Falls and complications from falls are a common problem among adults aged 65 years and older. About 60% of older adults fall every year, causing injuries, hospitalization, nursing home placement, and even death. Most studies on falls among skilled nursing facility (SNF) residents focus on fall preventive measures that fail to include staffing variables such as nursing hours. Although researchers have examined the relationship between nursing staff and patient outcomes in hospital settings, similar studies have not occurred in long-term care facilities. The purpose of this retrospective longitudinal study was to determine whether a correlation exists between nursing staff hours per shift and rate of falls. The secondary data included Minimum Data Set 3.0, Certification and Survey Provider Enhanced Reporting, and residents' event reports from four skilled nursing facilities over 6 months. Statistical analysis of Latent Growth Curve Model of SPSS informed this retrospective longitudinal study. The theoretical framework of Donabedian's model of structure, process, and outcome provided the background for this study. The findings suggested that there is no correlation between higher nursing staff ratios and decreased fall rates. However, there were more falls during the day shift, with a higher nursing staff ratio. The study findings have implications for social change. The dissemination of study findings could assist Medicare and Medicaid services to improve SNF staff rating systems. Additionally, findings could inform and influence SNF administrators, policymakers, and health care providers in the development and implementation of policies and intervention programs that assist in fall prevention measures.