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Staffing Quality Measures

Staffing Quality Measures- Phase 1 Continuation

Staffing is a vital component of quality care for nursing home residents. Associations have been found between higher staffing levels in nursing homes and fewer hospitalizations, fewer infections, fewer pressure ulcers, less skin trauma, less weight loss, decreased resistance to care, and improved functional status. Although little is known about the relationships between staff turnover and quality of patient care, it is reasonable to assume that high turnover has an impact on continuity and is disruptive to patients who do not cope well with frequent changes in staff. The overall goal of the Development of Staffing Quality Measures Project was to develop measures of staffing in nursing homes that could appropriately be used for public reporting. This special study extended the work completed under Phase I of the CMS Development of Staffing Quality Measures project, which included the review of relevant literature to identify reliable and valid measures of nurse staffing; consultation with experts and stakeholders to determine aspects of staffing most relevant to the industry and most associated with quality; investigation of data collection options for obtaining necessary data for calculating staffing measures; collection of payroll data from 1,453 nursing home facilities; and development and descriptive analyses of preliminary staffing measures.

Project activities focus on five major tasks:

  1. Analyzed the relationship of staffing measures to outcome measures for the short-stay population in nursing homes
  2. Analyzed the relationship of staffing measures to outcome measures for the long-stay population in nursing homes
  3. Specified payroll data reporting requirements
  4. Conducted feasibility testing for obtaining payroll data to meet reporting requirements
  5. Analyzed contract staff hours to the degree possible

The Colorado Foundation for Medical Care (CFMC), the Medicare quality improvement organization for Colorado, prepared this material under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS Policy.