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NewsWeb-only News

Online-only: Nursing home study links nurse staffing hours, quality

Teddi Dineley Johnson
The Nation's Health September 2011, 41 (7) E36;
Teddi Dineley Johnson
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Nursing homes with high nurse staffing levels have higher quality of care, a recent study finds.

Published in the journal Gerontologist in May, the study shows the quality of care delivered by nursing homes increases in tandem with the per-patient ratio of nurses on the facility’s payroll. Moreover, providing details about the nursing home’s average number of nurses employed per resident and the grade given to the nursing home during its annual inspection can help families make informed decisions when shopping for long-term care for an elderly loved one, according to the study.

“Choosing a nursing home for a long-term placement is a daunting and emotionally charged task for families,” the study authors wrote. “We hypothesize that higher nurse staffing levels — both certified nursing assistant hours per resident day and licensed nurse and licensed practical nurses, will be significant predictors of lower deficiency scores after controlling for facility characteristics.”

In affirming the link between low “deficiency scores” — violations that are often used as a measure of a nursing home’s quality — and high nursing staff levels, researchers found that every additional hour worked by a certified nursing assistant per resident per day resulted in a 10 percent decrease in a nursing home’s total deficiency score. On the flipside, cutting staffing by just one hour per resident per day resulted in a 33 percent increase in quality-of-care deficiencies, according to the study, which was funded in part by the Commonwealth Fund.

Such findings can help families navigate the information available to consumers on public websites, according to the study authors. For example, the Centers for Medicare and Medicaid Services summarizes and disseminates inspection data on the Nursing Home Compare website. Online at www.medicare.gov, the site provides information to consumers about the quality of care provided at nursing homes, including the average number of nursing hours each resident receives and details about violations of federal safety regulations found during annual inspections. Such deficiencies include quality of care, resident rights and physical environment. CMS has access to inspection data because nearly 96 percent of all U.S. nursing homes directly bill Medicare and Medicaid for residents’ services, and must therefore be certified and inspected annually, according to the study.

The findings are especially timely in light of the rapid growth of the older population. According to the U.S. Census Bureau, the number of Americans 85 and older — a group whose members often require additional care and support — will increase from about 14 percent of the older population today to 21 percent in 2050.

“Because this is a tool consumers use to select a nursing home, providers would benefit from hiring more certified nursing assistant staff because our study has demonstrated a relationship between higher certified nursing assistant staffing levels and lower deficiency scores,” the study authors wrote.

For more information, visit www.commonwealthfund.org.

  • Copyright The Nation’s Health, American Public Health Association

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