blog home Nursing Home Abuse What Are the Legal Requirements for Nursing Home Staffing in Omaha, Nebraska?

What Are the Legal Requirements for Nursing Home Staffing in Omaha, Nebraska?

By Jason Bottlinger on June 7, 2025

Caring for our elders is one of society’s most important responsibilities. When families entrust loved ones to a nursing home, they expect safe, competent, and compassionate care. But that level of care is only possible when nursing facilities are properly staffed.

In Omaha, nursing home staffing requirements are guided by a mix of federal and state laws. Knowing these rules and how they impact care standards can help families make informed decisions while protecting the rights of the residents when problems arise.

The Federal Baseline: Minimum Staffing Requirements

Before diving into Omaha nursing home laws, it’s important to understand the federal baseline for staffing. The Centers for Medicare & Medicaid Services (CMS) mandates that every nursing home participating in Medicare or Medicaid must provide:

• Licensed nursing services 24 hours per day
• A registered nurse (RN) on duty for at least 8 consecutive hours, 7 days a week

These minimal standards are outlined in the Code of Federal Regulations (42 CFR § 483.35).

CMS also requires facilities to have “sufficient staff” to meet residents’ needs. However, “sufficient staff” is a frustratingly vague phrase. This is where state regulations come in.

Nebraska’s Nursing Home Staff Regulations

Nebraska law adds more structure to these minimum requirements. According to the Nebraska Department of Health and Human Services (DHHS), all nursing homes in the state must:

• Employ enough staff to meet each resident’s physical, mental, and psychosocial needs
• Have a licensed nursing director (typically an RN)
• Ensure daily staffing logs are maintained and available for inspection

For skilled nursing facilities in Omaha, Nebraska’s Administrative Code (Title 175, Chapter 12) specifies more detailed staff-to-resident ratios, particularly during daytime and nighttime hours. Unfortunately, the law still falls short of prescribing a fixed ratio (e.g., one nurse per 10 residents), opting instead for flexibility based on the facility’s census and resident awareness levels.

Facilities must conduct comprehensive assessments of each resident and ensure care plans are properly implemented—which directly ties back to having enough qualified staff on hand.

Staffing Levels and Care Quality

The phrase “legal standards for care” isn’t just about having warm bodies in the room—it’s about ensuring that staff can safely, effectively, and humanely care for residents.

Despite state and federal regulations, elder care staffing issues remain a chronic problem in many Omaha facilities. Reports from state inspections, CMS audits, and family testimonials repeatedly show that short-staffing is one of the leading causes of poor care outcomes.

In practice, understaffing in nursing homes leads to a cascade of issues:

• Delayed response to emergencies
• Increased risks of falls, pressure ulcers, and infections
• Neglect in feeding, hygiene, and mobility assistance
• Emotional and psychological harm due to isolation or mistreatment

Recent Legislative Changes and Reform Efforts

The COVID-19 pandemic exposed deep cracks in the long-term care industry, prompting renewed calls for reform across the country. Nebraska has not been immune to these pressures. In recent years, the state has taken steps to:

• Increase wage support and training funds for certified nursing assistants (CNAs) and other long-term care workers
• Streamline the licensing process to attract more out-of-state healthcare workers
• Enhance transparency requirements, forcing facilities to disclose staffing levels to the public

However, critics argue that these changes don’t go far enough. As a result, advocacy groups continue to push for fixed minimum staffing ratios, more aggressive enforcement of violations, and criminal penalties in extreme cases of neglect or abuse.

Red Flags to Consider

If you’re evaluating a facility or currently have a loved one in a nursing home, keep an eye out for signs that staffing levels may be inadequate:

• Call lights that go unanswered for extended periods
• Staff who appear rushed, exhausted, or inattentive
• Residents showing signs of malnutrition, dehydration, or poor hygiene
• Frequent transfers to emergency departments
• Low CMS staffing ratings on Medicare’s Nursing Home Compare tool

Omaha residents can also file complaints with Nebraska’s Long-Term Care Ombudsman Program, which investigates issues related to resident rights, safety, and staffing concerns.

Legal Recourse for Understaffing

When a nursing home fails to meet its legal duties, families may have grounds to take legal action. This could include:

• Filing a formal complaint with DHHS or CMS
• Pursuing civil litigation for negligence, abuse, or wrongful death
• Seeking damages for medical costs, pain and suffering, and emotional distress

Omaha lawyers who have experience handling nursing home neglect cases can help determine whether a facility violated nursing home staff regulations or failed to meet Nebraska’s legal standards for care.

Key factors in these cases often include:

• Staffing schedules and payroll records
• Witness statements from residents and staff
• Medical documentation of injuries or neglect
• Prior inspection reports and citations

Advocacy and the Path Forward

The reality is that no amount of fancy decor or marketing can make up for insufficient staffing in nursing homes. Sadly, elder care in Omaha and across Nebraska will continue to suffer until nursing homes are required to meet concrete, enforceable staffing benchmarks.

The good news is that change is possible—but it often starts with informed families, whistleblowing staff, and relentless advocates who demand better. So if you suspect that a nursing home in Omaha isn’t meeting staffing requirements, don’t stay silent. Ask questions. Request records. File reports. And seek legal advice.

Nursing home staffing requirements in Omaha aren’t just about checking regulatory boxes. They’re about dignity, safety, and quality of life for the people who raised us, taught us, and loved us.

Talk to an Omaha Nursing Home Injury Attorney Today

At Bottlinger Law L.L.C., we treat all our clients with respect and compassion—that’s why we have a perfect A+ rating from the Better Business Bureau. Lead attorney Jason Bottlinger belongs to the exclusive Multi-Million Dollar Advocates Forum but will always have time for clients.

Call (402) 505-8234 to schedule a FREE consultation with an Omaha nursing home abuse lawyer today with Bottlinger Law L.L.C. We can keep you informed about how your case is progressing from start to finish!