+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Nursing home staffing and quality under the nursing home reform act



Nursing home staffing and quality under the nursing home reform act



Gerontologist 44(1): 13-23



We examine whether the Nursing Home Reform Act (NHRA) improved nursing home staffing and quality. Data from 5,092 nursing homes were linked across the 1987 Medicare/Medicaid Automated Certification System and the 1993 Online Survey, Certification and Reporting system. A dummy-year model was used to examine the effects of the NHRA on pressure ulcers, physical restraints, and urinary catheters, and a first-difference approach to fixed-effects regression analyses was used to estimate the effects of time-varying staffing on the quality of care. Overall, we found a significant increase in nursing home staffing levels from 1987 to 1993. Moreover, after controlling for other facility, resident, market, and state factors, there was a significant decrease in the proportion of residents with pressure ulcers, physical restraints, and urinary catheters following the implementation of the NHRA. Across all facilities, the increase in staffing was not directly related to the improvement in quality over the period of our study, but there was a positive relationship between registered nurse staffing and quality for facilities that were particularly deficient prior to the NHRA. Following the NHRA, quality improvements were found in nursing homes nationwide, and these results suggest that part of this improvement was due to the quality and staffing regulations within the NHRA.

(PDF emailed within 0-6 h: $19.90)

Accession: 049722561

Download citation: RISBibTeXText

PMID: 14978317

DOI: 10.1093/geront/44.1.13


Related references

Effect of nurse staffing on rehospitalizations and emergency department visits among short-stay nursing home residents: A Cross-sectional study using the US Nursing Home Compare database. Geriatric Nursing: -, 2018

Absent voices compromise the effectiveness of nursing home regulation: a critique of regulatory reform in the UK nursing home industry. Health & Social Care in the Community 9(6): 490-494, 2001

Absent voices compromise the effectiveness of nursing home regulation: a critique of regulatory reform in the UK nursing home industry. Health & Social Care in the Community 9(6): 490-494, 2002

Does quality influence consumer choice of nursing homes? Evidence from nursing home to nursing home transfers. Inquiry 40(4): 343-361, 2004

Does Quality Influence Consumer Choice of Nursing Homes? Evidence from Nursing Home to Nursing Home Transfers. Inquiry - Journal of Health Care Organization, Provision & Financing 40(4): 343-361, 2003

Nursing home reform: addressing critical staffing issues. Nursing Outlook 35(5): 208-209, 1987

The relationship between nursing home residents' perceptions of nursing staff and quality of nursing home care. Activities Adaptation and Aging 8(3-4): 143-156, 1986

Effects of state minimum staffing standards on nursing home staffing and quality of care. Health Services Research 44(1): 56-78, 2008

Nursing home financing reform: how would it affect expenditures for nursing home care?. Inquiry 31(2): 141-152, 1994

Association between the Nursing Home Minimum Data Set for Vision and Vision-Targeted Health-Related Quality of Life in Nursing Home Residents As Assessed by Certified Nursing Assistants. Journal of Optometry 2(3): 148-154, 2009

Bedside nursing. Home nursing with emphasis on rehabilitation: nursing of a stroke patient recovering ambulatory function through home nursing. Kangogaku Zasshi 42(11): 1162-1167, 1978

Staffing, quality, and productivity in the nursing home. Journal of the American Medical Directors Association 14(11): 784-786, 2014

The Impact of Nursing Home Pay-for-Performance on Quality and Medicare Spending: Results from the Nursing Home Value-Based Purchasing Demonstration. Health Services Research 52(4): 1387-1408, 2016

The Nursing Home Compare Report Card: Perceptions of Residents and Caregivers Regarding Quality Ratings and Nursing Home Choice. Health Services Research 51 Suppl 2: 1212-1228, 2017

Nursing home quality: a comparative analysis using CMS Nursing Home Compare data to examine differences between rural and nonrural facilities. Journal of the American Medical Directors Association 14(8): 593-598, 2013