The Institute of Medicine, in a report from the Committee on Improving Quality in Long Term Care (2001), indicated the continued use of standardized assessment data was essential for improving quality of resident care in long term care. This study utilized staffing measures, hours/resident/day, for Registered Nurses (RN), Licensed Vocational Nurses (LVN), and Certified Nurses Aides (CNA) to determine if there were significant differences in quality measure scores (QMs), obtained from Nursing Home Compare (NHC) in Feb 2004, across different staffing levels. In addition, this study used facility level data, collected from the Missouri Department of Health and Senior Services, to evaluate differences in QMs associated with frequency of administrative turnover ten years prior to this evaluation.
Staffing measures were calculated for each group with a high (RN>.44, LVN>.73, CNA>2.59), medium (RN>.30, LVN>.53, CNA>2.14) and low (RN<.30, LVN<.53, CNA<2.14) number of staffing hours/resident/day. Frequency of administrative turnover was calculated for the number of times each facility had an administrator change since 1994. Analysis of variance was used to determine mean differences in QMs using three staffing levels. Post hoc Bonferroni analyses were tabulated for each QM indicating a significant difference. Statistical analysis revealed significant differences in three QMs for staffing measures including: 1) Percentage of residents need for help with daily activities has increased, 2) Percentage of low-risk residents who lose control of the bowels or bladder, and 3) Percentage of short stay residents who have moderate to severe pain. Currently we are carrying out similar statistical analyses for the administrator turnover data.
Different staffing levels can significantly affect QMs in nursing homes. Furthermore, administrative turnover in nursing home facilities, while required by HCFA and reported to states, is not part of NHC. Understanding how these variables affect nursing home quality is essential to providing good nursing home care.
Session #1223 - Graduate Student Poster Session
The 29th Annual MNRS Research Conference (April 1-4, 2005)