How Do You Report Suspected Understaffing in a Nursing Home?

How Do You Report Suspected Understaffing in a Nursing Home?If you suspect your loved one’s nursing home is understaffed, you’re probably not alone. But how do you report your concerns?

Nursing home residents have a variety of rights, and one of those rights includes the right to have equal access to quality care. You also have the right to be free of any adverse actions if you exercise your rights. When a nursing home is understaffed, residents can quickly suffer the consequences. Understaffing can lead to abuse and neglect, some of the biggest problems facing seniors in nursing homes.

Signs of understaffing in nursing homes

Nursing homes can be understaffed to the point that they can’t provide quality care. Some signs of understaffing include:

  • High staff turnover
  • Less staff on weekends
  • A “skeleton crew” at night
  • Call bells and lights taking a long time to be answered
  • Patients left in their beds late into the morning
  • Patients awakened and dressed early against their preference
  • Patients not being regularly turned and repositioned
  • Food trays left uneaten
  • Lack of fresh water

Understaffing can be caused by cost, a lack of education, or a lack of qualified staff. Overworked and exhausted staff may be more prone to medication errors, and understaffed nurses may not be able to check on patients frequently. There is no excuse for chronic understaffing in a nursing home.

Reporting suspected understaffing

First, if someone is injured, call 9-1-1 or get them immediate medical attention. Second, document your suspicions. Include the date, time, and descriptions of incidents. Third, initially, you should talk to the nursing home administration about your concerns. Sometimes issues can be resolved through dialogue. However, if this doesn’t work, you should file a grievance. Medicare states that every nursing home (also called a skilled nursing facility) must have a formal grievance process. They also must post the name, address, and phone numbers of state groups, including:

  • State Survey Agency
  • State Licensure Office
  • State Ombudsman Program
  • Protection and Advocacy Network
  • Medicaid Fraud Control Unit

The Centers for Medicare & Medicaid Services (CMS) is responsible for overseeing nursing homes. On September 1, 2023, CMS proposed a rule that would establish minimum staffing standards for long-term care facilities. The rule would include national minimum nurse staffing standards, a 24/7 RN requirement, and an enhanced facility assessment requirement.

Federal resources for reporting nursing home understaffing

The Long Term Care Community Coalition lists the following email addresses across the nation to file a complaint directly with the regional office of the federal Centers for Medicare and Medicaid Services:

  • Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee.
  • Arkansas, Louisiana, New Mexico, Oklahoma, and Texas.
  • Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia, New York, New Jersey, Puerto Rico, Virgin Islands, Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont.
  • Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
  • Iowa, Kansas, Missouri, Nebraska
  • Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming
  • Alaska, Idaho, Oregon, Washington, Arizona, California, Hawaii, Nevada, and the Pacific Territories

State-specific resources

Here are state-specific resources for reporting nursing home overstaffing and neglect.


In California, you can file a complaint with the California Department of Public Health (CDPH) Licensing and Certification Division about nursing home understaffing. You can file a complaint by:

You can also contact the Long Term Care Ombudsman in your county. You can reach the California Ombudsman crisis center at 1-800-231-4024.


You can report nursing home understaffing and neglect in Louisiana by calling the Louisiana Department of Health’s (LDH) Health Standards Section (HSS) Nursing Home Abuse Hotline at (888) 810-1819. You can also file a complaint online. When reporting abuse, you should include as much information as possible.

You can also find contact information for the Long Term Care Ombudsman in your region or parish on this page. If calling from outside the state of Louisiana, use this phone number: (866) 632-0922.


In Arizona, you can contact the Arizona Department of Economic Security (Adult Protective Services) at (877) SOS-ADULT or (877) 767-2385. You can fill out an online complaint here.

You can file an online complaint with the Arizona Department of Health Services. You can also contact them directly at 1-602-364-2536.

You can also reach out to the Arizona Long-Term Care Ombudsman Program. Find the number for your county and region here.


The Florida Department of Health does not accept complaints over the phone, so you will need to fill out their online form.

You can also register a complaint with the Florida Agency for Health Care Administration here. You can file over the phone at 1-888-419-3456.

You can find the Florida Long-Term Care Ombudsman at:

  • Call: 1-888-831-0404 (toll-free) or 1-850-414-2323
  • Fax: 1-850-414-2377
  • Write: 4040 Esplanade Way Tallahassee, FL 32399-7000

You may also call the Elder Helpline at 1-800-963-5337.

After you make a report, the appropriate regulatory facility will step in and investigate. Again, if your loved one is in immediate danger or having a medical emergency, call 9-1-1 right away.

With over 30 years of experience, the nursing home abuse and neglect attorneys at Garcia & Artigliere are here to help. If your elderly loved one suffered injuries or losses due to nursing home understaffing, our lawyers can launch an investigation and work to secure the compensation to which they’re entitled. When you’re ready to discuss your case, fill out our contact form or call our office to arrange a free, no-obligation case review today. We have offices in PhoenixLong BeachLos AngelesLouisville, and New Orleans.