The Gerontologist
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Mueller, C.
Right arrow Articles by Joy, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mueller, C.
Right arrow Articles by Joy, A.
The Gerontologist 46:74-80 (2006)
© 2006 The Gerontological Society of America

Nursing Home Staffing Standards: Their Relationship to Nurse Staffing Levels

Christine Mueller, PhD, RN1, Greg Arling, PhD2, Robert Kane, MD3, Julie Bershadsky, BA3, Diane Holland, MS, RN1 and Annika Joy, MS, RN1

Correspondence: Address correspondence to Christine Mueller, PhD, RN, University of Minnesota School of Nursing, 5-160 WDH, 308 Harvard Street SE, Minneapolis, MN 55455. E-mail: cmueller{at}umn.edu

Purpose: This study reviews staffing standards from the 50 states and the District of Columbia to determine if these standards are related to nursing home staffing levels. Design and Methods: Rules and regulations for states' nursing home staffing standards were obtained for the 50 states and the District of Columbia. Nurse staffing data were obtained from the Centers for Medicare and Medicaid Services On-Line Survey, Certification, and Reporting (known as OSCAR) database. The minimum hours per resident day (HPRD) staffing standards for each state were categorized according to the following: no state-specific HPRD standard (adheres only to federal staffing guidelines); low HPRD standard (≤ 2.5 HPRD); and high HPRD standard (> 2.5 HPRD). A series of hierarchical linear models examined the relationships between state staffing standards and actual facility staffing (total, licensed, and certified nurse aide HPRD), using a number of covariates. Results: The variance in facility staffing was much greater within than between states. Facilities in states with high staffing standards had somewhat higher staffing than states with no standards or low standards, whereas facility staffing in states with low standards was not significantly different from that in states with no standards. Other factors, such as resident acuity and average state Medicaid rate, also were related to staffing. Implications: State staffing standards may not be effective policy tools because they are only one of many factors that affect facility staffing levels. Setting a low minimum HPRD standard may fail to raise staffing, or it may even have a dampening effect on staffing rates in facilities.

Key Words: Staffing levels • Quality of care • Nursing home • State standards • Policy




This article has been cited by other articles:


Home page
Journal of Applied GerontologyHome page
N. G. Castle
State Differences and Facility Differences in Nursing Home Staff Turnover
Journal of Applied Gerontology, November 1, 2008; 27(5): 609 - 630.
[Abstract] [PDF]


Home page
Journal of Applied GerontologyHome page
N. G. Castle
Nursing Home Caregiver Staffing Levels and Quality of Care: A Literature Review
Journal of Applied Gerontology, August 1, 2008; 27(4): 375 - 405.
[Abstract] [PDF]


Home page
GerontologistHome page
N. G. Castle and J. Engberg
Further Examination of the Influence of Caregiver Staffing Levels on Nursing Home Quality
Gerontologist, August 1, 2008; 48(4): 464 - 476.
[Abstract] [Full Text] [PDF]


Home page
Med Care Res RevHome page
N. G. Castle, J. Engberg, and Aiju Men
Nurse Aide Agency Staffing and Quality of Care in Nursing Homes
Med Care Res Rev, April 1, 2008; 65(2): 232 - 252.
[Abstract] [PDF]


Home page
GerontologistHome page
B. A. Kash, N. G. Castle, G. S. Naufal, and C. Hawes
Effect of staff turnover on staffing: a closer look at registered nurses, licensed vocational nurses, and certified nursing assistants.
Gerontologist, October 1, 2006; 46(5): 609 - 619.
[Abstract] [Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
All GSA journals Journals of Gerontology Series A: Biological Sciences and Medical Sciences Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Copyright © 2006 by The Gerontological Society of America.