Nursing home staffing and its relationship to deficiencies

Objectives. The authors examined the relationships between different types of nursing home staffing and nursing home deficiencies to test the hypothes is that fewer staff hours would be associated with higher numbers of defici encies. Methods. Data were from the On-Line Survey, Certification. and Reporting Sy stem for all certified nursing homes in the United States. Regression model s examined total deficiencies, quality of care, quality of life, and other deficiencies. Results. Fewer registered nurse hours and nursing assistant hours were asso ciated with total deficiencies and quality of care deficiencies, when other variables were controlled. Fewer nursing assistant staff and other care st aff hours were associated with quality of life deficiencies. Fewer administ rative staff hours were associated with other deficiencies. Facilities that had more depressed and demented residents, that were smaller, and that wer e nonprofit or government-owned had fewer deficiencies. Facilities with mor e residents with urinary incontinence and pressure sores and with higher pe rcentages of Medicaid residents had more deficiencies, when staffing and re sident characteristics were controlled. Discussion. Facility characteristics and states were stronger predictors of deficiencies than were staffing hours and resident characteristics. Becaus e only a small portion of the total variance in deficiencies could be expla ined. much work remains to explore factors that influence deficiencies.