SESSION ABSTRACT: “Nursing home staffing, costs and quality of care”

Quality of care in nursing home continues to be of concern to nursing home residents, their families, advocates and policy makers. Despite decades of debates, reforms and policy initiatives by both the CMS and state governments, recent statistics continue to highlight major concerns about the quality that the 1.6 million elderly residing in nursing home receive. It has long been recognized that the nature of the care required by nursing home residents, being low-tech and high-touch, implies that the quality and costs of care are highly dependent on staffing levels, training and staff organization. In this session we will present empirical evidence on several aspects of staffing initiatives in California and New York State and their implications for nursing home care.

•"Factors associated with perceived work effectiveness in nursing homes." Temkin-Greener H., Cai S., Mukamel D.B.

•"Impact of California's 2004 reimbursment reform on staffing and quality." Harrington C., O Meara J., Collier E., Kang T., Stephens C.

•"Effects of improving nursing staff wages on turnover." Schnelle J.F., Simmons S.S., Sato. H.W., Chang J.J., Mukamel D.B.

•"Do management practices affect nursing home staff turnover?" Temkin-Greener H., Cai S., Mukamel D.B.

•"Can teams in nursing homes save costs?" Mukamel D.B., Cai S., Temkin-Greener H.

These studies offer empirical evidence on the value of organizing staff in teams and of enhancing reimbursement to increase staffing. They also raise important questions about the effectiveness of financial incentives alone in achieving costs and quality goals.