Intended and unintended consequences of minimum staffing standards for nursing homes.

Abstract:

:Staffing is the dominant input in the production of nursing home services. Because of concerns about understaffing in many US nursing homes, a number of states have adopted minimum staffing standards. Focusing on policy changes in California and Ohio, this paper examined the effects of minimum nursing hours per resident day regulations on nursing home staffing levels and care quality. Panel data analyses of facility-level nursing inputs and quality revealed that minimum staffing standards increased total nursing hours per resident day by 5% on average. However, because the minimum staffing standards treated all direct care staff uniformly and ignored indirect care staff, the regulation had the unintended consequences of both lowering the direct care nursing skill mix (i.e., fewer professional nurses relative to nurse aides) and reducing the absolute level of indirect care staff. Overall, the staffing regulations led to a reduction in severe deficiency citations and improvement in certain health conditions that required intensive nursing care.

journal_name

Health Econ

journal_title

Health economics

authors

Chen MM,Grabowski DC

doi

10.1002/hec.3063

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

822-39

issue

7

eissn

1057-9230

issn

1099-1050

journal_volume

24

pub_type

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