TUESDAY, Jan. 10, 2023 (HealthDay News) — Day-to-day staffing stability is a marker of better quality of nursing homes, according to a study published online Jan. 10 in JAMA Network Open.

Dana B. Mukamel, Ph.D., from the University of California in Irvine, and colleagues examined whether staffing instability, defined as the percentage of days with below-average staffing levels, is associated with nursing home quality in a quality improvement study conducted at 14,717 nursing homes.

The researchers found that the mean percentage of days with below-average staffing was 30.2, 16.4, and 5.1 percent for registered nurses, licensed practical nurses, and certified nurse aides, respectively. Per resident-day, the mean staffing hours were 0.44, 0.80, and 2.20 for registered nurses, licensed practical nurses, and certified nurse aides, respectively. In regression models that included average staffing, there was a significant association observed between a higher percentage of below-average staffing days and worse quality for licensed practical nurses in 10 of 12 models; long-stay residents had the largest association for decline in activities of daily living. In nine of 12 models, a higher percentage of below-average staffing days was significantly associated with worse quality for certified nurse aides; the largest association was seen for short-stay functioning.

“It is clear that average staffing levels do not tell the whole story; now that the data are available to examine more nuanced aspects of staffing, such as the frequency with which a facility has below-average staffing, a more comprehensive view of nursing home staffing should be pursued,” the authors write.

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