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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Amir Qaseem, MD, MHA1, Robert Weech-Maldonado, PhD2, Kathryn Dansky, PhD2, and Vincent Mor, PhD3. (1) Department of Health Policy & Administration, The Pennsylvania State University, 16 Henderson Bldg., University Park, PA 16802, (814) 863-8062, aqaseem@psu.edu, (2) Health Policy & Administration, Pennsylvania State University, 116 Henderson Building, University Park, PA 16801, (3) Center for Gerontology and Health Care Research, Brown University, P.O. Box GA-411, Providence, RI 02912
The Prospective Payment System (PPS) was implemented under BBA (1997) to control the increasing costs of providing care in nursing homes. Reduced payments under PPS added pressures on nursing homes to reduce costs. Using the production function of the firm framework, this study seeks to investigate the impact of BBA on nursing staff intensity and skill levels. Our sample consists of all Medicare and Medicaid certified nursing homes during the period of 1995 to 1998. Data sources include the Online Survey Certification and Reporting System (OSCAR) and the Area Resource File (ARF). This study used regression to model the effect of time on staff intensity level (staff per 100 beds) and skill mix (proportion of total staff) for different types of nursing staff: Registered Nurses (RN), Licensed Practical Nurses (LPN), and Certified Nurse Aides (CNA). Our analysis shows a significant decrease in RN and CNA skill mix with an increase in LPN ratio during 1997 and 1998. There was also a decrease in RN, LPN, and CNA intensity level during 1998. Preliminary results indicate that the PPS might have resulted in a decrease in the proportion of RNs to total staff and RNs per 100 beds. However, it was somewhat compensated with an increase in the percentage of LPNs to total staff. Policymakers should monitor the impact of PPS on staffing patterns. There is a need to balance cost containment with the maintenance of proper levels of nursing staff to ensure quality care.
Learning Objectives:
Keywords: Long-Term Care, Population
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.