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Higher staffing levels mean better quality, report card finds

September 11, 2013
by Lois A. Bowers, Senior Editor
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Staffing levels and quality care are directly linked, according to a new analysis of nursing homes by Families for Better Care, a Florida-based nursing home resident advocacy group.

“The data reflect what academicians, residents, families and ombudsmen have heralded for years: The higher the staffing levels, the better the care,” says Brian Lee, the organization’s executive director. Alaska, Hawaii and Maine had “superior” scores in every staffing measure, whereas Georgia, Louisiana, Tennessee and Texas each had below-average grades.

The top overall states for nursing homes, according to the group’s report card, are Alaska, Rhode Island and New Hampshire. The worst are Texas, Louisiana and Indiana.

“We’re excited about getting this report into the hands of public officials, nursing home owners, advocates and—most importantly—residents and their families,” Lee says. “Our goal is to applaud those states that provide good care while motivating improvement for those that score poorly.”

The group scored, ranked and graded states on eight different federal quality measures, including the percentage of facilities with severe deficiencies and the number of hours frontline caregivers average per resident per day, among others. Data came from the Kaiser Family Foundation, the Center for Medicare and Medicaid Services’ Nursing Home Compare program, and Office of State Long-Term Care Ombudsman programs. In general, high-ranking states had homes that had higher levels of staffing, Lee says.

Other key findings from the report card, according to the group:

  • Only seven states provided more than one hour of professional nursing care per resident per day.
  • 96 percent of states offered residents fewer than three hours of direct resident care per day.
  • One in five nursing homes abused, neglected or mistreated residents in almost half of all states.

See detailed findings and state grades and rankings at

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