Nursing Home Laws & Staff to Resident Ratio

Updated July 19, 2017

When considering a nursing home, know that all nursing homes are subject to federal and state laws yet they all have their own policies and procedures. All regulations try to ensure the quality of care for its residents and many new rules try to make the facility as "homelike" as possible. Guidelines also include a facility's staff to resident ratio. Federal and state laws recognise the importance of establishing the number of patients per staff member within a nursing home setting.

Before visiting a nursing home facility, investigate all federal and state laws regarding nursing homes, like what minimum condition can a patient be in to live in the facility or where a patient can live alone or must live with a roommate. Be aware that these laws may vary from state to state. The Department of Health and Human Services division, CMS Centers for Medicale and Medicaid Services, lists all federal and state regulations relating to nursing homes as well as Nursing Home Abuse and Neglect Resource Center.

Meet with the director of the nursing home when trying to decide on a nursing home for you or a loved one. Ask for a list of their regulations, walk the grounds, and try to talk with some of the staff and residents.

Visit the facility more than once and never at the same time of day. Note if a staff member was working in the more and the evening, the facility my be short-staffed and employees may be pulling double shifts. Inquire about on-call doctors, available special therapists, or visits to your personal doctor.

Study their polices and bring your powers of observation on your visits. Notice the cleanliness of rooms, the odours, and look for situations like a patient being left unattended in a hallway for more than 30 minutes when a policy states no resident will be left unattended longer than 20 minutes.

Inquire about staff to patient ratio, including available staff on weekends. Most state regulations offer a minimum number of staff per patient, but make sure you inquire as to the number of staff per shift since this number may vary. There may not always been a sufficient number of staff members to properly care for all residents' needs.


Use your instinct to find a facility that is not only comfortable for you or your loved one but provides an environment that is safe, patient's are well-cared for, the staff will treat a person with dignity, and the facility will provide stimulating activities.


Neglect and abuse happen in nursing homes. Report any suspected neglect or abuse immediately to the director of the facility.

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