For SNFs, antipsychotic use is a publicly reported quality measure that contributes to Five Star ratings and CMS compliance oversight.
The Relationship between Nursing Home Staffing and Health Outcomes Revisited (August 2024)
Our findings demonstrate the importance of accounting for endogeneity in studies of staffing and quality. Endogeneity changes conclusions about significance, direction, and magnitude of the relationship between staffing and specific quality measures. These findings highlight the need to further study and understand the nuanced relationship between different staffing types and different health outcomes such as the difference between the relationship of RN and CNA hours per resident day to antipsychotic quality measures.
Mukamel, Dana B., et al. “The Relationship Between Nursing Home Staffing and Health Outcomes Revisited.” Journal of the American Medical Directors Association, vol. 25, no. 8, June 2024, p. 105081. https://doi.org/10.1016/j.jamda.2024.105081.
There was a 0.75% decrease in inappropriate antipsychotic prescribing per unit increase in overall staff-to-patient ratio. When looking at staffing types, a 3.09% decrease in inappropriate antipsychotic prescribing was observed per unit increase in licensed staff hours. More specifically, we saw a 2.25% decrease per unit increase in RN staffing hours, a 1.83% decrease per unit increase in LPN staffing hours, and nursing aide staffing hours were not associated with antipsychotic use.
Chappell, Victoria, et al. “Association Between Long-Term Care Facility Staffing Levels and Antipsychotic Use in US Long-Term Care Facilities.” Journal of the American Medical Directors Association, vol. 23, no. 11, Nov. 2022, pp. 1787–1792.e1. doi:10.1016/j.jamda.2022.06.029.
Antipsychotics use falls when LTC nurse staffing hours rise: study
“Nonpharmacological strategies are recommended as the first-line strategy to address behaviors in dementia; however, this approach is more time-consuming and therefore more difficult in low-staffing environments,” they wrote.
— McKnight’s Long-Term Care, August 05, 2022
Antipsychotic Use in US LTC Facilities Connected With Staffing Levels
“These findings provide support for policy-based interventions to decrease antipsychotic use in LTC facilities by improving staffing skill mix and staffing levels,” wrote researchers.
— Annals of Long-Term Care, August 03, 2022
