Relationship of nursing home staffing to quality of care

To compare nursing homes (NHs) that report different staffing statistics on quality of care.

Staffing information generated by California NHs on state cost reports and during onsite interviews. Data independently collected by research staff describing quality of care related to 27 care processes.

Two groups of NHs (n=21) that reported significantly different and stable staffing data from all data sources were compared on quality of care measures.

Direct observation, resident and staff interview, and chart abstraction methods.

Staff in the highest staffed homes (n=6), according to state cost reports, reported significantly lower resident care loads during onsite interviews across day and evening shifts (7.6 residents per nurse aide [NA]) compared to the remaining homes that reported between 9 to 10 residents per NA (n=15). The highest-staffed homes performed significantly better on 13 of 16 care processes implemented by NAs compared to lower-staffed homes.

The highest-staffed NHs reported significantly lower resident care loads on all staffing reports and provided better care than all other homes.