title: Organizational correlates of the risk-adjusted pressure ulcer prevalence and subsequent survey deficiency citation in California nursing homes.
abstract: Organizational correlates of the risk-adjusted pressure ulcer prevalence and subsequent deficiency citation in nursing homes are not known. The purpose of this study was to examine the relationships between these two outcomes and selected organizational variables, including total nurse staffing levels, specialization, centralization, nursing wages, and facility ownership. Secondary data analysis was conducted on a sample of 897 California nursing homes included in the 1996 On-line Survey Certification and Reporting system and the Office of Statewide Health Planning and Development financial disclosure reports of individual California nursing homes. Organizational variables explained a small amount of the variation (adjusted R2 = .04, p < .01). A higher PU prevalence was associated with lower licensed nurse centralization and facilities participating exclusively in the Medicaid program. Receipt of a deficiency was less likely in facilities having a higher total nurse staffing level (OR = .49, p < .001). It was more likely in facilities having a higher risk-adjusted PU prevalence (OR = 1.05, p < .001), more licensed nurses (OR = 2.74, p < .05), a size of 160 beds or more (OR = 1.93, p < .01), and survey teams from specific counties (OR ranging from 2.3 to 6.8, p < .05).
authors.affiliation: VA San Diego Healthcare System, John A. Hartford Foundation Building Academic Geriatric, Nursing Capacity Scholar, San Diego, CA 92161, USA.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Dellefield
mesh_terms: D002140:California / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D009735:Nursing Homes / Q000706:statistics & numerical data*; D009740:Nursing Staff / Q000706:statistics & numerical data*; D003668:Pressure Ulcer / Q000453:epidemiology*; D015995:Prevalence; D011787:Quality of Health Care; D012306:Risk