11 Jul The Scandal Has Returned to Colorado Long Term-Care Facilities as the Federal Government Cuts Staffing Requirements
A very stark article about the deterioration of care conditions from abysmal staffing levels in Colorado long-term care facilities just ran in the Denver Post under the title Complaints and violations mount at Colorado’s understaffed nursing homes and assisted living facilities.
This article depressingly reports that the Federal Government has repeatedly acted to lower both the amount and the level of nurse staffing required in long-term care facilities by eliminating minimum daily staffing levels and mandates that Registered Nurses (RNs) be present 2/3rds of the time. As a result, your loved ones can now be kept in facilities that are no longer required to even have an RN working 24/7 in their buildings.
Many staffing studies have long since concluded that about 3 ½ hours of nursing care per resident per day is the minimum level required to maintain quality care standards. Now, with strong industry support, the federal government is seeking to eliminate any hourly staffing mandates, including even the much-too-low 2-hour minimum nursing staffing requirements that Colorado has long maintained as a backstop.
The Risks of Replacing Registered Nurses with Licensed Practical Nurses
Worse, facilities are being allowed to operate with no RN in their buildings for up to 16 out of every 24 hours a day if a Licensed Practical Nurse (LPN) is present and an RN is on call somewhere outside the building. LPNs undergo significantly less training than RNs and are often required to work under the supervision of an RN. While an RN can administer treatment and coordinate care, LPNs can only do basic patient care and collect medical information that will be used by an RN or a doctor. The federal government’s decision to return to LPN-only nursing level care for much of every day is a dangerous cutback on the most basic requirement for proper care. Who would have thought that nursing homes would ever again be allowed to operate mostly without registered nurses?
What Will Happen to Long-Term Care Facilities?
Facilities are very likely to take maximum advantage of the return to mostly LPN-only care. When these facilities are understaffed, they cut labor costs and siphon profits to themselves, rather than hiring enough staff or paying them what their important work is worth. To the corporate bean counters that make these decisions, your loved one’s care takes a back seat to their desire for a good quarterly earnings report.
Our History of Fighting for Nursing Home Residents
We helped to establish the legal right to high-quality nursing and rehabilitation care services for nursing home residents. We did this in the landmark nursing home lawsuit of Smith v. Heckler against the federal government, which struck down the previous nursing home inspection system and replaced it with a patient-focused survey process, and also contributed to the development and passage of the 1987 Nursing Home Reform Act. See the 10th Circuit ruling here, as well as an article about this important case.
A Return to the Dark Ages of Long-Term Care
All this staffing deregulation amounts to an effort to return this industry to an earlier dark age.
In 1975, a United States Senate Blue Ribbon Commission unequivocally concluded, after hearings in 25 cities, that half of the nation’s nursing homes were providing scandalously substandard care with life-threatening conditions. The federal government, with its industry allies, has now set the stage for a return to this earlier scandal-plagued situation.
The Denver Post article shockingly reports that:
The conditions in nursing homes and assisted living centers around Colorado, where residents often receive as little as two hours of direct care each day, are deteriorating. Chronic understaffing has led to severe deficiencies at these facilities, more than in most states, with rising numbers of complaints lodged by residents.
In 2025, 40% of nursing homes in Colorado had severe deficiencies, defined as problems that can threaten residents’ lives, according to the Centers for Medicare and Medicaid Services data. The state’s number went up from 14% in 2019.
The only states with higher nursing home deficiency rates were Illinois (61%), South Dakota (53%), Delaware (45%), and Rhode Island (45%). Meanwhile, the rules governing care, such as the federal requirement that nursing homes keep a registered nurse on-site 24/7, have been relaxed.
Put in simple terms, residents’ lives are in more danger in Colorado and elsewhere than they have been since the system was reformed to focus on resident care and the prevention of abuse and neglect.
How Families Can Help Protect Their Loved Ones in Long-Term Care Facilities
For those of you with loved ones in long care facilities, we recommend that you go frequently to the facilities where your loved one is staying. Perhaps the single most important tool for abuse and neglect prevention is simply showing up. Be there for your loved one. Make sure the likely overburdened staff are paying attention to them and their well-being.
If you have more than one family member where your loved one is housed, you should consider working out formal visitation schedules to try to ensure that someone is present as often as possible, ideally daily. Do not go at the same time. Go on weekends and nights. Go during shift changes.
Families of heavy needs residents need to go to their facility as often as possible and be unpredictable in doing so. As we learned from extensive experience suing nursing homes and assisted living facilities, one of the crueler realities about long-term care is the axiom that the more care your loved one needs, the less likely they are to receive it.
Consult a Nursing Home Abuse Attorney in Denver, Colorado
This situation is obviously not getting better. And we expect that there will be more claims than in previous years as this situation continues to deteriorate. Also, sadly, the only deterrent to this deterioration is likely to be more such claims and lawsuits. The public needs to be very vigilant to protect their loved ones. While we spent years seeking real regulation and high-quality care standards, we have also spent many years bringing lawsuits as the other primary way to enforce the rights of nursing home and assisted living residents. If you determine you need advocates to hold facilities accountable, we at Holland, Holland Edwards & Grossman have extensive experience doing so and are available to help.
Images used under creative commons license – commercial use (7/10/2026). Photo by AI25.Studio Studio on Pexels