![]() ![]() Outcome measures were as follows: mean (SD) COV, 0.5 (0.6) for RNs and 0.1 (0.1) for CNAs mean (SD) TOD, 220 (69) for RNs and 44 (45) for CNAs and mean (SD) LOD, 116 (45) for RNs and 22 (24) for CNAs. ![]() The mean (SD) hours-per–resident-day were 0.41 (0.29) for RNs and 2.16 (0.49) for CNAs, and a mean (SD) 55% (26%) of residents were Medicaid beneficiaries. Results A total of 13 339 nursing homes were included in this study, with 9476 (71%) for-profit facilities. The association between these measures and quality rankings and other facility characteristics were evaluated. Main Outcomes and Measures Three measures of daily variation, ie, coefficient of variation (COV), total outlier days (TOD), and low outlier days (LOD), were calculated for RNs and CNAs. Data were analyzed from January 2017 to December 2018. Retrospective analyses of the Payroll-Based Journal, Medicare Cost Reports, and Nursing Home Care Compare were conducted. Objective To examine daily variation in staffing, its association with quality, and whether daily variation provides information regarding quality ranking of nursing homes over and above the information provided by average staffing levels.ĭesign, Setting, and Participants This quality improvement study included registered nurses (RNs) and certified nurse aide (CNAs) at 13 339 certified nursing homes throughout the United States during 2017 to 2018. They may, however, mask daily variation in staffing, additional information that could be important for understanding nursing home quality and relative ranking. Importance Average staffing measures are a focus of nursing homes’ quality assessments and reporting. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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