Nursing Home Caregiver Staffing Levels and Quality of Care

Abstract

In this research, the author reviewed 70 studies that had examined the relationship between staffing levels and quality in nursing homes (covering the years 1991 to 2006). The results of the review including all of this literature show that approximately 40% of the quality indicators examined show an association with nursing home staffing levels. Nevertheless, this finding is further interpreted in the context of the limitations of many of these prior studies. The author discusses the limitations of poor quality staffing data, small sample size, quality indicators used, methodological concerns, and underspecified models inherent to many prior studies. The author finds no study representing a "gold standard" exists in this area. Still, the few studies that seem methodologically most robust would seem to indicate that an association between nursing home staffing levels and quality exists. However, the author concludes that studies in this area need to be further enhanced.

Leadership, staffing and quality of care in nursing homes

“…The lack of any significant positive effect for staffing levels or ratio of registered nurses on the quality of care indexes stands in contrast to most prior studies [10,11]. An explanation for the present result may be the relatively high staffing levels and the relatively high ratio of registered nurses in Norwegian nursing homes compared with many other countries.…”

Leadership, staffing and quality of care in nursing homes

“…The lack of any significant positive effect for staffing levels or ratio of registered nurses on the quality of care indexes stands in contrast to most prior studies [10,11]. An explanation for the present result may be the relatively high staffing levels and the relatively high ratio of registered nurses in Norwegian nursing homes compared with many other countries.…”

Medicare Beneficiary Factors Associated with Skilled Nursing Facility Lengths of Stay

“…Our findings were consistent with earlier work that identified registered nurse staffing as a significant factor associated with shorter SNF LOS and documented higher availability of nursing staff as a benchmark for higher quality in nursing facilities (Castle, 2008; Castle & Anderson, 2011; Harrington et al, 2000). However, there is some evidence of potential gaming by nursing homes with respect to reported LPN and RN staffing (Sharma et al, 2019).…”

Association of Staffing Instability With Quality of Nursing Home Care

“…For CNAs, instability is associated with more improvement in 6 of the outcomes compared with 4 of the outcomes for an increase in HPRD. Table 3 demonstrates that a 1-SD increase in HPRD also improved many of the outcomes, particularly for RNs and CNAs, a finding reported in many prior studies …”

Leadership, staffing and quality of care in nursing homes

“…The lack of any significant positive effect for staffing levels or ratio of registered nurses on the quality of care indexes stands in contrast to most prior studies [10,11]. An explanation for the present result may be the relatively high staffing levels and the relatively high ratio of registered nurses in Norwegian nursing homes compared with many other countries.…”

Medicare Beneficiary Factors Associated with Skilled Nursing Facility Lengths of Stay

“…Our findings were consistent with earlier work that identified registered nurse staffing as a significant factor associated with shorter SNF LOS and documented higher availability of nursing staff as a benchmark for higher quality in nursing facilities (Castle, 2008; Castle & Anderson, 2011; Harrington et al, 2000). However, there is some evidence of potential gaming by nursing homes with respect to reported LPN and RN staffing (Sharma et al, 2019).…”

Association of Staffing Instability With Quality of Nursing Home Care

“…For CNAs, instability is associated with more improvement in 6 of the outcomes compared with 4 of the outcomes for an increase in HPRD. Table 3 demonstrates that a 1-SD increase in HPRD also improved many of the outcomes, particularly for RNs and CNAs, a finding reported in many prior studies …”

Leadership, staffing and quality of care in nursing homes

“…The lack of any significant positive effect for staffing levels or ratio of registered nurses on the quality of care indexes stands in contrast to most prior studies [10,11]. An explanation for the present result may be the relatively high staffing levels and the relatively high ratio of registered nurses in Norwegian nursing homes compared with many other countries.…”

Medicare Beneficiary Factors Associated with Skilled Nursing Facility Lengths of Stay

“…Our findings were consistent with earlier work that identified registered nurse staffing as a significant factor associated with shorter SNF LOS and documented higher availability of nursing staff as a benchmark for higher quality in nursing facilities (Castle, 2008; Castle & Anderson, 2011; Harrington et al, 2000). However, there is some evidence of potential gaming by nursing homes with respect to reported LPN and RN staffing (Sharma et al, 2019).…”

Association of Staffing Instability With Quality of Nursing Home Care

“…For CNAs, instability is associated with more improvement in 6 of the outcomes compared with 4 of the outcomes for an increase in HPRD. Table 3 demonstrates that a 1-SD increase in HPRD also improved many of the outcomes, particularly for RNs and CNAs, a finding reported in many prior studies …”