MNSTR
Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes
(Nursing Home Staffing)
Funded by: Health Care Financing Administration
Project Period: 3/99 - 9/01
In response to heightened public concern over adequate nursing home staffing,
many states have imposed specific staffing requirements through legislation or
licensure requirements. This Congressionally-mandated study investigated the
adequacy of nursing home staffing levels and proposed and evaluated a minimum
nurse-to-patient staffing ratio. Quantitative analyses linked MDS assessments,
Medicare Part A claims, OSCAR data, payroll data, and Medicaid cost reports for
residents in approximately 5000 facilities in 10 states. Qualitative analyses
assessed the influence of additional features of nurse staffing, such as staff
allocation, absenteeism, knowledge, training, and management and supervision on
quality of care. Intensive, two-week site visits were conducted in 17 facilities
in three states. Two reports were submitted to Congress (July 2000 and December
2001), and testimony was given before the Senate Special Committee on Aging.
Key Staff: Kramer, Louwe
Research Monographs:
Kramer AM, Eilertsen TB, Lin MK, Hutt E. "Effects of Nurse Staffing on Hospital Transfer Quality Measures for New Admissions." Chapter 9 in Study and Report to Congress on Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes. Completed under contract number 500-95-0062 T.O. 3. From the Health Care Financing Administration. July 2000.
Hutt E, Lin MK, Kramer AM. "Effects of Nurse Staffing on Selected Quality Measures for Long Term Residents Derived from MDS." Chapter 10 in Study and Report to Congress on Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes. Completed under contract number 500-95-0062 T.O.3. From the Health Care Financing Administration. July 2000.
Martau JM, Lin MK, Kramer AM. "Effects of Nurse Staffing on Selected Quality Measures for Long Term Residents Derived from Primary Data." Chapter 11 in Study and Report to Congress on Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes. Completed under contract number 500-95-0062 T.O. 3. From the Health Care Financing Administration. July 2000.
Kramer AM, Eilertsen TB, Lin MK, Martau JM, Hutt E. "Synthesis of Findings on Effects of Staffing On Quality of Care." Chapter 12 in Study and Report to Congress on Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes. Completed under contract number 500-95-0062 T.O. 3. From the Health Care Financing Administration. July 2000.
Lin MK, Louwe HM, Tufts J, Ecord MK, Kramer AM. "Design Plan for Task 4 Case Studies." Completed under contract number 500-95-0062 T.O. 3. From the Health Care Financing Administration. November 2000.
Louwe HM, Kramer AM. "Case Studies of Nursing Facility Staffing Issues and Quality of Care." Chapter 6 in Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes: Phase II Final Report. Abt Associates Inc., December 2001.
Kramer AM, Fish RH. "The Relationship Between Nurse Staffing Levels and the Quality of Nursing Home Care." Chapter 2 in Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes: Phase II Final Report. Abt Associates Inc., December 2001.
Congressional Testimony:
Testimony before Senate Special Committee on Aging Hearing. "Appropriateness of Minimum Nursing Staff Ratios in Nursing Homes." Washington, D.C.. July 27, 2000.
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