Many residents are totally reliant on staff for care, and rely on the federal Medicare program to pay the bills. The problem at nursing homes is poor staffing. I just read an article that discusses the issue and explains how and why it is a system wide problem.
The article talks about an investigation that found the staffing shortage wasn’t an oversight. The homes and their upper management were "padding their balance sheets on the backs of helpless residents in their care".
“They were all trying to make a buck,” said Alan Peak, an FBI agent in the white collar crimes unit. The probe revealed criminal conditions at the nursing homes—residents suffering from bed sores, malnutrition, beatings, neglect—all the result of their management company’s directives to cut costs. Meanwhile, managers rewarded themselves handsomely for their efficiency.
The fraud prosecution is one of the first of its kind. While systematically cutting back on service at the nursing homes, management continued to collect money from Medicare and Medicaid for services they knew were inadequate, or in some cases not performed at all.
The management company and its CEO, as well as the nursing homes, pled guilty last fall to fraud conspiracy charges. In February, the CEO was sentenced to 18 months in prison, and the nursing homes were each fined $180,000. The company president was sentenced April 20 to two months in prison for his role.