSD Elder Rights Intake Unit at 702-486-6930 (Clark County) or 888-729-0571 statewide (Report Abuse).
- Consult an Experienced Trial Lawyer. Subpoenaed PBJ data, payroll records, and sworn staff testimony often reveal staffing cuts hidden from families.
How Cogburn Davidson Holds Understaffed Homes Accountable
Understaffing isn’t just poor management—it’s a direct pipeline to falls, infections, and wrongful deaths. Armed with credible documentation and experienced legal counsel, you can stop the cycle and secure full accountability.
Cogburn Davidson Car Accident & Personal Injury Lawyers stands ready with the expertise, authority, and relentless advocacy that Nevada families deserve.
Our firm deploys forensic nurses, staffing experts, and data analysts to prove exactly how many caregivers were on the floor—and how many should have been when your loved one was injured. We’ve turned those findings into life-changing verdicts and settlements across Nevada.
We’re here to help. Contact us today to book your case evaluation and learn more about your legal options.