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Florida's efforts to improve quality of nursing home care through nurse staffing standards, regulation, and Medicaid reimbursement



Florida's efforts to improve quality of nursing home care through nurse staffing standards, regulation, and Medicaid reimbursement



Journal of Aging and Social Policy 21(4): 318-337



Between 1999 and 2007, Florida implemented two initiatives combining legislative, regulatory, and reimbursement strategies to increase nurse staffing levels in nursing homes to improve quality of care. Despite a $40 million incentive package allocated for direct-care staffing, per-resident-day staffing increased only after legislative requirements mandated minimum nursing hours per resident day. Total Medicaid expenditures grew by $1.1 billion over the 8 years; per diem rates increased 65% to reimburse providers' costs. Registered nurses' hours decreased, while licensed nurses' and paraprofessionals' hours increased. This article describes the impact of staffing policy changes, includes stakeholders' views about approaches to achieve quality outcomes, and documents state policy implementation efforts. Seven lessons from the implementation of state nurse staffing standards to improve quality of care outcomes are also presented.

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Accession: 053262031

Download citation: RISBibTeXText

PMID: 20092125

DOI: 10.1080/08959420903166910


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