The influence of registered nurse staffing on the quality of nursing home care

Munroe, Donna J.

doi:10.1002/nur.4770130409

Cited by 145 publications

(96 citation statements)

References 6 publications

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“…Nursing homes provide little in the way of professional care; most care is provided by NAs. As Munroe (1990) describes, staffing in nursing homes is ''bottom-heavy.'' The provision of individualized care to improve quality outcomes is seen as intricate.…”

Section: Analytic Modelmentioning

confidence: 97%

Mental Health Care Deficiency Citations in Nursing Homes and Caregiver Staffing

Castle

Myers

2006

Adm Policy Ment Health

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In this paper, we examine the association between caregiver staffing levels and mental health outcomes in approximately 17,000 U.S. nursing homes. As outcomes, we focus on deficiency citations available in the Center for Medicare and Medicaid Services' Online Survey, Certification, And Recording data. We examine nurse aide, licensed practical nurse, registered nurse, and mental health provider staffing. Our results show that the level of nursing staff matter with respect to mental health outcomes. Whereas greater RN staffing was associated with a lower likelihood of being cited for deficiencies in mental health care, greater LPN and NA staffing were associated with a higher likelihood. We found no association between mental health provider staffing levels and mental health outcomes.

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Section: Analytic Modelmentioning

confidence: 97%

Mental Health Care Deficiency Citations in Nursing Homes and Caregiver Staffing

Castle

Myers

2006

Adm Policy Ment Health

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“…Previous studies have provided mainly indirect evidence of quality differences between nonprofit and for-profit nursing homes [20,24,25]. Several studies use measures of quality based on regulator judgement [7,[26][27][28] or resource use [10,18,29].…”

Section: Empirical Evidence On For-profit and Nonprofit Nursing Homesmentioning

confidence: 99%

The impact of ownership type on nursing home outcomes

Spector¹,

Selden²,

Cohen³

1998

Health Econ.

119

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This paper examines the sorting of residents between for-profit and nonprofit nursing homes and the health outcomes of those residents conditional on ownership type. Using data from the 1987 National Medical Expenditure Survey, we find evidence of systematic sorting of residents by ownership type, and significant effects of ownership type on outcomes. These results are broadly consistent with the hypothesis that for-profit and nonprofit homes exploit their informational advantages to differing extents in a market characterized by asymmetric information.

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“…The vast majority of nursing home workers are CNAs or other workers of similar skill levels, such has housekeeping and food service staff. The labor market for these types of workers is characterized by great fluidity and wages close to the minimum wage (Munroe 1990). This implies that most nursing home workers earn wages that are about the same as the wages of similar skill-level 13 An alternative model specification that was utilized that does not require a time trend to be defined is to utilize a long-differenced model.…”

Section: Exclusion Restriction Variablementioning

confidence: 99%

The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession

Antwi¹,

Bowblis²

2016

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in ABSTRACTWe estimate the causal effect of nurse turnover on mortality and the quality of nursing home care with a fixed effect instrumental variable estimation that uses the unemployment rate as an instrument for nursing turnover. We find that ignoring endogeneity leads to a systematic underestimation of the effect of nursing turnover on mortality and quality of care in a sample of California nursing homes. Specifically, 10 percentage point increase in nurse turnover results in a facility receiving 2.2 additional deficiencies per annual regulatory survey, reflecting a 19.3 percent increase. Not accounting for endogeneity of turnover leads to results that suggest only a 1 percent increase in deficiencies. We also find suggestive evidence that turnover results in lower quality in other dimensions and may increase mortality. An implication of our mortality results is that turnover may be a mechanism for the procyclicality of mortality rates. JEL Classification Codes: I11, J21, E24

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The influence of registered nurse staffing on the quality of nursing home care

Cited by 145 publications

References 6 publications

Mental Health Care Deficiency Citations in Nursing Homes and Caregiver Staffing

Mental Health Care Deficiency Citations in Nursing Homes and Caregiver Staffing

The impact of ownership type on nursing home outcomes

The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession

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