For skilled nursing facilities, these findings connect PBJ-reported agency staffing patterns directly to CMS Five-Star outcomes.
Threads of Care: Unraveling the Impact of Agency Nursing Staff on Nursing Home Quality
A 10% increase in agency registered nurses, licensed practical nurses, and certified nursing assistants (logged) was associated with a decrease in the odds of achieving a higher star rating by 4%, 5%, and 4%, respectively (P < 0.001). The use of agency nursing staff can negatively impact NH quality. Efforts to better integrate agency nursing staff into NHs, combined with strategies to recruit and retain permanent nursing staff, could lead to improved outcomes for residents.
Pradhan, Rohit, et al. “Threads of Care: Unraveling the Impact of Agency Nursing Staff on Nursing Home Quality.” Medical Care, vol. 63, no. 7, 2025, pp. 479–486. DOI: 10.1097/MLR.0000000000002114.
Agency Nursing Staff Utilization and Turnover in Nursing Homes: A Longitudinal Analysis
NHs identified as high utilizers had significantly higher turnover rates among permanent RNs (7%) and CNAs (1.9%) compared to facilities that had low utilization of agency nurses (p < 0.001). Given that turnover can negatively impact nursing home performance, administrators should carefully balance the use of agency nursing staff to meet immediate needs against its potential negative impact on staff retention and overall performance.
— Healthcare (MDPI), February 11, 2025
Agency nurses linked to lower CMS nursing home quality ratings
The use of agency registered nurses, licensed practical nurses and certified nursing assistants decreased a facility’s chance of attaining higher star ratings by 4%, 5% and 4%, respectively, researchers discovered. ”
Agency nurses have less familiarity with residents’ specific needs and facility protocols, potentially impacting continuity and consistency in care,” Rohit Pradhan, health services researcher at Texas State University, told McKnight’s Long-Term Care News Sunday. “Their presence may also create issues for permanent nursing staff who may feel that they have to ‘guide’ the agency nursing staff.”
— McKnight’s Long-Term Care News, January 6, 2025
Agency nurses linked to lower CMS ratings: 2 notes
Researchers found that a 10% increase in agency staff was associated with a decrease in the odds of achieving a higher star rating by 4% to 5%.
“The use of agency nursing staff can negatively impact nursing home quality,” the study authors wrote. “Efforts to better integrate agency nursing staff into nursing homes, combined with strategies to recruit and retain permanent nursing staff, could lead to improved outcomes for residents.”
— Becker’s Hospital Review, January 6, 2025
