ArticleJournal of the American Medical Directors Association2025
Association of Racial and Ethnic Composition with Staff Levels in Nursing Homes: 2013-2019.
Article in Journal of the American Medical Directors Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed.
- Medicaid payment rates and nursing home staffing levels across ownership types.Innovation in aging · 2026Article
- Exploring Chinese Family Caregivers' Experience as They Support Loved Ones With Dementia Transitioning Into Nursing Homes: A Qualitative Study.Research on agingArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectivesThe nursing home (NH) population has become increasingly diverse, yet many facilities remain de facto racially segregated. This study examines whether a high proportion of Black, Indigenous, and People of Color (BIPOC) residents is associated with nursing staff levels.
designWe constructed a longitudinal cohort of NHs (2013-2019) by linking Certification and Survey Provider Enhanced Reports, LTCFocUS.org, Medicare Cost Reports, and Payroll-Based Journal data. Separate multivariable random effects linear regressions were conducted. SETTING AND
participants14,075 Medicare- and Medicaid-certified NHs in the United States.
methodsThe proportion of BIPOC residents was categorized as the 10% of nursing homes serving the highest minority residents in each state each year (High-BIPOC) and the remaining 90% (Low-BIPOC). Total nursing staff levels in hours per resident-day (HPRD) included both hours paid (2013-2019) and hours worked (2017-2019). The total staff included registered nurses, licensed practical nurses, and certified nurse aides.
resultsThe unadjusted difference in total staff levels between High-BIPOC and Low-BIPOC NHs increased from -0.23 HPRD (4.19 vs 4.42) in 2013 to -0.35 HPRD (3.94 vs 4.29) in 2019 for hours paid. The difference in hours worked increased from -0.19 (3.55 vs 3.74) in 2017 to -0.23 (3.50 vs 3.73) in 2019. The difference became smaller but remained significant after controlling for covariates (-0.037 HPRD for hours paid, and -0.038 for hours worked). Analyses of individual staff types found lower levels of registered nurses and certified nurse aides (but not licensed practical nurses) among High-BIPOC nursing homes. Findings were robust to treating racial and ethnic composition as a continuous variable or excluding payer mix from the models. CONCLUSIONS AND IMPLICATIONS: NHs with high concentrations of minority residents reported lower nursing staff levels. Improving staffing in NHs serving primarily marginalized racial and ethnic groups remains a policy priority.
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