Nursing Home Staffing Requirements and Input Substitution: Effects on Housekeeping, Food Service, and Activities Staff

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Nursing homes, regulation, staffing requirements, support staff, housekeeping, food service, activities staff

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Objective: To study the effect of minimum nurse staffing requirements on the subsequent employment of nursing home support staff.

Data Sources: Nursing home data from the Online Survey Certification and Reporting (OSCAR) System merged with state nurse staffing requirements.

Study Design: Facility-level housekeeping, food service, and activities staff levels are regressed on nurse staffing requirements and other controls using fixed effect panel regression.

Data Extraction Method: OSCAR surveys from 1999 to 2004.

Principal Findings: Increases in state direct care and licensed nurse staffing requirements are associated with decreases in the staffing levels of all types of support staff.

Conclusions: Increased nursing home nurse staffing requirements lead to input substitution in the form of reduced support staffing levels.

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Citation / Publisher Attribution

Health Services Research, v. 48, issue 4, p. 1539-1550