Tip Sheets

Increasing nursing home staffing levels is a great ‘first step’

Media Contact

Adam Allington

The White House has issued new rules establishing minimum staffing levels for nursing homes. The rules require that all facilities receiving funding through Medicare and Medicaid have staffing equivalent of at least 3.48 hours of nursing care per resident, per day. These facilities must also have a registered nurse on site at all times. 

Ariel Avgar

Professor of labor relations, law and history and senior associate dean for outreach and sponsored research

Ariel Avgar, is a professor in Cornell University’s school of Industrial and Labor Relations, where his research focuses on employment relations in the healthcare industry. He says setting mandatory staffing ratios is a great first step in making sure that residents receive high quality care, however, it should not be a standalone measure.

Avgar says:

“On the one hand, we know that better staffing levels has a positive effect on patient care. Studies on the relationship between staffing levels and error rates and other measures of quality-of-care show that where staffing levels are higher, care is better.

“On the other hand, how staffing levels get set might affect the ways in which they influence patient care. Most of the studies documenting a positive relationship between staffing levels and care are based on voluntary setting of staffing levels, not on mandatory ratios.

“While we might expect mandatory ratios to have the same effect as voluntary levels, the fear is that nursing homes will reach required staffing levels in ways that actually undermine patient care. For example, nursing homes might resort to use of overtime to reach required staffing ratios or they might hire part-time contingent workers who are employed in multiple facilities. In both cases, there is reason to worry that achieving staffing ratios in this manner could lead to burn out and stress, which has been shown to undermine patient care.”

Cornell University has television, ISDN and dedicated Skype/Google+ Hangout studios available for media interviews.