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. 2023 Dec;80(6):631-640.
doi: 10.1177/10775587231187782. Epub 2023 Jul 18.

Beyond Nursing Staff Levels: The Association of Nursing Home Quality and the Five-Star Quality Rating System's New Staffing Measures

Christopher S Brunt  1 , John R Bowblis  2
Affiliations

Beyond Nursing Staff Levels: The Association of Nursing Home Quality and the Five-Star Quality Rating System's New Staffing Measures

Christopher S Brunt et al. Med Care Res Rev. 2023 Dec.

Abstract

Recently, the Centers for Medicare & Medicaid Services (CMS) introduced staffing measures related to staffing variability and turnover in the Nursing Home (NH) Care Compare Five-Star Quality Rating System. While the consensus within the literature is that reduced variability and turnover are associated with higher NH quality of care and life, no existing studies have evaluated the relationship between CMS's newly introduced staffing measures and quality. This study uses regression analysis to estimate the relationship between 13 quality measures (used in Care Compare) and CMS's new staffing measures (i.e., weekend nursing staff levels, total nursing and registered nurse staff turnover, and administrator turnover) as well as a measure of daily staffing variation recently introduced in the literature called the coefficient of variation. Regressions analysis finds strong evidence of an association between quality and these staffing measures, though some measures (e.g., nursing staff turnover) are highly correlated and may be duplicative.

Keywords: nursing homes; quality of care; staffing; turnover.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: C.B. has received funds from the State of Georgia’s Office of Health Strategy and Coordination to conduct research and advise on nursing home policy. J.B. has received funds from various state agencies and the federal government to conduct research on nursing homes and advise on nursing home policy. He has also been retained as an expert witness in legal matters involving the health care and other industries.

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