Relationship of Nursing Home Staffing to Quality of Care

<jats:p><jats:bold>Objective. </jats:bold> To compare nursing homes (NHs) that report different staffing statistics on quality of care.</jats:p><jats:p><jats:bold>Data Sources. </jats:bold> Staffing information generated by California NHs on state cost reports and during onsite interviews. Data independently collected by research staff describing quality of care related to 27 care processes.</jats:p><jats:p><jats:bold>Study Design. </jats:bold> Two groups of NHs (<jats:italic>n</jats:italic>=21) that reported significantly different and stable staffing data from all data sources were compared on quality of care measures.</jats:p><jats:p><jats:bold>Data Collection. </jats:bold> Direct observation, resident and staff interview, and chart abstraction methods.</jats:p><jats:p><jats:bold>Principal Findings. </jats:bold> Staff in the highest staffed homes (<jats:italic>n</jats:italic>=6), according to state cost reports, reported significantly lower resident care loads during onsite interviews across day and evening shifts (7.6 residents per nurse aide [NA]) compared to the remaining homes that reported between 9 to 10 residents per NA (<jats:italic>n</jats:italic>=15). The highest‐staffed homes performed significantly better on 13 of 16 care processes implemented by NAs compared to lower‐staffed homes.</jats:p><jats:p><jats:bold>Conclusion. </jats:bold> The highest‐staffed NHs reported significantly lower resident care loads on all staffing reports and provided better care than all other homes.</jats:p>