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KMID : 1138720120380010057
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Korean Public Health Research
2012 Volume.38 No. 1 p.57 ~ p.68
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Factors Associated with Nurse Staffing Levels in Nursing Homes
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Lee Hyang-Yuol
Blegen Mary A.
Harrington Charlene
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Abstract
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Objectives: This study examined the association of Medicaid nursing home reimbursement and resident casemix (acuity), and other factors on nurse home staffing levels in a small rural state of United States.
Methods: Secondary data were used from the Online Survey Certification and Reporting (OSCAR) system, the Minimum Data Set, state reimbursement and staffing data, and the Area Resource File (ARF) to examine 195 freestanding nursing homes in Colorado. Two-stage least squares regression models were used to take into account the endogeneity of Medicaid reimbursement rates, resident case mix, and staffing levels, while controlling for clustering by geographical regions.
Results: The findings showed that higher estimated Medicaid reimbursement rates were associated with higher
RN hours, the percent of RN to total staffing hours, and total nurse staffing levels, but estimated resident casemix was not associated with staffing levels.
Conclusion: Medicaid payment is an important incentive for improving staffing levels in nursing homes, even
in a small rural state like Colorado.
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KEYWORD
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Nursing Homes, Medicaid Reimbursement, Resident Casemix, Nurse Staffing Levels
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