Disparities in Nursing Staffing in Nursing Homes

Abstract

There are published reports of racial/ethnic disparities in nursing home (NH) resident health outcomes and quality of care. NH staffing (registered nurses, licensed practical nurses, and certified nursing assistants) is thought to be related to these outcomes. Information is lacking about disparities in NH staffing. The purpose of my study was to assess the relationship between NH staffing and the racial/ethnic composition of NHs (n=446), NH location and the socioeconomic status (SES) of the NH community. Data were from 3 large data sets from 2000-2002: Minimum Data Set for resident demographics (n=111,533), Online Survey, Certification, and Reporting for NH staffing, and US Census for community data. Correlations using registered nurse (RN) staffing in hours per resident per day (hrd) significant at p<.05 level are presented. RN staffing (.08 (. 08) hrd) (mean (sd)) were negatively associated with the % of Blacks in NHs (9.13 (15.7), r= -.15), community poverty level of 50-99% (.07 (.05) r=-0.12), and % working class of the community (64.4 (11.0) r=-.15). There were positive associations between RN hrd and % whites in NHs (87.5 (17.4) r=.14), proportion of census tracts in an urban location (.51 (.49) r=.11), and median household income of the community ($39,116 ($15,402) r=0.2). In conclusion, knowledge of RN staffing in NHs can guide efforts to reduce disparities and improve resident health outcomes.