Assisted Living, Residential Care, and Memory Care Staffing Level Dynamics: Oregon, 2017-2023

Area of Science:

• Gerontology
• Healthcare Management
• Public Health Policy

Background:

• Assisted living and residential care (AL/RC) communities provide essential services to diverse resident populations.
• Staffing levels are a critical determinant of care quality and operational efficiency in AL/RC settings.
• Understanding temporal trends in AL/RC staffing is vital for addressing workforce challenges and ensuring resident well-being.

Purpose of the Study:

• To analyze changes in staffing levels within Oregon AL/RC communities from 2017 to 2023.
• To investigate the impact of the COVID-19 pandemic on staffing patterns in AL/RC settings.
• To identify factors contributing to variations in staffing across different AL/RC communities.

Main Methods:

• A longitudinal study design was employed, analyzing 1720 setting-year observations from 535 Oregon AL/RC communities.
• Data were collected via the Oregon Community-Based Care (CBC) study, measuring care staff hours per resident per day.
• Fixed-effects linear regression models were used to control for time-invariant community characteristics.

Main Results:

• Mean care staff hours per resident per day ranged from 3 hours 11 minutes to 4 hours 1 minute.
• Occupancy rates declined significantly during the pandemic, from 80.3% to 72.2%.
• Total care staff levels increased by 19 minutes/resident/day in 2021 and 28 minutes/resident/day in 2023 compared to 2017, with most variation attributed to inter-community differences.

Conclusions:

• Significant variations in staffing levels across AL/RC communities suggest differences in operations, resources, and resident needs, impacting care quality.
• Post-pandemic shifts in staffing levels and mix necessitate policy development to enhance the adaptability and resilience of AL/RC settings.
• Further research into the relationship between staffing patterns and care outcomes is crucial for informing best practices.