As CMS enforces the federal minimum staffing rule and PBJ data continues to drive Five-Star ratings, this research signals that the composition of RN, LPN, and CNA hours shapes outcomes across the quality measures CMS uses to score facilities.
The Relationship between Nursing Home Staffing and Health Outcomes Revisited
“Several findings are of particular interest. The first is that increasing CNA staffing lowers use of antipsychotic medications while increasing RN staffing increases it… These findings suggest that there are important nuances and interplays between staffing types. Although they suggest in some of the cases that increasing staff HPRDs improves outcomes, they also indicate that considering how the scope of practice among RNs, LPNs, and CNAs plays out in practice, and how they interact and support each other is an important consideration in optimizing the quality of care they provide.”
Mukamel, Dana B., et al. The Relationship between Nursing Home Staffing and Health Outcomes Revisited. JAMDA, 12 June 2024. https://doi.org/10.1016/j.jamda.2024.105081
Staffing: Does it really matter?!
Overall, the findings remind us we need to learn more about staffing and the interplay between staffing levels across RNs, LPNs and CNAs. We may need to explore more about scope of practice and make sure the scope of practice and knowledge and ability of the individual match what they are able to perform.
Although the idea of staffing requirements for nursing homes is of great concern, maybe it will help us to finally learn more about the impact of staffing on the needs of residents and the best way to optimize the quality of care.
— McKnight’s Long-Term Care News, September 27, 2024
“In an era when new staffing regulations are under consideration and specific levels are being debated, it is important to have accurate estimates of the relationship between staffing levels and quality… The intricate relationship between nursing disciplines and resident care requires a nuanced approach to policies that go beyond simple headcounts. Hiring decisions, including ones about staffing mix, should be tailored to meet the needs of individual residents.”
— Skilled Nursing News, July 18, 2024
Nursing Home Staffing Decisions and Policies Must Go ‘Beyond Simple Headcounts’: Researchers Find
“These outcomes suggest that RNs and CNAs have a different focus in their roles. CNAs are often closer to residents. This enables them to develop insights into residents’ routines and offer behavioral modifications to mitigate symptoms, while RNs might focus on communicating behavioral issues to prescribing providers and developing overall care plans.”
— McKnight’s Long-Term Care News, July 18, 2024
