Evidence map›Paper›PMID 37247823›Full record

ArticleJournal of the American Medical Directors Association2023

New Dimensions of Staffing Patterns in Nursing Homes and Nursing Home Quality: Comparing Staffing Instability to Staffing Turnover.

Soham Sinha, Dana B Mukamel, Debra Saliba, Heather Ladd, R Tamara Konetzka

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Directors Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
5.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 13 citations in OpenAlex.

  1. Effect of Staffing and Wages on Turnover of Nonclinical Support Staff in Nursing Homes.Journal of the American Medical Directors Association · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Soham SinhaDepartment of Public Health Sciences, The University of Chicago Biological Sciences, Chicago, IL, USA. Electronic address: sohams@uchicago.edu.
Dana B MukamelDepartment of Medicine, Public Health and Nursing, information Technology Enhancing Quality Care (iTEQC) Research Program, University of California, Irvine, Irvine, CA, USA.
Debra SalibaBorun Center at University of California, Los Angeles, Geriatric Research, Education, and Clinical Centers, Veterans Administration, Los Angeles, CA, USA; RAND, Santa Monica, CA, USA.
Heather LaddDivision of General Internal Medicine, Department of Medicine, iTEQC Research Program, University of California, Irvine, Irvine, CA, USA.
R Tamara KonetzkaDepartment of Public Health Sciences, Department of Medicine, The University of Chicago Biological Sciences, Chicago, IL, USA.
University of California, Irvine · USChicago Department of Public Health · USUniversity of California, Los Angeles · USUniversity of Chicago · US

Funding

Staffing and Health Outcomes in Nursing Homes for Residents with and without DementiaR01AG066742 · NIA · UNIVERSITY OF CALIFORNIA-IRVINE · PI MUKAMEL, DANA B · 2020 to 2024
$3.0M
NIA NIH HHS R01 AG066742
6 · The paper itself

Abstract

objectiveThis study examines how measures of staffing-turnover and instability-are associated with one another and how they independently contribute to quality of care in nursing homes.

designCross-sectional analysis of 2021-2022 administrative data. Data included the Payroll Based Journal for daily staffing information, merged with Nursing Home Care Compare (NHCC) data for nursing home characteristics, total staffing turnover, and nursing home quality. SETTING AND

participantsA total of 11,840 nursing homes nationally reporting data on daily staffing and staffing turnover.

methodsWe explored correlations between measures of staffing and estimated facility-level regression models with robust standard errors. The dependent variables were indicators of nursing home quality included in the NHCC 5-star ratings. The independent variables of interest were average total staffing hours per resident-day, total staffing turnover, and total staffing instability.

resultsFor the 11,840 nursing homes in the study, there was a weak positive correlation between turnover and instability, with some overlap between nursing homes with high instability and high turnover. Regression analysis revealed that staffing instability and turnover contributed independently to nursing home quality, with instability having a stronger association with some measures of quality and turnover with others. Staffing instability was positively and more strongly associated with long-stay residents' decline in activities of daily living levels and receipt of antipsychotic drugs and short-stay residents' functioning at discharge. Turnover was positively and more strongly associated with long-stay residents' prevalence of pressure ulcers and worsening mobility, and short-stay residents' hospitalizations. CONCLUSION AND IMPLICATIONS: Instability and turnover in total nursing home staffing independently contribute to nursing home quality. This suggests that adding measures of staffing instability to the existing measures of average staffing and staff turnover in NHCC may enhance the report card's value for providers engaged in quality improvement and consumers searching for high-quality nursing homes.

Indexed as

Activities of Daily LivingNursing HomesCross-Sectional StudiesHumansPersonnel Staffing and SchedulingSkilled Nursing FacilitiesWorkforcenursing homesqualityStaffing

Identifiers

PMID37247823
PMCPMC10524116
OpenAlexW4378472699

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.