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Published in: Administration and Policy in Mental Health and Mental Health Services Research 2/2006

01-03-2006

Mental Health Care Deficiency Citations in Nursing Homes and Caregiver Staffing

Authors: Nicholas G. Castle, PhD, Sarah Myers, MPH

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 2/2006

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Abstract

In this paper, we examine the association between caregiver staffing levels and mental health outcomes in approximately 17,000 U.S. nursing homes. As outcomes, we focus on deficiency citations available in the Center for Medicare and Medicaid Services’ Online Survey, Certification, And Recording data. We examine nurse aide, licensed practical nurse, registered nurse, and mental health provider staffing. Our results show that the level of nursing staff matter with respect to mental health outcomes. Whereas greater RN staffing was associated with a lower likelihood of being cited for deficiencies in mental health care, greater LPN and NA staffing were associated with a higher likelihood. We found no association between mental health provider staffing levels and mental health outcomes.
Literature
go back to reference Bartels S. J., Moak G. S., Dums A. R. (2002). Models of mental health services in nursing homes: a review of the literature. Psychiatric Services 53:1390–1396PubMedCrossRef Bartels S. J., Moak G. S., Dums A. R. (2002). Models of mental health services in nursing homes: a review of the literature. Psychiatric Services 53:1390–1396PubMedCrossRef
go back to reference Burgio L. D., Fisher S. E., Fairchild J. K., Scilley K., Hardin J. M. (2004). Quality of care in the nursing home: effects of staff assignment and work shift. The Gerontologist 44:368–377PubMed Burgio L. D., Fisher S. E., Fairchild J. K., Scilley K., Hardin J. M. (2004). Quality of care in the nursing home: effects of staff assignment and work shift. The Gerontologist 44:368–377PubMed
go back to reference Castle N. G., Lowe T. (2005). Report cards and nursing homes. The Gerontologist 45(1):48–67PubMed Castle N. G., Lowe T. (2005). Report cards and nursing homes. The Gerontologist 45(1):48–67PubMed
go back to reference Castle N. G. (2001). Citations and compliance with the Nursing Home Reform Act of 1987. The Journal of Health and Social Policy 13(1):73–95CrossRef Castle N. G. (2001). Citations and compliance with the Nursing Home Reform Act of 1987. The Journal of Health and Social Policy 13(1):73–95CrossRef
go back to reference Castle N. G. (2000). Deficiency citations for physical restraint use in nursing homes. Journal of Gerontology: Social Sciences 55B:S33–S40 Castle N. G. (2000). Deficiency citations for physical restraint use in nursing homes. Journal of Gerontology: Social Sciences 55B:S33–S40
go back to reference Centers for Medicare and Medicaid Services. (2002). Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes Phase II Final Report. Baltimore, Maryland: Centers for Medicare and Medicaid Services Centers for Medicare and Medicaid Services. (2002). Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes Phase II Final Report. Baltimore, Maryland: Centers for Medicare and Medicaid Services
go back to reference Day P., Klein R. (1987). Quality of institutional care and the elderly: policy issues and options. British Medical Journal 7:384–387CrossRef Day P., Klein R. (1987). Quality of institutional care and the elderly: policy issues and options. British Medical Journal 7:384–387CrossRef
go back to reference Decker F. H., Dollard J., Kraditor K. R. (2001). Staffing of Nursing Services in Nursing Homes: Present Issues and Prospects for the Future. Seniors Housing & Care Journal 9:3–26 Decker F. H., Dollard J., Kraditor K. R. (2001). Staffing of Nursing Services in Nursing Homes: Present Issues and Prospects for the Future. Seniors Housing & Care Journal 9:3–26
go back to reference Demaris A. (1992). Logit modeling: practical applications. Sage Publications, Newbury Park, CA Demaris A. (1992). Logit modeling: practical applications. Sage Publications, Newbury Park, CA
go back to reference Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General—Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General—Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health
go back to reference General Accounting Office (1999). Nursing Homes: HCFA Initiatives to Improve Care Are Under Way but Will Require Continued Commitment. T-HEHS-99–155. June 30, 1999 General Accounting Office (1999). Nursing Homes: HCFA Initiatives to Improve Care Are Under Way but Will Require Continued Commitment. T-HEHS-99–155. June 30, 1999
go back to reference Graber D. R., Sloane P. D. (1995). Nursing home survey deficiencies for physical restraint use. Medical Care 33:1051–1063PubMedCrossRef Graber D. R., Sloane P. D. (1995). Nursing home survey deficiencies for physical restraint use. Medical Care 33:1051–1063PubMedCrossRef
go back to reference Grabowski D. C. (2001). Does an increase in Medicaid reimbursement improve nursing home quality?. Journal of Gerontology: Social Sciences 56B:S84–S93 Grabowski D. C. (2001). Does an increase in Medicaid reimbursement improve nursing home quality?. Journal of Gerontology: Social Sciences 56B:S84–S93
go back to reference Harrington C., Carrillo H. (1999). The regulation and enforcement of federal nursing home standards, 1991–1997. Medical Care Research and Review 56:471–494PubMedCrossRef Harrington C., Carrillo H. (1999). The regulation and enforcement of federal nursing home standards, 1991–1997. Medical Care Research and Review 56:471–494PubMedCrossRef
go back to reference Harrington C., Swan J. H. (2003). Nursing home staffing, turnover, and case mix. Medical Care Research and Review 60:366–392PubMedCrossRef Harrington C., Swan J. H. (2003). Nursing home staffing, turnover, and case mix. Medical Care Research and Review 60:366–392PubMedCrossRef
go back to reference Harrington C., Mullan J. T., Carrillo H. (2004). State nursing home enforcement systems. Journal of Health Politics, Policy, and Law 29:43–73CrossRef Harrington C., Mullan J. T., Carrillo H. (2004). State nursing home enforcement systems. Journal of Health Politics, Policy, and Law 29:43–73CrossRef
go back to reference Harrington C., Kovner C., Mezey M., Kayser-Jones J., Burger S., Mohler M., Burke R., Zimmerman D. (2000). Experts recommend minimum nurse staffing standards for nursing facilities in the United States. The Gerontologist 40:5–16PubMed Harrington C., Kovner C., Mezey M., Kayser-Jones J., Burger S., Mohler M., Burke R., Zimmerman D. (2000). Experts recommend minimum nurse staffing standards for nursing facilities in the United States. The Gerontologist 40:5–16PubMed
go back to reference Harrington C., O’Meara J., Collier E., Schnelle J. F. (2003). Nursing indicators of quality in nursing homes. A Web-based approach. Journal of Gerontological Nursing 29:5–11PubMed Harrington C., O’Meara J., Collier E., Schnelle J. F. (2003). Nursing indicators of quality in nursing homes. A Web-based approach. Journal of Gerontological Nursing 29:5–11PubMed
go back to reference Horton N. J., Bebchuk J. D., Jones C. L., Lipsitz S. R., Catalano P. J., Zahner G. E. P., Fitzmaurice G. M. (1999). Goodness-of-Fit for GEE: An example with mental health service utilization. Statistics in Medicine 18:213–222PubMedCrossRef Horton N. J., Bebchuk J. D., Jones C. L., Lipsitz S. R., Catalano P. J., Zahner G. E. P., Fitzmaurice G. M. (1999). Goodness-of-Fit for GEE: An example with mental health service utilization. Statistics in Medicine 18:213–222PubMedCrossRef
go back to reference Hughes C. M., Lapane K. L., Mor V. (2000). Influence of facility characteristics on use of antipsychotic medications in nursing homes. Medical Care 38:1164–1173PubMedCrossRef Hughes C. M., Lapane K. L., Mor V. (2000). Influence of facility characteristics on use of antipsychotic medications in nursing homes. Medical Care 38:1164–1173PubMedCrossRef
go back to reference Institute of Medicine (2001). Quality of care in nursing homes. National Academy Press, Washington, D.C. Institute of Medicine (2001). Quality of care in nursing homes. National Academy Press, Washington, D.C.
go back to reference Kennedy P. (1992). A guide to econometrics 3rd ed. Cambridge MA, MIT Press Kennedy P. (1992). A guide to econometrics 3rd ed. Cambridge MA, MIT Press
go back to reference Konetzka R. T., Yi D., Norton E. C., Kilpatrick K. E. (2004). Effects of Medicare payment changes on nursing home staffing and deficiencies. Health Services Research 39:463–488PubMedCrossRef Konetzka R. T., Yi D., Norton E. C., Kilpatrick K. E. (2004). Effects of Medicare payment changes on nursing home staffing and deficiencies. Health Services Research 39:463–488PubMedCrossRef
go back to reference Mor V., Berg K., Angelelli J., Gifford D., Morris J., Moore T. (2003). The quality of quality measurement in U.S. nursing homes. The Gerontologist 43(Special Issue II):37–46PubMed Mor V., Berg K., Angelelli J., Gifford D., Morris J., Moore T. (2003). The quality of quality measurement in U.S. nursing homes. The Gerontologist 43(Special Issue II):37–46PubMed
go back to reference Mukamel D. B. (1997). Risk-adjusted outcome measures and quality of care in nursing homes. Medical Care 35:367–385PubMedCrossRef Mukamel D. B. (1997). Risk-adjusted outcome measures and quality of care in nursing homes. Medical Care 35:367–385PubMedCrossRef
go back to reference Mukamel D. B., Spector W. D. (2003). Quality report cards and nursing home quality. The Gerontologist 43:58–66PubMed Mukamel D. B., Spector W. D. (2003). Quality report cards and nursing home quality. The Gerontologist 43:58–66PubMed
go back to reference Munroe D. J. (1990). The influence of registered nurse staffing on the quality of nursing home care. Research on Nursing and Health 13:263–270CrossRef Munroe D. J. (1990). The influence of registered nurse staffing on the quality of nursing home care. Research on Nursing and Health 13:263–270CrossRef
go back to reference Omnibus Budget Reconciliation Act of 1987. P.L. 100–203. Subtitle C. The Nursing Home Reform Act. 42 U.S.C. 1395i-3(a)-(h)(Medicare); 1396r (a)-(h)(Medicaid) Omnibus Budget Reconciliation Act of 1987. P.L. 100–203. Subtitle C. The Nursing Home Reform Act. 42 U.S.C. 1395i-3(a)-(h)(Medicare); 1396r (a)-(h)(Medicaid)
go back to reference Schnelle, J. F., Simmons, S. F., Harrington, C., Cadogan, M., Garcia, E., Bates-Jenson, B. (2004). Relationship of nursing home staffing to quality of care. Health Services Research 39(2):225–250PubMedCrossRef Schnelle, J. F., Simmons, S. F., Harrington, C., Cadogan, M., Garcia, E., Bates-Jenson, B. (2004). Relationship of nursing home staffing to quality of care. Health Services Research 39(2):225–250PubMedCrossRef
go back to reference Scott W. R. (1998). Organizations: rational, natural, and open systems (Fourth Edition). Upper Saddle River, NJ, Prentice Hall Scott W. R. (1998). Organizations: rational, natural, and open systems (Fourth Edition). Upper Saddle River, NJ, Prentice Hall
go back to reference Streim J. E., Beckwith E. W., Arapakos D., Banta P., Dunn R., Hoyer T. (2002). Regulatory oversight, payment policy, and quality improvement in mental health care in nursing homes. Psychiatric Services 53:1414–1418PubMedCrossRef Streim J. E., Beckwith E. W., Arapakos D., Banta P., Dunn R., Hoyer T. (2002). Regulatory oversight, payment policy, and quality improvement in mental health care in nursing homes. Psychiatric Services 53:1414–1418PubMedCrossRef
go back to reference Sullivan-Marx E. M, Strumpf N. E., Evans L. K., Baumgarten M., Maislin G. (1999). Predictors of continued physical restraint use in nursing home residents following restraint reduction efforts. Journal of the American Geriatrics Society 47(3):342–348PubMed Sullivan-Marx E. M, Strumpf N. E., Evans L. K., Baumgarten M., Maislin G. (1999). Predictors of continued physical restraint use in nursing home residents following restraint reduction efforts. Journal of the American Geriatrics Society 47(3):342–348PubMed
go back to reference Weech-Maldonado R., Meret-Hanke L., Neff M. C., Mor V. (2004). Nurse staffing patterns and quality of care in nursing homes. Health Care Management Review 29:107–116PubMed Weech-Maldonado R., Meret-Hanke L., Neff M. C., Mor V. (2004). Nurse staffing patterns and quality of care in nursing homes. Health Care Management Review 29:107–116PubMed
go back to reference Zeger S. L., Liang K. Y. (1992). An overview of methods for the analysis of longitudinal data. Statistics in Medicine 11:1825–1839PubMedCrossRef Zeger S. L., Liang K. Y. (1992). An overview of methods for the analysis of longitudinal data. Statistics in Medicine 11:1825–1839PubMedCrossRef
Metadata
Title
Mental Health Care Deficiency Citations in Nursing Homes and Caregiver Staffing
Authors
Nicholas G. Castle, PhD
Sarah Myers, MPH
Publication date
01-03-2006
Publisher
Springer US
Published in
Administration and Policy in Mental Health and Mental Health Services Research / Issue 2/2006
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI
https://doi.org/10.1007/s10488-006-0038-2

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