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Nurse Staffing Levels and Quality of Care in Rural Nursing Homes

Hung P., Casey M., Moscovice I.

The purpose of this study was to examine the relationship between nurse staffing levels and care quality in rural nursing homes, and to assess potential differences between hospital-based and freestanding rural nursing homes.

Key Findings:

  • Hospital-owned nursing homes in rural areas have higher nursing staffing levels than freestanding nursing homes.
  • From 2006 to 2011, most quality of care measures for long-stay residents improved in both rural hospital-based and freestanding nursing homes.
  • Higher registered nurse (RN) shares of nurse staffing [the ratio of RN FTEs divided by all RN FTEs and licensed practical nurse (LPN) FTEs were associated with better quality in both rural hospital-based and freestanding nursing homes.
  • On average, a rural facility had to have at least one RN FTE per four total nurse FTEs to significantly improve the composite quality measure for long-stay residents.

 

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