( States that set high staffing standards...)Policy Changes Have Direct Effect on Nursing Home Care,Health

States that set high staffing standards for elder care in nursing homes are the only ones that come close to having enough staff nurses to prevent serious safety violations, according to a new study by a professor in the UCSF School of Nursing.

The majority of the nation's elderly and disabled in nursing homes remain in situations where staffing is well below national recommendations for safe care, the study found. While no states have ideal nursing levels, those states with higher Medicaid reimbursements or higher mandated nursing levels have come closer to meeting the recommendations, according to the analysis published in the June issue of the journal "Health Services Research."

The study's initial objective was to examine the relationship between Medicaid reimbursement rates, which many states have reduced under their cost-containment efforts, and nurse staffing levels in US nursing homes, according to Charlene Harrington, PhD, RN, UCSF professor of sociology and nursing and lead author of the report.

She said previous studies have shown a direct correlation between staffing levels and higher Medicaid reimbursement for nursing homes, but this is the first to show that states with higher mandated staffing standards had substantially higher staffing as well.

"For years, families have struggled with low staffing levels in the nursing homes that care for their elderly family members, but very few studies have assessed how to change that on a broad level," Harrington said. "This study shows that the simple step of raising the state minimum staffing ratio has a direct impact on the quality of care our seniors receive."

Harrington based her analysis on staffing reports submitted by nursing homes to the federal government and data from multiple other sources. She examined the hours that nurses worked in nursing homes in 2002 and analyzed the data against two variables: Medicaid reim
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