Licensed Nurse Staffing and Health Service Availability in Residential Care and Assisted Living

Abstract

Structured Abstract Objectives To create data driven typologies of licensed nurse staffing and health services in residential care/assisted living (RC/AL). Design Cluster analysis was used to describe the patterns of licensed nurse staffing and 47 services, and the extent to which these clusters were related. Setting RC/AL communities in the United States. Participants A convenience sample of administrators and health care supervisors from 89 RC/AL communities in 22 states. Measurement RC/AL characteristics, licensed nurse staffing (total number of hours worked by registered nurses [RNs] and licensed practical nurses [LPNs]), number of hours worked by contract nurses, and availability of 47 services. Results Analysis revealed four licensed nurse staffing clusters defined by total number of hours and the type of nurse providing the hours (RN, LPN, or a mix of both). They ranged from no/minimal RN and LPN hours to high nursing hours with a mix of RNs and LPNs. The 47 services clustered into five clusters including Basic Services, Technically Complex Services, Assessments, Wound Care and Therapies, Testing and Specialty Services, and Gastrostomy and IV Medications. The availability of services was related to the presence of nurses (both RNs and LPNs) except for the Gastrostomy and IV Medications services, which were not readily available. Conclusion The amount and skill mix of licensed nurse staffing varies in RC/AL and is related to the types of services available. These findings may have implications for resident care and outcomes. Future work in this area, including extension to include non-nurse direct care workers, is needed.

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