The Relationship Between Reported Staffing and Expenditures in Nursing Homes

Medical Care Research and Review : MCRR
Hari SharmaFabrice Smieliauskas

Abstract

Dramatic improvements in reported nursing home quality, including staffing ratios, have come under increased scrutiny in recent years because they are based on data self-reported by nursing homes. In contrast to other domains, the key mechanism for real improvement in the staffing ratios domain is clearer: to improve scores, nursing homes should increase staffing expenditures. We analyze the relationship between changes in expenditures and reported staffing quality pre- versus post the 5-star rating system. Our results show that the relationship between expenditures and licensed practical nurse staffing is weaker in the post-5-star period, overall, and across subgroups; furthermore, there is a weaker relationship between expenditures and registered nurse staffing among for-profit facilities with a high share of Medicaid residents in the post-5-star period. The weaker relationship between staffing expenditures and staffing scores in the post-5-star era underscores the potential for gaming of the self-reported staffing scores and the need for more reliable sources.

References

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Citations

Jun 10, 2018·Medical Care Research and Review : MCRR·John R Bowblis, Amy Restorick Roberts
Apr 9, 2019·Journal of Applied Gerontology : the Official Journal of the Southern Gerontological Society·Hari SharmaR Tamara Konetzka
Jun 17, 2020·Medical Care Research and Review : MCRR·R Tamara KonetzkaRachel M Werner
May 1, 2021·Journal of the American Medical Directors Association·Hari Sharma, Lili Xu
Apr 28, 2021·The Gerontologist·R Tamara KonetzkaTetyana P Shippee
Jan 28, 2022·Journal of Applied Gerontology : the Official Journal of the Southern Gerontological Society·Colleen KummetSara Vitolo

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