Abstract
Objective
Public reporting is a policy to improve quality and increase data transparency. The
objective was to examine the association between publicly available staffing ratios
and the Five-Star Quality Ratings from Nursing Home Compare over time.
Design
Panel data analysis.
Setting and Participants
About 146 nursing homes with complete quarterly data in New Jersey between January
1, 2012, and December 31, 2019.
Methods
Using data from the State of New Jersey Department of Health and Nursing Home Compare,
staff-to-resident ratios were trended for registered nurses, licensed practical nurses,
and certified nursing assistants by shift and over time. Panel data analysis was used
to test the association between the ratios and the ratings.
Results
Compared to 2012, staffing ratios improved slightly for licensed practical nurses
but not for registered nurses or certified nursing assistants in 2019 (P < .001). The number of residents assigned doubled at night for all personnel. During
the day and evening shifts, registered nurse staffing was significantly associated
with the Nursing Home Compare staffing rating (P < .01) but not the overall rating.
Conclusions and Implications
Decreasing the number of residents assigned to a registered nurse in NHs results in
an increase in staffing ratings. Mandatory public reporting holds nursing homes accountable
for quality outcomes but does not improve staffing ratios. Quality resident care is
the cumulative result of multiple measures inclusive of staffing; therefore, administrators
should continue to focus on improving quality in NHs, which may improve staffing ratios
across shifts.
Keywords
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Article info
Publication history
Published online: April 13, 2021
Footnotes
This work was supported by the Agency for Healthcare Research and Quality (AHRQ; grant number 1K08HS024339-01A1) Mentored Clinical Scientist Research Career Development Award. The findings are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the US Department of Health and Human Services.
The authors declare no conflicts of interest.
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© 2021 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
