When families ask why their loved one was hurt, the honest answer is usually that there were not enough people on the floor to keep them safe. Understaffing is the root cause behind most falls, pressure injuries, dehydration, and missed medications, because a resident who needs help getting to the bathroom, turning in bed, or eating cannot get it if the staff are stretched across too many residents. Florida law sets a floor for how much care a facility must provide, and knowing that floor is the first step in seeing whether a facility fell below it.
Staffing is where these cases are often won, because a facility’s own records show what it actually staffed, day by day, against what the law and the residents required, and having worked the defense side of these cases I know how to read those records against the standard. I know how a facility and its insurer will explain a thin shift, and where that explanation stops holding up. I represent families, not facilities, and I am a trial lawyer who came up as a public defender, tried numerous cases, and cross-examined witnesses constantly. I am willing to put your case in front of a jury, which is often what moves a facility’s insurer to pay fair value, and I handle it personally from the first call through trial. Learn more about my background.
Section 400.23 sets the floor. A facility’s own staffing records show what it actually staffed, day by day, against what the law and the residents required.
What Florida requires today
Under section 400.23 of the Florida Statutes, a nursing home must provide a weekly average of 3.6 hours of direct care per resident per day. Within that total, at least 2.0 hours must come from a certified nursing assistant and at least 1.0 hour must come from a licensed nurse, meaning a registered nurse or a licensed practical nurse. The law also sets hard ratios: a facility may not staff below one certified nursing assistant for every 20 residents, or below one licensed nurse for every 40 residents. Those are minimums, not targets, and a facility caring for sicker residents needs more than the floor.
The change many folks have not caught up to
Here is what many families, and even many websites, get wrong. In 2022 Florida lowered its own standard. The required certified nursing assistant hours dropped from 2.5 to 2.0 per resident per day, and the law began allowing certain non-nursing direct care staff, such as therapeutic and dietary and mental health personnel, to count toward part of the 3.6-hour total. The licensed nurse minimum and the overall 3.6 stayed, but the mix changed. In plain terms, the total hours a facility posts can now include people who are not nurses or nursing assistants at all, so the number alone can overstate how much hands-on nursing care a resident actually received. That distinction matters, and it is one the stale pages still get wrong.
How the numbers become evidence
Florida does not just set the standard, it makes facilities prove they met it. A facility has to post the names of the licensed nurses and certified nursing assistants on duty each day, keep its staffing records for five years, and report staffing data to the federal government. That paper trail is the heart of an understaffing case. Set the required hours against the hours the facility actually worked during the period the resident was hurt, and the gap, if there is one, is right there in the facility’s own documents. Payroll-based staffing data published for each facility gives an independent check on what was really delivered rather than what was promised.
When a facility cannot staff safely
The law has a backstop for facilities that fall short. A nursing home that fails to meet the minimum staffing standard for a set period is barred from admitting new residents until it catches up. A facility that kept taking in residents it could not safely staff, or that ran below the floor while a resident in its care declined, has a problem that goes to the center of a case. Repeated staffing failures are not a paperwork issue. They are the reason people get hurt, and they are usually documented.
Common Questions
What is the minimum staffing a Florida nursing home must provide?
Florida law sets a weekly average of 3.6 hours of direct care per resident per day, which must include at least 2.0 hours from a certified nursing assistant and 1.0 hour from a licensed nurse. A facility may not fall below one CNA for every 20 residents or one licensed nurse for every 40 residents.
Did Florida lower its nursing home staffing requirements?
Yes. In 2022 the state reduced the required CNA hours from 2.5 to 2.0 per resident per day and began allowing certain non-nursing direct care staff to count toward part of the 3.6-hour total. That means the posted total can include people who are not nurses or nursing assistants, which is worth understanding when you look at a facility’s numbers.
How do I find out what a facility actually staffed?
Facilities have to post their nursing staff on duty each day and keep staffing records for five years, and they report staffing data to the federal government. Those records, along with the payroll-based data published for each facility, show the real hours delivered rather than the promise, and they are often where an understaffing case is proven.
Is understaffing itself a case?
Understaffing is usually the cause behind the case rather than the case itself. When a facility runs below what its residents needed and a resident is hurt by a fall, a pressure injury, dehydration, or a missed medication as a result, the staffing records tie the injury to the shortfall.
What happens if a facility cannot meet the minimum?
Florida law bars a facility from admitting new residents while it is failing to meet the minimum staffing standard for a set period. A facility that kept admitting residents it could not safely staff has a serious problem, and that history can matter a great deal in a case.
Related: Nursing home abuse and neglect, How these cases are proven, Falls in a nursing home, Bedsores and pressure injuries.
This page is general information about Florida law, not legal advice, and it does not create an attorney-client relationship. Florida’s nursing home minimum staffing standards appear in section 400.23 of the Florida Statutes, as amended in 2022, and the nursing home cause of action appears in sections 400.022 and 400.023. Staffing standards can change, so current figures should be confirmed against the statute. Every case is different, and past results do not guarantee a similar outcome. The hiring of a lawyer is an important decision that should not be based solely on advertisements.
