Florida Nursing Home Staffing Requirements

Q: What counts as “direct care” under Florida’s staffing laws?

Direct care staff are those who provide hands-on or care-management services, including licensed nurses, CNAs, therapists, activities staff, and mental health workers. Administrative tasks such as nursing administration, staff development, or documentation do not count toward direct care hours.

Q: Are nursing home facilities required to publicly display their staffing levels?

Yes. Florida law requires nursing homes to post daily the names of licensed nurses and CNAs on duty. Facilities must also keep staffing records for at least five years and report them per federal regulation 42 C.F.R. §483.70(q).

Q: Can licensed nurses be counted in place of CNAs in Florida?

Yes, but only if the licensed nurse performs only CNA duties for the entire shift. Their hours can then count toward CNA hours, but cannot be double-counted for both nurse and CNA minimums.

Q: Do feeding assistants count toward the minimum staffing hours?

No. Florida law prohibits counting paid feeding assistants or other non-nursing personnel who help residents eat toward the 3.6, 2.5, or 1.0 required direct care hours.

Understaffed Nursing Homes in Florida

Choosing a nursing home for your loved one is a deeply emotional decision, often driven by serious concerns about safety, dignity, and quality of care. One of the most critical factors affecting resident well-being is the nurse to patient ratio in nursing homes in Florida. When staffing levels fall short, residents may suffer from neglect, poor hygiene, or even life-threatening health complications. Understanding the Florida nursing home staffing requirements is essential if you suspect that understaffing may have contributed to a loved one’s injury or decline.

This guide will break down the legal minimum staffing standards, explore how facilities sometimes fall short, and explain your rights if negligence has occurred.

Did a loved one suffer abuse or neglect because a facility was understaffed below Florida nursing home staffing requirements? Appropriate staffing is necessary for a facility to properly care for its residents. Understaffing can lead to neglect or abuse.

If you believe a loved one was injured at an understaffed nursing home, call Senior Justice Law Firm for a free consultation today. 561-717-0817

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Michelle T

00:28 04 Feb 23

I don't have the words to say to cover the amount of gratitude for the team, and especially Attorney Dylan Hanson, and his team. When your parent is in a position they have no control over, and you, the child, have to step in, Mr. Hanson and the ENTIRE team at Senior Justice stepped up, and I do mean the ENTIRE team because I learned very quickly that they actually work together so noone is missed! They not only helped resolve the problem, they were there for any questions, concerns, support, and guidance, in full honest, upfront detail! We need more teams like this! For my parent, and myself though, we are truly grateful for everything they did! Again, thank you ALL!

Eric G

23:43 01 Feb 23

My brother and I lost our Mom due to the negligence and neglect of a nursing home. Once she passed, I really just wanted the nightmare to be over but my brother insisted that we pursue some action against the facility. We had no luck with the state or the government oversight so we turned to Senior Justice.
Honestly I wasn’t expecting much and I was skeptical going in. The team at Senior Justice proved themselves to be compassionate and respectful as well as holding the facility responsible for their actions. We received a much larger compensation than I had imagined and my brother and I are truly thankful for the folks at Senior Justice.

Lynn Odinov-Daniels

21:53 28 Dec 22

Sr. Justice Law Firm, under the direction of Michael Brevda and David Brevda, exacts justice for the most vulnerable. Dylan J. Hanson, expertly and compassionately, smoothly steers the complex process to a successful and just outcome. Tamar Green-Martin completes the team approach with her detailed administrative assistance. This is an outstanding law firm!

Simone McClure

17:01 16 Dec 22

The sincere compassion, and diligence from the Senior Justice Law Firm in handling my father's case made the whole experience easier. We are eternally grateful that they were able to right a terrible wrong done to us. I whole heartedly recommend hiring them if you want justice for your loved ones!

jesse devoursney

13:56 06 Apr 22

Great and very competent staff. Not one person is missing a beat from intake to the attorneys!

Melo C

12:16 04 Dec 21

Our attorney David was kind, understanding, compassionate and helpful. He fought for my mom and made us feel important. He showed us that this was more than just a job for him rather a passion he has to help those in need. He always kept us updated with the progress, asked how my mom was doing and sincerely cared about getting justice for my mom. I’m so thankful to him and his team.

Crystal Burrows-Rochez

19:47 03 Jun 21

Senior Justice Law Firm is the best, everyone at the office showed compassion and concern. The Firm was able to help my family with a situation that my 96 year old Grandmother, experienced while she was a patient at a local Nursing and Rehab Center. She was there for several weeks to recover and have physical therapy from having surgery due to a fall that caused her to break her right hip. When she returned home I was not informed she had two bed sores one on her buttock and on her heal of the injured hip, hair matted, very stiff in her limbs and weak. My family felt she did not get the proper care as promised and she was neglected due to her having dementia and not able to communicate. The communication was awful from all staff. During the entire stay I constantly complained and worried. I highly recommend this Law Firm to help you out in any legal matters of this nature.

Only Lord Knows

06:04 20 Feb 21

Senior Justice law firm, is a professional and friendly company that provides great customer service and, Gives great referrals to best fit their customer needs. Thank you for a great experience. Keep fighting for the people that need you the most, keep it up guys...God bless🙏🏽

K & E McDonnell

04:41 02 Aug 17

Mr. Michael Brevda and his staff were so compassionate and supportive of me in my situation. My mother had experienced multiple falls while in a care center and I didn’t know where to turn for help, until I personally spoke with Michael on the phone. I was sorry to learn that he wasn’t able to assist me because he was not licensed to practice law in my state. But to my surprise, Michael, gave me a follow-up call with a name of a local attorney to contact.

Michael more than exceeded my expectations and I will always be grateful for what he did to help me during a very trying time in my life.

I highly recommend the Senior Justice Law Firm, if you are searching for a professional team of attorneys who will be looking out for your best interest.

Are There Florida Nursing Home Staffing Requirements?

Section 400.23(3)(a)(1) sets the minimum requirements for nursing home staffing in Florida. The staffing ratios consist of three levels of care providers: Certified Nursing Assistants (CNAs), Licensed Practical Nurses (LPNs) and Registered Nurses (RNs). Together, LPNs and RNs are considered “licensed nursing staffing”.

Below is a breakdown of the minimum staffing requirements for nursing homes in Florida:

A minimum weekly average of certified nursing assistant and licensed nursing staffing combined of 3.6 hours of direct care per resident per day.
A minimum certified nursing assistant staffing of 2.5 hours of direct care per resident per day. A facility may not staff below one certified nursing assistant per 20 residents.
A minimum licensed nursing staffing of 1.0 hour of direct care per resident per day. A facility may not staff below one licensed nurse per 40 residents.”

Understaffed nursing homes

More than 90% of US nursing homes are understaffed. Injuries and wrongful death occur frequently at facilities with low staff numbers. Contact us today for a free consultation.

How Do National Requirements Compare to Florida’s Staffing Requirements?

Unlike the Florida nursing home staffing requirements (which focus on quantitative numbers), National requirements are qualitative. In 1987, Congress passed a law requiring that each facility “care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident.” The law also requires the facility to develop an individualized care plan for each resident based on their needs.

Further, Federal rules require that staffing be set to the need of residents. If two facilities each have 100 residents, but one is full of extremely needy residents (e.g. they suffer dementia, are unable to walk on their own) and another has nearly independent residents, they should not have the same staffing requirements. Acuity levels are found for each resident in their RUG score as determined on their MDS 3.0.

Do the Staffing Requirements in Florida Conflict with the National Requirements?

No – both requirements apply to all nursing homes in the state of Florida. While the Florida nursing home staffing requirements give a numerical floor for staffing, the national requirements require even more…especially if the majority of the residents need extensive care. In fact, many nursing homes in Florida take in too many high acuity residents in order to get high payments from the government while not staffing to the needs of their residents. This is tax fraud.

What Can Happen if a Facility Is Staffing Below the Florida Nursing Home Staffing Requirements?

Failure to hire enough CNAs, LPNs and RNs to meet the minimum Florida Nursing home staffing requirements can lead to severe injuries, such as falls, subdural hematoma, bedsores, breaks and fractures, and wrongful death.

If you were injured in a facility, and you believe it was understaffed, call Senior Justice Law Firm immediately at 561-717-0817.

FAQs

What are the nursing home staffing requirements under Florida Statute §400.23?

Under §400.23(3)(b) of the Florida Statutes, nursing homes must provide a combined minimum of 3.6 hours of direct care per resident per day, calculated as a weekly average. This includes at least 2.5 hours by certified nursing assistants (CNAs) and 1.0 hour by licensed nurses (RNs or LPNs). Additionally, the facility must maintain at least one CNA per 20 residents and one licensed nurse per 40 residents.

What counts as “direct care” under Florida’s staffing laws?

“Direct care staff” means those who provide hands‑on or care‑management services—such as licensed nurses, CNAs, therapists, activities staff, mental health workers, etc. Importantly, administrative duties (like nursing administration, staff development, or care planning documentation) are excluded from this calculation.

Are nursing home facilities required to publicly display their staffing levels?

Yes. Florida law requires nursing homes to post daily the names of licensed nurses and CNAs on duty for the benefit of residents and the public. Facilities must also retain staffing records for at least five years and report staffing per federal regulation 42 C.F.R. §483.70(q).

Can licensed nurses be counted in place of CNAs in Florida?

Yes, but only under strict conditions. A licensed nurse can fill in for CNA hours if they are performing only CNA duties for the entire shift and the facility still meets its required licensed nurse hours. The nurse’s hours cannot be counted twice toward both categories.

Do feeding assistants count toward the minimum staffing hours?

No. Florida law explicitly prohibits counting paid feeding assistants or non-nursing staff who help residents eat as part of the minimum 3.6, 2.5, or 1.0 direct care hours.

What Are Florida Nursing Home Staffing Requirements