Snapshot: Staffing and Quality in California Nursing Homes

Publication Date: July 2006

Publisher: California HealthCare Foundation

Author(s): Charlene Harrington; Janis O'Meara; Taewoon Kang

Research Area: Health

Type: Brief

Coverage: California

Abstract:

In response to research linking increased nursing hours to better quality of care, California passed legislation in 1999 that raised the minimum required amount of nursing services in nursing homes from 3.0 to 3.2 hours per resident day. Staffing levels have improved steadily and most of the state's nursing homes are now meeting this standard. In an effort to improve the quality of care nationally, the U.S. Centers for Medicare and Medicaid Services recommends a staffing level of 4.1 to 4.5 hours per resident day. However, the additional resources necessary to meet this goal are limited or unavailable. Studies indicate that California nursing homes that achieve the federally recommended staffing level have, on average, lower staff turnover rates, fewer deficiencies and standards violations, and fewer complaints. This snapshot examines a range of issues linked to quality of care including compliance with minimum staffing standards, turnover rates, deficiencies, and comparisons of for-profit and nonprofit settings. Key findings include:

*Turnover rates for nursing staff in freestanding nursing homes decreased by 19% from 2000 to 2003. *Nonprofit nursing home staff turnover rates are 17% lower than for-profit homes, and the number of deficiencies and citations is 36% lower. *For-profit nursing homes are making significant progress in meeting California's minimum staffing standard.