Date of Conferral

2023

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Matt Frederiksen-England

Abstract

Long term care facilities continue to struggle to improve the quality of care, which affects publicly reported data and reimbursement. The purpose of this study was to evaluate if state-mandated staffing ratios affected Centers for Medicare and Medicaid Services (CMS) survey ratings for CMS Region 7, which consisted of Iowa, Kansas, Missouri, and Nebraska. The theoretical framework was grounded by Donabedian’s quality theory, which described quality is made up of the elements of structure, process, and outcomes. This study included two research questions evaluating if there was a correlation between minimum staffing ratios and quality of care in long-term care facilities among the four states in CMS Region 7 and if quality of care scores were higher in long-term care facilities due to state minimum staffing requirements among the four states in CMS Region 7. A quantitative correlation research design was used with non-probability sampling to include all nursing homes in the identified states using secondary data from CMS. Spearman’s ρ determined that a correlation existed between staffing ratios and quality of care rating. A Mann-Whitney U test concluded that there wasnot a significant difference between the groups with no minimum staffing requirements and states with minimum staffing requirements. The potential impact of this study onpositive social change is at the individual, organizational, and policy levels. Individual patients and nursing home facilities can benefit from the recognition of providers regarding association of minimum staffing ratios impacting quality of care that is delivered in long term care facilities.

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