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Nursing Home Staffing Ratios and Abuse Risk

Published on Feb 4, 2026 at 4:55 pm in Nursing Home Abuse.

Nursing homes are regulated by state and federal agencies. The West Virginia Department of Health Facilities (WV DHHR) and the Office of Health Facility Licensure and Certification (OHFLAC) are charged with enforcing state licensure rules. These agencies also align with rules set forth by the federal Centers for Medicare and Medicaid Services.

One of the most important standards that these agencies put in place is for staffing ratios. Those ratios can have a direct impact on the risk of abuse for nursing home residents.

The WV DHHR sets the standard for the state’s 128 nursing homes. The rules stipulate that there must be 2.25 hours of nursing personnel time per resident each day. However, over the past few years, the CMS mandated 3.48 hours of nursing care per resident.

Obviously, the more time devoted to residents, the better their outcomes. Unfortunately, with the recent federal budget, CMS repealed its mandates, leaving each state to set staffing standards. This is where inadequate staffing can endanger residents in nursing homes.

What Are the Common Causes of Understaffing?

Understaffing means too few staff to meet residents’ needs. When you toured the nursing home for your loved one, staff numbers were probably discussed. However, those figures can change due to new budget constraints.

There can also be problems with employee turnover. As with other healthcare workers, nursing home staff can often experience burnout, leading them to quit. What compounds understaffing is that newly hired staff are often brought in without proper training. That can lead to gaps in resident care.

How Are Residents Impacted?

Understaffing can severely compromise patient care. This leads to many forms of potential neglect.

This is how residents can be impacted:

Health Risks

One of the most critical ways that understaffing impacts a resident is on their health. The vast majority of nursing home residents deal with some type of health challenge that requires consistent medication. In some situations, a nursing home resident could develop a cold or the flu, which could lead to further complications. If there aren’t enough staff to respond to these care needs, the resident’s health can be jeopardized. These shortages can also delay response times during medical emergencies, leading to fatalities.

Poor Hygiene

Without the right number of staff on hand, personal hygiene and sanitation needs fall by the wayside. This can lead to harmful infections and a diminished quality of life.

Nutritional Deficiencies

Not all residents can make their way to a nursing home’s dining facility. Some need assistance getting to the service or having their meals brought to them. When there are staff shortages and not enough staff to provide meals, residents may suffer from malnutrition or dehydration.

Where to Report Nursing Home Abuse in Charleston

Your loved one will always appreciate a visit to their nursing home. This is the best time to check in and see how they are doing. It is also a good opportunity for you to see the staff in action.

Do they feel stressed? Are they responding to a resident’s needs?

It might be smart to plan your next visit around mealtime so that you can get the full picture of how the facility operates.

No one wants to think of their loved one being abused, but if it happens, it is vital that you report your concerns immediately. You should first raise the matter with the nursing home’s management.

There might be a reason why a bathroom wasn’t cleaned, or your loved one hasn’t had a change of bedding. A one-time incident is understandable, but when it becomes a repeated pattern, that is cause for concern.

Outside the nursing home, you can also report what you witness to OHFLAC. Your complaint will generate a file and require an immediate response. That can mean an inspection and intervention.

If you’re not satisfied with how your complaint is handled, you can speak with one of the Charleston nursing home abuse attorneys at DiPiero Simmons McGinley & Bastress, PLLC. We have assisted many families with concerns about nursing homes. We are proud to take on the role of advocate to help cut through the red tape and ensure that the needs of their loved ones are being met.

If you have concerns about a nursing home and the level of care your loved one is receiving, let’s talk.

Call to schedule a free and confidential consultation today.