For skilled nursing facilities, this research signals that day-to-day staffing variability already captured through Payroll Based Journal data may become a separate quality metric under Care Compare’s Five-Star rating system.
Our study found that instability in total nursing home staffing is only weakly correlated with total staffing turnover, and that the 2 measures are independently associated with nursing home quality. These findings demonstrate that 2 key measures of nursing home staffing—staffing instability and turnover—conceptually and empirically measure different things, over and above average staffing levels. Therefore, adding measures of staffing instability to the existing measures of average staffing and staff turnover in NHCC may enhance the report card’s value for providers engaged in quality improvement and consumers searching for high-quality nursing homes.
Sinha, Soham, et al. “New Dimensions of Staffing Patterns in Nursing Homes and Nursing Home Quality: Comparing Staffing Instability to Staffing Turnover.” Journal of the American Medical Directors Association, vol. 24, no. 8, Aug. 2023, pp. 1099–1105.e7, doi:10.1016/j.jamda.2023.04.009.
Recommendation Issued for Making Staffing Instability a Care Compare Quality Measure
“Turnover was positively and more strongly associated with the prevalence of pressure ulcers and worsening mobility in long-stay residents and hospitalizations in short-stay residents,” researchers wrote.
— Skilled Nursing News, August 16, 2023
