Biomaterial Database

Nursing home quality, staffing, and malpractice paid-losses. 2011

Mei Zhao, and D Rob Haley

Public Health Department, Brooks College of Health, University of North Florida, Jacksonville, Florida, USA. mzhao@unf.edu

Litigation activity against Florida's nursing home providers increased dramatically over the past two decades. This has been a significant concern for policy makers and nursing home administrators as they attempt to balance the realities of negligent behavior with its impact on the overall cost and quality of long-term care. This study uses Medicare Cost Report data and OSCAR (Online Survey, Certification, and Reporting) data for Florida's nursing facilities over a five-year period from 2001 to 2005 to examine the effect of quality and staffing on malpractice paid-losses. The results from the multiple regression analyses indicate that staffing levels are strongly associated with paid-losses for malpractice claims. Nursing homes with higher registered nurse to resident ratios are less likely to experience malpractice paid-losses. In contrast, higher nursing assistant to resident ratios are significantly related to higher probability of malpractice paid-losses. The effect of total deficiency on malpractice is not significant. These findings suggest that increases in more skilled nurse staffing are associated with lower likelihood of nursing home malpractice paid-losses. However, nursing homes need to balance the overall cost and quality of their facilities related to staffing and malpractice litigations.

UI	MeSH Term	Description	Entries
D007351	Insurance, Liability	Insurance against loss resulting from liability for injury or damage to the persons or property of others.	No-Fault Insurance,Insurance, No-Fault,Liability Insurance,No Fault Insurance
D008134	Long-Term Care	Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care.	Care, Long-Term,Long Term Care
D008318	Malpractice	Failure of a professional person, a physician or lawyer, to render proper services through reprehensible ignorance or negligence or through criminal intent, especially when injury or loss follows. (Random House Unabridged Dictionary, 2d ed)	Professional Negligence,Negligence,Negligence, Professional,Professional Negligences
D008484	Medicaid	Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.	Dental Medicaid Program,Medical Assistance, Title 19,Dental Medicaid Programs,Medicaid Program, Dental,Medicaid Programs, Dental,Program, Dental Medicaid,Programs, Dental Medicaid
D009735	Nursing Homes	Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization.	Homes, Nursing,Nursing Home
D009740	Nursing Staff	Personnel who provide nursing service to patients in an organized facility, institution, or agency.	Nursing Staffs,Staff, Nursing,Staffs, Nursing
D010561	Personnel Staffing and Scheduling	The selection, appointing, and scheduling of personnel.	Staffing and Scheduling,Personnel Staffing,Work Schedule,Schedule, Work,Scheduling and Staffing,Staffing, Personnel,Work Schedules
D011787	Quality of Health Care	The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.	Pharmacy Audit,Quality of Care,Quality of Healthcare,Audit, Pharmacy,Care Quality,Health Care Quality,Healthcare Quality,Pharmacy Audits
D012044	Regression Analysis	Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.	Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D005431	Florida	State bounded on east by the Atlantic Ocean, on the south by the Gulf of Mexico, on the west by Alabama and on the north by Alabama and Georgia.