Recent Study Confirms the Link between Understaffing and Falls

A new study that was published in the May 2012 edition of the Journal of the American Geriatrics Society was the first national study to assess fall rates among newly-admitted nursing home residents. Researchers for the study, which was spearheaded by University of Southern California gerontology and occupational science researcher Natalie Leland, evaluated data from over 230,000 first time nursing home residents in the year 2006. This data was obtained when patients who had stayed at the nursing home facility for at least thirty days completed a minimum data set (MDS). A MDS is a federal prescribed clinical evaluation of all residents in a certified nursing home that serves to assess each patient’s health needs and functionalities.

The data shows that approximately 21% of the patients studied (over 47,000 patients) experienced one or more falls within the first thirty days after admission to a nursing home. The study also identified characteristics of nursing homes that reported fewer incidents of falls suffered by newly-admitted residents. Most important to a lower fall incidence was a higher ratio of certified nursing assistants to residents. Most first-time nursing home residents are faced with unfamiliar surroundings and people. The constant presence of attentive staff is vital to residents adjusting to their new life and ensuring their safety. Qualified staff are needed to accompany new residents around the facility, orient residents with important procedures (such as use of call buttons), and to take notice of the residents’ former and current health issues.

Even with this study confirming the obvious – that higher staff-to-patient ratios reduce the incidence of falls – it is an unfortunate fact that many nursing homes continue to operate chronically understaffed to the detriment of the welfare of its residents. A properly staffed nursing facility is not just essential for the transitioning of newly admitted residents. Existing long-term residents also need the staff’s attention in monitoring changes in their conditions and assisting with basic activities of life.

To have an understaffed facility is to have distracted and overwhelmed workers which could lead to careless acts or omissions. Staff will most likely struggle to attend to the unique needs of all its residents, and therefore puts them all at risk of suffering not only preventable injuries like falls, but also preventable ailments such as pressure ulcers and infections. Furthermore, understaffing creates potential situations where staff may choose convenience over what is right for the resident.

Adequate staffing levels are so important to the well-being of elderly residents in nursing homes that specific ratios are codified into the California Health and Safety Code as a resident’s enforceable right. The California Health and Safety Code section 1430(b) provides strong statutory authorization for a plaintiff to seek civil relief from nursing home facilities if this or any other rights within its provisions are violated.


If you believe that you or a family member has suffered a preventable fall or any other injury because of inadequate attention from staff at a nursing facility, please contact us for a free consultation. The experts at the Law Offices of Ben Yeroushalmi are committed to helping nursing home residents and their families seek justice in neglect and abuse cases.