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.
- 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.