title: Nursing home quality, staffing, and malpractice paid-losses.
abstract: 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.
authors: Public Health Department, Brooks College of Health, University of North Florida, Jacksonville, Florida, USA. mzhao@unf.edu
authors: Mei
authors: M
authors: Zhao
authors: D Rob
authors: DR
authors: Haley
mesh_terms: D005431:Florida; D006801:Humans; D007351:Insurance, Liability / Q000191:economics / Q000639:trends; D016365:Liability, Legal / Q000191:economics; D008134:Long-Term Care / Q000191:economics* / Q000331:legislation & jurisprudence / Q000592:standards; D008318:Malpractice / Q000191:economics* / Q000331:legislation & jurisprudence; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000191:economics* / Q000331:legislation & jurisprudence / Q000592:standards; D009740:Nursing Staff / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000191:economics* / Q000331:legislation & jurisprudence / Q000592:standards; D011787:Quality of Health Care / Q000191:economics* / Q000592:standards; D012044:Regression Analysis; D014481:United States