Is there a law that limits how many residents a Certified Nurse Assistant can care for?

A fellow caregiver asked...

Is there a law that limits how many residents each CNA (Certified Nurse Assistant)can care for? I have seen one CNA care for up to 20 residents at a time before. Are the laws different for each state?

Expert Answer

Carolyn Rosenblatt, R.N. and Attorney is the author of author of The Boomer's Guide to Aging Parents. She has over 40 years of combined experience in her two professions. As a nurse, she has extensive experience with geriatrics, chronic illness, pain management, dementias, disability, family dynamics, and death and dying. As a trial attorney, she advocated for for the rights of injured individuals and neglected elders. She is also co-founder of

I do not know of a law that specifically limits the number of residents a CNA can have at any one time. I don't claim expertise on that point. The law does give some guidance on how many hours per day of nursing care a nursing home resident must receive. The laws that affect nursing facilities are both from the Centers For Medicare/Medicaid Services (CMS) and from state laws and regulations. In that regard, they do vary from state to state. For instance, in California, there is a state law setting nurse/patient ratios in hospitals while other states don't have the same law.

You do not say whether you have a loved one in a nursing home, or what the cause of your concern is. I suspect you are close to the problem of overworked nursing assistants and have raised the question because it affects the care of someone close to you. If that is your situation, it is important to raise your concerns with the facility where you are seeing this overload on CNA's. It does not sound safe. Have you spoken to the director of nursing?

It has been historically true that long term nursing care facilities were understaffed. Whether that is different where you are depends on many factors, including the attitude of the administrators and the availability of CNA's. Many facilities are out of compliance with applicable laws about staffing. I know from my own experience of working as a nurse's aide in nursing homes, lifting, moving, bathing, feeding, dressing, transferring, turning, cleaning and checking bedridden residents that no one can safely care for 20 infirm people like that at the same time. If that is what you are seeing, I hope you will speak up about it and try to get it changed.