Study Confirms Link Between Higher Staffing Ratios and Better Quality of Care in Nursing Homes

Nursing homes that get reimbursed from Medicare and Medicaid for residents’ services- approximately 96% of all U.S. nursing homes- must be certified and inspected annually. If a nursing home fails to meet federal requirements, inspectors cite the nursing home for violating specific standards (deficiency citations). Violations cited are first assessed by the scope of their effect on residents and the severity of harm to residents and then placed within categories, such as quality of care, quality of life, or resident rights. Under this methodology, both the scope and severity of deficiencies are evaluated and reported as a total point score, and such deficiency score is a reliable indicator of the nursing home’s quality of care.

Given that deficiencies have significant implications for the quality of care and the quality of life of nursing home residents, many studies have used nursing homes’ deficiency scores in measuring their quality of care. A recent study titled “The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes,” and published by The Gerontologist in May 2011, also used Florida nursing homes’ deficiency scores to find a strongly correlated relationship between the quality of nursing homes and nursing staff levels.

According to this study, higher nursing staff levels are “associated with lower scores on both total deficiencies and deficiencies related specifically to quality of resident care.” Specifically, the findings of this study demonstrate that “with every 6 minute increase (tenth of an hour) in [CNA hours per resident day], there is a 3% reduction in the quality of care deficiency score.” This means that if the nursing homes increase the average nursing hours per patient per day by hiring more CNAs or RNs, they would provide better quality of nursing services in compliance with federal requirements and thus receive lower deficiency scores. The study concludes that higher nursing staff levels would also benefit the nursing home providers because by increasing nurse staffing levels, providers subsequently will receive lower deficiency scores and “thereby improve their quality score and marketability to attract residents.”


The Centers for Medicare and Medicaid Services (CMS) grades each nursing home under their Five-Star Quality Rating System and provides information on factors related to the quality of care, including the average number of nursing hours each resident receives and deficiencies issued to a facility. Before choosing a nursing home, we advise you to check the Nursing Home Compare website for detailed information on each nursing home’s quality of services and their history of deficiencies.

If your loved one has suffered from elder abuse or neglect due to substandard quality of services in a nursing home in Riverside, San Bernardino, Fontana, Ontario, or Corona, California, or if you believe a nursing home failed to provide adequate care to prevent or treat your loved one’s nursing home injuries, please contact us today so that we can help protect your best interests and hold the responsible parties accountable.