What Are the Staff Requirements in a Nevada Nursing Home?

Nursing homes need to ensure that they have an adequate number of staff members with the appropriate qualifications and training to provide quality care to residents. Failure to meet staffing requirements can result in penalties, fines, or even the loss of license for the facility. Therefore, nursing homes in Nevada must carefully adhere to state regulations regarding staffing to ensure the safety and well-being of residents.

With more than eight in every 10 nursing homes facing staffing shortages, this means many residents at understaffed nursing homes are not getting the standard of care they deserve. What is Nevada doing to protect this most vulnerable part of the population?

Nevada requirements for nursing home staffing

Here in Nevada, staffing requirements for nursing homes are as follows. Staff can include a mix of physicians, licensed nurses (LNs), registered nurses (RNs), and certified nursing assistants (CNAs).

• One administrator, who provides “oversight and direction” for facility staff. “Administrators must be licensed by the Nevada State Board of Examiners for Administrators of Facilities for Long Term Care and must designate one or more employees to be in charge of the facility during those times when the administrator is absent. Caregivers provide personal care services and may assist with medication services after completing required training.”
• For facilities licensed for 20 to 49 residents, one staff member designated to “organize, conduct, and evaluate activities.” For facilities with 50 or more residents, there must be one full-time person to assist with activities. Volunteers may be used, but they may not replace staff members.
• There are no minimum staff ratios for CNAs in nursing homes in Nevada. Instead, “Facilities must maintain staffing patterns that are sufficient to meet residents’ care needs and enable them to achieve and maintain their functioning, self-care, and independence. There must be at least one caregiver on the premises of the facility if one or more residents are present at the facility. Facilities with more than 20 residents must ensure that at least one employee is awake and on duty at all times. An additional employee must be available to provide care within 10 minutes after being informed that his or her services are needed.”

In terms of nursing staff, Nevada nursing homes must have one full-time Director of Nursing (DON) with one registered nurse alternate when the regular DON is absent. Facilities should add one assistant DON if they have more than 150 beds. One RN should be on duty during all day shifts and one RN on duty or on call during all evening and night shifts. For facilities with more than 150 beds, one RN should be available 24 hours a day, seven days a week.

Facilities should also have:

• A medical director
• Physicians
• Nursing staff
• Nursing assistants and assistant trainees
• Other healthcare professionals

Facilities should employ these as necessary to provide adequate care for all residents in a facility.

Federal requirements for nursing home staffing

Nursing homes that receive Medicare and Medicaid (which is nearly all of them) must also meet federal staffing requirements. Nursing homes must employ an RN for at least eight hours a day, seven days a week.

Per federal regulations:

The facility must have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care and considering the number, acuity and diagnoses of the facility’s resident population in accordance with the facility assessment required at § 483.70(e).

As you can see, the federal government does not require facilities to have a certain number of certified nursing assistants on staff – they simply must provide “sufficient nursing staff.”

Understaffing in nursing homes can lead to neglect

Understaffing can lead to serious consequences for patients in Nevada nursing homes.

• Insufficient attention to residents: When nursing homes are understaffed, caregivers may not have enough time to provide adequate attention and care to each resident. This can result in residents not receiving timely assistance with activities of daily living, such as bathing, toileting, or eating.
• Medication errors: Understaffing can contribute to medication errors due to rushed administration or lack of oversight. Residents may receive incorrect dosages or medications at the wrong times, leading to adverse effects or worsening health conditions.
• Delayed response to emergencies: In cases of emergencies or medical crises, understaffing can lead to delayed responses. If there aren’t enough caregivers available to attend to residents promptly, critical situations may not be addressed in a timely manner, potentially leading to complications or fatalities.
• Inadequate supervision: Understaffing may result in inadequate supervision of residents, particularly those who are at risk of falls, wandering, or exhibiting challenging behaviors. Without proper monitoring, residents may be more susceptible to accidents, injuries, or neglectful treatment by other residents or staff members.
• Decreased quality of care: Understaffing can compromise the quality of care provided in nursing homes. Caregivers may feel overwhelmed by their workload, leading to burnout, stress, and decreased job satisfaction. As a result, they may be less attentive, compassionate, or thorough in their interactions with residents.
• Neglect of basic needs: Understaffing may also result in neglect of residents’ basic needs, such as hydration, nutrition, and hygiene. If caregivers are stretched thin, they may prioritize tasks based on urgency, potentially overlooking essential aspects of care.
• Increased risk of abuse: Understaffing can create an environment where abusive behaviors are more likely to occur. In settings where there is a lack of supervision and accountability, staff members may feel emboldened to mistreat or neglect residents without fear of consequences.

The World Health Organization (WHO) reports that “abuse of older people is an important public health problem.” They also state that one in six people aged 60 years and older were subjected to some kind of abuse in the past year. Worse, 64.2% of nursing home staff reported perpetrating some type of abuse over the past year.

Nursing home abuse and neglect is never okay. If you or a loved one have experienced abuse or neglect in a Nevada nursing home, talk to the attorneys at Claggett & Sykes right away. We know how to help. We have an excellent track record in achieving results for our clients, and we can help your family, too. To schedule a free consultation, call us or use our contact form. We have offices in both Las Vegas and Reno to better serve our clients.