Do Minimum Staffing Levels Improve Nursing Home Quality?
Author Information
Author(s): Bowblis John, Brunt Christopher
Primary Institution: Miami University, Oxford, Ohio, United States
Hypothesis
How do changes to minimum staffing regulations impact staffing and quality in nursing homes?
Conclusion
Increasing staffing levels through mandated minimums had small to negligible impact on most aspects of nursing home quality.
Supporting Evidence
- California nursing homes increased CNA staffing levels by 0.15 HPRD (6.5% increase).
- Total nursing staff levels increased by 0.184 HPRD (4.8% increase) on average.
- Only about 70% of nursing homes met the new CNA requirement.
- 90% of nursing homes met the new 3.5 HPRD staffing requirements in 2019.
- Improvement in incontinence among long-stay residents was statistically significant.
- Improvement in pressure ulcers among long-stay residents was significant at the 10% level.
- Short-stay rehospitalization rate showed improvement at the 10% level.
Takeaway
This study looked at whether having more nursing staff in nursing homes makes the care better. It found that while there were some increases in staff, it didn't really help improve the quality of care much.
Methodology
Utilized a difference-in-differences regression framework to analyze the impact of staffing regulation changes.
Limitations
Only 3 of the 13 quality measures examined showed statistically significant improvements.
Statistical Information
P-Value
p<0.05 for incontinence improvement; p<0.10 for pressure ulcers and rehospitalization rate improvements.
Statistical Significance
p<0.10
Digital Object Identifier (DOI)
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