Keywords

minimum staffing standards, nursing homes, nurse staffing, staffing ratios

 

Authors

  1. WELLS, JANET C. AB

Abstract

Since the late 1960s, consumer advocates have urged government implementation of mandatory minimum nurse staffing standards in nursing homes to overcome chronic understaffing, high staff turnover, and consequent neglect of residents. The debate over the efficacy and affordability of mandatory staffing standards has continued for more than 35 years. This report reviews the growing body of research verifying the connection between identified nursing staff-to-resident ratios and quality care; the prevalence of avoidable medical conditions and hospitalizations below certain hours per resident day of direct care; and inadequate enforcement by state and federal regulators. While the nursing home industry, federal health officials, and US Congress remain resistant to mandatory staffing standards, a few state legislatures have adopted legislation requiring the minimum ratios or hours of direct care per resident day recommended by experts. A larger number of states have implemented standards below the recommended minimums.