title: Licensed nurse staffing and health service availability in residential care and assisted living.
abstract: OBJECTIVE
  To create data-driven typologies of licensed nurse staffing and health services in residential care and assisted living (RC/AL).
  
  
  METHODS
  Cluster analysis was used to describe the patterns of licensed nurse staffing and 47 services and the extent to which these clusters were related.
  
  
  METHODS
  RC/AL communities in the United States.
  
  
  METHODS
  A convenience sample of administrators and healthcare supervisors from 89 RC/AL communities in 22 states.
  
  
  METHODS
  RC/AL characteristics, licensed nurse staffing (total number of hours that registered nurses (RNs) and licensed practical nurses (LPNs) worked), number of hours that contract nurses worked, and availability of 47 services.
  
  
  RESULTS
  Analysis revealed four licensed nurse staffing clusters defined according to total number of hours and the type of nurse providing the hours (RN, LPN, or a mix of both). They ranged from no or minimal RN and LPN hours to high nursing hours with a mix of RNs and LPNs. The 47 services clustered into five clusters: basic services; technically complex services; assessments, wound care, and therapies; testing and specialty services; and gastrostomy and intravenous medications. The availability of services was related to the presence of nurses (RNs and LPNs) except for the gastrostomy and intravenous medication services, which were not readily available.
  
  
  CONCLUSIONS
  The amount and skill mix of licensed nurse staffing varies in RC/AL and is related to the types of services available. These findings may have implications for resident care and outcomes. Future work in this area, including extension to include nonnurse direct care workers, is needed.
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Beeber
authors.forename: Sheryl
authors.initials: S
authors.lastname: Zimmerman
authors.forename: David
authors.initials: D
authors.lastname: Reed
authors.forename: C Madeline
authors.initials: CM
authors.lastname: Mitchell
authors.forename: Philip D
authors.initials: PD
authors.lastname: Sloane
authors.forename: Brandy
authors.initials: B
authors.lastname: Harris-Wallace
authors.forename: Rosa
authors.initials: R
authors.lastname: Perez
authors.forename: John G
authors.initials: JG
authors.lastname: Schumacher
mesh_terms: D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D016000:Cluster Analysis; D003695:Delivery of Health Care / Q000379:methods*; D005260:Female; D006801:Humans; D008004:Licensure; D008297:Male; D024802:Nurse's Role; D064689:Nurses, Public Health / Q000706:statistics & numerical data*; D009741:Nursing Staff, Hospital / Q000600:supply & distribution; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D014481:United States
keywords: assisted living; health services; nursing; residential care; staffing
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