Quality at nursing homes with high proportion of residents with cognitive impairment

There is limited data on staffing ratings at nursing homes (NHs) serving residents with dementia, despite staffing impacting quality of care.

Residents' cognitive impairment status, staffing rating, and facility characteristics were obtained for 11,469 NHs, using data from the Centers for Medicare & Medicaid Services and Long-term Care: Facts on Care in the U.S. The association between the proportion of residents with cognitive impairment and nurse staffing rating was analyzed using multiple logistic regression in a cross-sectional study design.

NHs with a high proportion of residents with cognitive impairment were 41% less likely to have a high staffing rating or high RN staffing rating (95% CI: 0.52-0.67) compared to NHs with a low proportion.

NHs that serve a higher proportion of residents with cognitive impairment have lower staffing ratings, and this disparity is more pronounced in NHs with more minority residents. Increasing staffing levels is a necessary policy measure to improve care in these facilities.