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Nursing home spending, staffing and ...

Kash, Bita Arbab.

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Nursing home spending, staffing and turnover.

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	Nursing home spending, staffing and turnover./
作者:	Kash, Bita Arbab.
面頁冊數:	126 p.
附註:	Adviser: Catherine Hawes.
Contained By:	Dissertation Abstracts International67-10B.
標題:	Economics, Labor. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3238272
ISBN:	9780542922572

Nursing home spending, staffing and turnover.
Kash, Bita Arbab.

Nursing home spending, staffing and turnover. - 126 p.

Adviser: Catherine Hawes.

Thesis (Ph.D.)--The Texas A&M University System Health Science Center, 2006.

This analysis of Texas nursing homes explored (1) the effects of nursing home spending on staffing levels and staff turnover, (2) clarified the relationship between staffing levels and turnover rates and (3) identified characteristics of facilities that over-report staffing levels in the Online Survey and Certification Reporting (OSCAR) system. Three data sources were used: the 2002 Texas Nursing Facility Cost Report, the 2002 OSCAR, and the 2003 Area Resources File. Outliers in the OSCAR were eliminated using three decision rules.

ISBN: 9780542922572Subjects--Topical Terms:

1019135
Economics, Labor.

Nursing home spending, staffing and turnover.
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245 1 0 $a Nursing home spending, staffing and turnover.
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500 $a Source: Dissertation Abstracts International, Volume: 67-10, Section: B, page: 5640.
502 $a Thesis (Ph.D.)--The Texas A&M University System Health Science Center, 2006.
520 $a This analysis of Texas nursing homes explored (1) the effects of nursing home spending on staffing levels and staff turnover, (2) clarified the relationship between staffing levels and turnover rates and (3) identified characteristics of facilities that over-report staffing levels in the Online Survey and Certification Reporting (OSCAR) system. Three data sources were used: the 2002 Texas Nursing Facility Cost Report, the 2002 OSCAR, and the 2003 Area Resources File. Outliers in the OSCAR were eliminated using three decision rules.
520 $a This analysis pointed out that higher profit margins were associated with lower staffing levels but not higher turnover rates. A positive effect of employee benefits expenses on registered nurse (RN) and licensed vocational nurse (LVN) levels was observed. Administrative expenses had a negative association with staffing levels while reducing staff turnover rates for LVNs and certified nursing assistants (CNAs).
520 $a Staffing levels showed strong dependency on facility resources. The ratio of contracted to employed nursing staff as well as RN turnover increased LVN turnover rates. CNA turnover was reduced by higher CNA wages. Turnover rates significantly reduced staffing levels for RNs and CNAs. LVN staffing levels were not affected by LVN turnover but were influenced by availability of LVNs in the county and proportion of women in the labor force.
520 $a Staffing levels were higher in the OSCAR when compared to the Medicaid Cost Report data. The odds of over-reporting LVN and CNA levels were reduced with higher Medicare and Medicaid census and market competition. RN levels were consistently over-reported by for-profit and larger facilities.
520 $a Findings from this study suggest that solutions to the staffing and turnover problem should focus on more effective management practices. Certain levels of administrative expenses might be necessary in order to reduce both staffing and turnover costs. Further, staff turnover is a predictor of RN and CNA staffing levels, while LVN staffing levels were mostly associated with market factors. It is important to focus on management initiatives that help reduce CNA and RN turnover and result in higher nurse staffing levels. Finally, certain types of facilities consistently over-report their staffing levels. These reporting errors affect consumer information systems, regulatory activities, and health services research results.
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