How Holiday Scheduling and Staffing Shortages Lead to Nursing Home Neglect

Holiday periods such as Thanksgiving, Christmas, and New Year’s consistently strain nursing homes that already struggle with chronic staffing shortages. When facilities operate with too few nurses or certified nursing assistants (CNAs), or rely heavily on temporary agency staff who are unfamiliar with residents, the quality of care can quickly deteriorate. Missed medications, delayed assistance, preventable falls, untreated pressure sores, and lapses in feeding or hydration are all far more likely when staffing levels are inadequate. These failures are not minor oversights, under the law, they may constitute nursing home negligence when they cause avoidable harm.

In this blog, we examine why holiday periods are especially dangerous for nursing home residents, outline data showing the extent of staffing shortages nationwide, and provide guidance for families who suspect neglect of their loved one in a nursing home.

“Residents deserve safe and consistent care every day of the year. Holidays are no excuse for cutting corners. When poor staffing or rushed scheduling leads to preventable injuries, our firm takes action to uncover the truth and hold negligent facilities accountable.” — John J. Malm, Naperville nursing home injury attorney

Why Holiday Periods Increase the Risk of Nursing Home Neglect

During holidays, multiple operational and staffing issues converge and increase resident risk:

• Increased time-off requests and absenteeism: Staff members often request vacation days to travel or spend time with family.
• Reduced shift overlap and thinner coverage: Nursing homes frequently “stretch” schedules to maintain minimum presence on the floor.
• Heavy reliance on temporary agency workers: Agency CNAs and nurses may be unfamiliar with individual care plans, mobility restrictions, or medication routines.
• Lower clinical oversight: Registered nurses (RNs) may be scheduled less frequently during holiday weekends or overnight hours.

These vulnerabilities translate directly into missed tasks that are critical to resident health and safety: timely medication administration, repositioning to prevent pressure ulcers, monitoring fluid intake, assistance with toileting, and proper supervision to prevent falls.

Statistics on Structural Staffing Shortages

Staffing shortages in long-term care facilities are not limited to holidays; they are systemic nationwide. Recent data underscores the severity of the problem:

• The Centers for Medicare & Medicaid Services (CMS) has established a proposed minimum staffing standard of 3.48 hours per resident per day (HPRD), including at least 0.55 HPRD from an RN. Many facilities fail to meet these requirements.
• Studies show CNA turnover rates approaching 100% annually, illustrating the instability of the workforce and the difficulty facilities have in maintaining continuity of care.
• Industry-wide surveys indicate that over 90% of nursing homes report staffing shortages, with one recent survey noting 94% of facilities struggling to hire and retain adequate staff.
• Analyses suggest that fewer than 20% of nursing homes could meet current federal minimum standards without hiring additional staff.

These numbers highlight the gap between regulatory expectations and the actual capacity of many facilities, especially during peak holiday periods when staffing pressures intensify.

How Staffing Shortages Cause Neglect

Below are the specific ways inadequate staffing leads directly to injuries and medical complications:

• Medication errors: Nurses rushing through high caseloads may miss dosages, double-dose residents, or deliver medications to the wrong person.
• Dehydration and malnutrition: Residents who need assistance eating or drinking may be left unattended during meals or receive inadequate monitoring.
• Pressure ulcer development and worsening: Turning, repositioning, and skin checks require time; short staffing leads to missed preventive care.
• Falls and delayed responses to injuries: Reduced supervision means residents may attempt to walk independently, and response times after a fall are slower.
• Missed monitoring of chronic conditions: Vital signs checks, blood sugar monitoring, and assessments of mental status may occur less frequently.
• Errors caused by unfamiliar agency workers: Staff who do not know residents may misunderstand mobility limitations, transfer techniques, or safety precautions.

Each of these failures can be documented through medical records, staffing logs, and witness accounts and may constitute negligence when they result in preventable harm.

Practices That Worsen Conditions During Holidays

Certain operational choices create an even greater risk of resident injury during holiday seasons:

• Flexible or “on-call” scheduling rather than fixed shifts, creating unpredictable gaps in coverage.
• Reassigning staff between units, stretching them thin across specialized care needs.
• Overuse of agency workers without proper orientation or oversight.
• Cutting “nonessential” activities, which reduces supervision and social interaction that help detect medical issues early.

Together, these practices compromise the facility’s ability to maintain safe and consistent care.

What Nursing Homes Should Do to Minimize Holiday Risks

To perform safely during holidays and weekends, nursing homes should implement best-practice staffing strategies:

• Plan holiday schedules months in advance, including incentives for staff to work key shifts.
• Maintain an internal float team of trained employees familiar with the facility and residents.
• Provide expedited orientation checklists for agency workers.
• Ensure sufficient RN presence during evenings, nights, and holiday weekends.
• Conduct medication audits and fall-prevention rounds during high-risk periods.
• Adjust staffing using actual acuity data, not minimal regulatory thresholds.

Failure to take reasonable steps to maintain adequate staffing may support a legal claim when residents suffer harm.

Warning Signs of Holiday-Related Nursing Home Neglect

Families visiting loved ones during the holidays should watch for:

• Sudden weight loss or signs of dehydration
• Unexplained bruises or injuries
• New or worsening pressure sores
• Long delays in responding to call lights
• Confusion, lethargy, or changes in mental state
• Staff expressing they are “too busy” to provide routine care
• Medication errors, inconsistent dosing, or unexplained changes in prescriptions

If you observe these signs, document what you see, speak with supervisors, and consult an experienced Illinois nursing home negligence attorney if the resident suffered an injury.

Frequently Asked Questions About Holiday Staffing Shortages and Nursing Home Neglect

Q: Do holiday staffing shortages automatically mean the nursing home was negligent?
A: No. However, if the facility fails to meet the standard of reasonable care, such as missing medications, failing to supervise residents, or neglecting basic needs, staffing shortages may form the basis of a negligence claim.

Q: What should families document if they suspect holiday-related neglect?
A: Take note of dates, times, visible injuries, staff statements, delays in care, and any deviations from standard routines. Photos and written logs are extremely helpful.

Q: Can families ask about holiday staffing and agency worker usage?
A: Yes. Families have the right to request information about staffing levels, care plans, and the qualifications of personnel providing care.

Q: Does the general staffing shortage excuse poor care?
A: No. Even during nationwide shortages, nursing homes are legally required to provide adequate staffing and safe care. Failure to do so may result in liability.

Contact the Award-Winning Illinois Nursing Home Neglect Lawyers at John J. Malm & Associates

Holiday staffing shortages should never jeopardize the safety, dignity, or well-being of nursing home residents. Unfortunately, many facilities fail to plan adequately for holiday absences, rely too heavily on temporary staff, or operate with dangerously low staffing levels that put vulnerable residents at risk. If your loved one suffered dehydration, malnutrition, falls, infections, pressure sores, or other avoidable injuries during a holiday period, these may be signs of serious neglect.

At John J. Malm & Associates, our attorneys have extensive experience investigating nursing home negligence cases, analyzing staffing records, and uncovering the systemic failures that lead to resident injuries. We know how to hold facilities accountable and pursue the compensation your family deserves.

Contact us today for a free consultation. We are ready to listen, review the facts, and help protect your loved one’s rights.