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Resources on Improving Nurse Staffing

  • Consumer Voice's Better Staffing: The Key to Better Care Campaign
    We know that higher levels of staffing lead to better care, but the federal government does not require nursing homes to have at least a minimum number of staff on duty. As a result, every day across the country there are nursing home residents who aren’t getting the care they need because there aren’t enough aides and nurses. Understaffing harms nursing home residents and can lead to pressure ulcers (bedsores), infections, malnutrition, dehydration and injuries from falls. Our Nursing Home Staffing Campaign will educate the public and policymakers about the need for stronger nursing home staffing laws at both the state and federal levels and advocate for such laws to be passed.

  • The Need for Higher Minimum Staffing Standards (2016)
    This report eviews how nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing.  The report by Charlene Harrington, John F. Schnelle, Margaret McGregor and Sandra F. Simmons discusses the relationship between nursin ghome quality and staffing and the barriers to staffing reform.  Multiple studies have demonstrated a need for higher minimum nurse staffing standards in nursing homes as it is shown to have a positive relationship with nursing home quality.  Yet, many barriers prevent the implementation of higher staffing standards like concerns about cost and enforcement and strong nursing home industry political opposition.

  • Kansas Legislation Proposed to Increase State Minimum Staffing Standard

  • Analyses on Outcomes of Increased Nurse Staffing Policies in Florida Nursing Homes: Staffing Levels, Quality and Costs (2002-2007) Section 6 of House Bill (HB) 5003 requires the Agency for Health Care Administration (AHCA) to “study the effects of the minimum nursing home staffing ratios found in s. 400.23(3), Florida Statutes, and the relationship to Medicaid reimbursement and the quality of care provided to residents. The agency shall report its findings to the Governor, the President of the Senate and the Speaker of the House of Representatives by February 1, 2009.” Researchers from the University of South Florida’s Florida Policy Exchange Center on Aging, the University of Florida’s College of Health Professions and Texas A&M contracted with the Agency for Health Care Administration to prepare a preliminary report in March. This final report provides some additional analysis using data on quality measures. Finally, this report builds on research supported by earlier grants from the Commonwealth Fund and the Administration on Aging.

  • Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes - Report to Congress: Phase II Final, Volume I This purpose of this report is to complete the Report to Congress that was mandated by Public Law 101-508 which required the Secretary to report to the Congress on the appropriateness of establishing minimum caregiver ratios for Medicare and Medicaid certified nursing homes. A Phase I report of preliminary findings was delivered to Congress in July 2000.

  • Nurse Staffing Standards Recommended by Consumer Voice: In 1998, Consumer Voice's members approved what are widely known as the Consumer Voice Minimum Staffing Standards for nursing homes.

  • Consumer Perspective on Quality Care (Executive Summary) This 1985 document is still a seminal study of quality care as defined by the experts -- nursing home residents themselves. It recounts the research, discussions and findings of a Consumer Voice survey of 400 residents in 15 cities and shows their strong endorsement of nurse staffing as the most important component of care.

  • Improving the Quality of Care - Increase Nursing Staffing Minimum Hours in Kansas Nursing Facilities (January 2011) Prepared by AARP-Kansas & Kansas Advocates for Better Care

  • Kansas Staffing Bill Senate Bill 184

  • Kentucky House Bill 337 - Staffing Ratios

  • Kentucky Staffing Bill Senate Bill 91

  • Nursing Home Staffing Standards in State Statutes and Regulations (December 2010) A compilation of nursing care requirements in all states. 

  • Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2005 Through 2010 by Charlene Harrington, Ph.D., et al The October 2011 edition of this book shows trends in U.S. nursing homes by state for 2005 through 2010. The data are from the federal On-Line Survey and Certification System (OSCAR) reports that are completed at the time of the annual nursing home surveys by state Licensing and Certification programs for the U.S. Centers for Medicare and Medicaid Services. Book sections include: Introduction; Facility Characteristics; Resident Characteristics and Services Provided; Staffing Levels; Facility Deficiencies from State Survey Evaluations; Summary; References; and Technical Notes.

  • PHI California’s Direct-Care Workforce Fact Sheet The Paraprofessional Healthcare Institute (PHI), with support from The SCAN Foundation, complied a fact sheet addressing critical issues surrounding the direct care workforce of California. Each day, more than a half million personal attendants, home health aides, and nursing aides provide essential daily living services and supports to persons with disabilities and chronic care needs, including the elderly. This fact sheet explores the demographics and growing demand for a highly trained direct care workforce to meet the current and future needs of older Californians and those with disabilities.

  • The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes (Abstract) This study examines the relationship between increasing certified nursing assistants (CNAs) and licensed nurse staffing ratios and deficiencies in Florida nursing homes over a four-year period.To view the full study, you must be a subscriber to the database.

  • Nursing Home Staffing Guide (second edition 2002) The Consumer Voice for Quality Long-Term Care guide for residents, families, friends, and caregivers


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