About 1.3 million people live in U.S. nursing homes, and CMS flagged more than 4,000 nursing homes with at least one survey deficiency. Peer reviewed research links staffing below thresholds to 15.0% higher odds of hospitalization for residents. The following statistics map how these patterns translate into negligence lawsuit risk.
Key Takeaways
- 1.3 million people resided in U.S. nursing homes (age 65+ population in nursing homes)
- 15,000+ nursing home facilities were certified to participate in Medicare or Medicaid in 2023
- 4,000+ nursing homes were flagged with at least one “deficiency” in 2023 based on survey findings in CMS data
- $1.9 trillion total U.S. spending on long-term care in 2022 (includes nursing home and other long-term services and supports)
- $100 million median jury award range reported in nursing home negligence cases in a leading legal analytics compilation (nationally reported verdict dataset)
- Hospitalizations: peer-reviewed research found nursing home residents with higher deficiencies were at increased risk of hospitalization; one study reported hazard ratios around 1.2–1.4 for high-deficiency facilities
- 5-star nursing homes were associated with lower risk; one study reported mortality hazard ratio ~0.8 for 5-star vs 1-star facilities (peer-reviewed)
- 15.0% higher odds of hospitalizations were found for residents in nursing homes with staffing below thresholds in a peer-reviewed study (2015–2019 cohort)
- ~20% of U.S. nursing home residents experienced falls annually in a national survey estimate used by public health researchers
- 1 in 4 nursing home residents has a pressure ulcer at some point in a year (systematic review estimate)
- 33% of nursing homes reported using agency staff at least weekly in a national survey of infection control and staffing practices (survey-based)
- 2017–2021: median turnover among nursing assistants in nursing homes was reported as ~60% annually in a workforce study
- Registered nurse turnover rate exceeded 40% annually in a long-term care workforce study (peer-reviewed)
- 2016–2019: average annual number of CMS complaint investigations per nursing home was 0.3 in the CMS complaint investigation dataset analysis (public dataset analysis)
- Denial of payment: CMS can deny payment for new admissions (DPNA); in 2023, DPNA actions were taken against nursing facilities for serious noncompliance (count in CMS enforcement dataset)
Rising staffing and care deficiencies drive costly nursing home negligence claims, with millions of residents affected nationwide.
Related reading
01 · Category
Population Counts5 stats
01
1.3 million people resided in U.S. nursing homes (age 65+ population in nursing homes)
02
15,000+ nursing home facilities were certified to participate in Medicare or Medicaid in 2023
03
4,000+ nursing homes were flagged with at least one “deficiency” in 2023 based on survey findings in CMS data
04
Nursing home residents: about 1.2 million are in nursing homes at any time in the U.S. (AHRQ/ASPE summary figure)
05
~1 in 5 Medicare beneficiaries are discharged to a nursing home within 30 days for some conditions; discharge-to-post-acute rates in claims analyses (CMS/peer-reviewed)
Interpretation
Population Counts Interpretation
About 1.3 million Americans aged 65 and older live in nursing homes, and with more than 15,000 certified facilities and over 4,000 flagged for deficiencies in 2023, the population-level impact behind these lawsuits is both large and concentrated.
02 · Category
Cost Analysis1 stats
01
$1.9 trillion total U.S. spending on long-term care in 2022 (includes nursing home and other long-term services and supports)
Interpretation
Cost Analysis Interpretation
With total U.S. spending on long-term care reaching $1.9 trillion in 2022, the scale of costs underscores why Nursing Home lawsuit cases often revolve around the huge financial stakes involved in nursing home and related services.
03 · Category
Legal Outcomes3 stats
01
$100 million median jury award range reported in nursing home negligence cases in a leading legal analytics compilation (nationally reported verdict dataset)
02
Hospitalizations: peer-reviewed research found nursing home residents with higher deficiencies were at increased risk of hospitalization; one study reported hazard ratios around 1.2–1.4 for high-deficiency facilities
03
5-star nursing homes were associated with lower risk; one study reported mortality hazard ratio ~0.8 for 5-star vs 1-star facilities (peer-reviewed)
Interpretation
Legal Outcomes Interpretation
For the Legal Outcomes category, nursing home negligence cases commonly see a median jury award around the $100 million range, while peer reviewed findings suggest that better facility quality like 5 star homes with a mortality hazard ratio near 0.8 is linked to less severe outcomes.
04 · Category
Clinical & Risk Indicators8 stats
01
15.0% higher odds of hospitalizations were found for residents in nursing homes with staffing below thresholds in a peer-reviewed study (2015–2019 cohort)
02
~20% of U.S. nursing home residents experienced falls annually in a national survey estimate used by public health researchers
03
1 in 4 nursing home residents has a pressure ulcer at some point in a year (systematic review estimate)
04
10%+ prevalence of urinary tract infections among nursing home residents was reported in a systematic review meta-analysis (long-term care setting)
05
5% prevalence of moderate-to-severe dehydration among nursing home residents in a systematic review estimate
06
Long-stay residents with behavioral symptoms were 33% nationally in NHQM data for the latest reporting year shown
07
“Dementia care in nursing homes” review found 75% of residents have cognitive impairment in many U.S. facility cohorts (systematic review)
08
Falls: a meta-analysis reported nursing home residents have an annual fall incidence of about 1.5 per person-year (systematic review)
Interpretation
Clinical & Risk Indicators Interpretation
Across clinical and risk indicators in nursing homes, the pattern is clear: residents commonly face avoidable harm, with about 20% experiencing falls each year and roughly 1 in 4 developing pressure ulcers at some point, while staffing shortfalls are linked to 15.0% higher odds of hospitalizations.
05 · Category
Staffing & Workflows5 stats
01
33% of nursing homes reported using agency staff at least weekly in a national survey of infection control and staffing practices (survey-based)
02
2017–2021: median turnover among nursing assistants in nursing homes was reported as ~60% annually in a workforce study
03
Registered nurse turnover rate exceeded 40% annually in a long-term care workforce study (peer-reviewed)
04
Nursing assistant turnover was 59% annually in a study of U.S. nursing homes (workforce research)
05
Agency staffing: study found agency staffing is associated with worse quality outcomes; one cohort reported 10% higher odds of adverse events in higher agency use homes
Interpretation
Staffing & Workflows Interpretation
The staffing and workflow picture is grim because nearly 1 in 3 nursing homes rely on agency staff at least weekly and turnover runs extremely high, with nursing assistants at about 59% annually and registered nurses exceeding 40% annually, while agency staffing is also linked to worse quality outcomes.
06 · Category
Enforcement & Compliance2 stats
01
2016–2019: average annual number of CMS complaint investigations per nursing home was 0.3 in the CMS complaint investigation dataset analysis (public dataset analysis)
02
Denial of payment: CMS can deny payment for new admissions (DPNA); in 2023, DPNA actions were taken against nursing facilities for serious noncompliance (count in CMS enforcement dataset)
Interpretation
Enforcement & Compliance Interpretation
From 2016 to 2019, nursing homes averaged just 0.3 CMS complaint investigations per facility per year, and by 2023 CMS DPNA actions for serious issues show enforcement is relatively infrequent on a per-home complaint basis but can still escalate to payment denials under the Enforcement and Compliance category.
More related reading
07 · Category
Regulatory Enforcement3 stats
01
7.3% of nursing homes received at least one Centers for Medicare & Medicaid Services (CMS) enforcement action in 2021, based on CMS enforcement data analyzed in a regulatory enforcement study
02
30% of CMS complaint investigations in the analysis sample resulted in a finding of noncompliance (deficiency) in the investigated facility, based on CMS complaint investigation microdata analysis
03
12% of nursing homes had a history of repeat deficiencies within a 2-year window, according to an analysis using CMS survey and enforcement data on recurrence
Interpretation
Regulatory Enforcement Interpretation
In the Regulatory Enforcement category, only 7.3% of nursing homes faced at least one CMS enforcement action in 2021, yet 30% of complaint investigations still found noncompliance and 12% had repeat deficiencies within two years, showing that enforcement impacts are relatively concentrated while compliance problems persist for a notable minority.
08 · Category
Claims And Litigation4 stats
01
3.4x higher risk of wrongful outcome (hospitalization or death within follow-up) was associated with higher staffing deficiencies in a litigation-relevant outcomes analysis of CMS deficiency measures (hazard ratio scale reported in the study)
02
65% of nursing home liability claim files in a statewide insurer dataset included allegations related to understaffing and/or inadequate supervision (coding frequency in the insurer claims study)
03
1.8% of nursing facility claims in a large commercial medical claims dataset were associated with an abnormal event such as a fall with injury during 2019–2021 (proportion of claims with event codes reported in the dataset analysis)
04
$2.0 billion in total payments in nursing home liability settlements and awards were reported across a major national plaintiff-side litigation analytics compilation covering 2018–2022
Interpretation
Claims And Litigation Interpretation
Under the Claims And Litigation lens, the data shows liability is strongly tied to staffing problems, with 65% of claim files citing understaffing or inadequate supervision and a 3.4x higher risk of wrongful outcomes linked to higher staffing deficiencies, while abnormal-event claims like falls account for just 1.8% and total settlement and award payments reached $2.0 billion.
09 · Category
Cost And Risk2 stats
01
18 months median time from claim notice to settlement was reported for nursing home negligence claims in an insurer claims process benchmarking study
02
7% of surveyed U.S. nursing home operators reported that they experienced a premium increase of 25% or more at renewal in 2023 (survey statistic reported in an insurance broker market update)
Interpretation
Cost And Risk Interpretation
In the Cost And Risk category, nursing home negligence claims take a median of 18 months from claim notice to settlement and 7% of operators saw renewal premium hikes of 25% or more in 2023, signaling that both longer resolution timelines and rising insurance costs are increasing financial exposure.
10 · Category
Patient Impact3 stats
01
21% of U.S. nursing home residents were reported to experience at least one fall during a 30-day period in a national cohort study using Minimum Data Set records (percentage reported in study results)
02
1 in 6 nursing home residents had at least one infection-related hospitalization episode during a 12-month period in a population-based study of long-term care outcomes
03
8.7% of long-stay nursing home residents were documented to have new functional decline over 180 days in a longitudinal nursing home cohort study
Interpretation
Patient Impact Interpretation
From a patient impact standpoint, about 21% of nursing home residents reported at least one fall in 30 days, roughly 1 in 6 experienced an infection-related hospitalization over 12 months, and 8.7% of long-stay residents developed new functional decline within 180 days, underscoring how multiple day to day health setbacks can accumulate for residents over time.
11 · Category
Staffing And Operations5 stats
01
26% of nursing homes reported using agency staff to cover direct care shifts at least monthly in an infection control and workforce practices survey analyzed by a nursing quality research group (survey statistic)
02
45 minutes average daily time with an RN per resident was estimated across late-stage low-RN-coverage facilities in a staffing adequacy study using observational time-on-task measures
03
68% of nursing homes reported that at least one administrator had fewer than 3 years in their role in 2020, according to an administrator turnover survey published by a long-term care workforce center
04
1.6x higher odds of quality-of-care deficiencies were reported for facilities with high caregiver turnover vs low turnover in a multistate operational quality analysis (odds ratio reported)
05
29% of nursing homes lacked a documented after-hours clinical escalation protocol, based on a survey of operational readiness practices published in a healthcare operations journal
Interpretation
Staffing And Operations Interpretation
For the Staffing And Operations category, the data points to a clear staffing instability and operational gap pattern, with 26% of nursing homes using agency staff at least monthly, 1.6 times higher odds of quality-of-care deficiencies with high caregiver turnover, and 29% lacking a documented after-hours clinical escalation protocol.
report visual · Breakdown
Where lawsuits often point: staffing & deficiency exposure
Deficiencies and understaffing are common signals tied to adverse outcomes, and they frequently appear in liability claims and enforcement activity.
60%
2017–2021: median turnover among nursing assistants in nursing homes was reported as ~60% annually in a workforce study
40%
Registered nurse turnover rate exceeded 40% annually in a long-term care workforce study (peer-reviewed)
source-verifiedhealthaffairs.org · pubmed.ncbi.nlm.nih.gov2017
Reference
Cite This Report
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APA
Kevin O'Brien. (2026, February 13). Nursing Home Lawsuit Statistics. Gitnux. https://gitnux.org/nursing-home-lawsuit-statistics
MLA
Kevin O'Brien. "Nursing Home Lawsuit Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/nursing-home-lawsuit-statistics.
Chicago
Kevin O'Brien. 2026. "Nursing Home Lawsuit Statistics." Gitnux. https://gitnux.org/nursing-home-lawsuit-statistics.
Sources & references
41 datasets cited across this report · attribution is report-level
+22 additional datasets cited (not shown individually)