title: How Does Rurality Influence the Staffing of Social Service Departments in Nursing Homes?
abstract: OBJECTIVE
  Social service departments in nursing homes (NHs) are staffed by qualified social workers (QSWs) and paraprofessionals. Due to greater workforce challenges in rural areas, this article aims to describe the staffing levels and composition of these departments by rurality.
  
  
  METHODS
  Certification and Survey Provider Enhanced Reports data from 2009 to 2015 are used to examine the effect of rurality on social service staffing using random-effects linear panel regressions.
  
  
  RESULTS
  The average NH employed 1.8 full-time equivalents (FTEs), with approximately two thirds of social services staffed by QSWs. Large NHs had more staff, but employed fewer staff hours per resident day. Staffing levels were lower and QSWs made up a smaller percentage of staff in rural areas.
  
  
  CONCLUSIONS
  National trends indicate variability in staffing by NH size and degree of rurality. Very low staffing within rural NHs is a concern, as staff may have less time to respond to residents' needs and these NHs may utilize fewer QSWs.
authors.affiliation: Department of Family Science and Social Work and Scripps Gerontology Center, Oxford, Ohio.
authors.forename: Amy Restorick
authors.initials: AR
authors.lastname: Roberts
authors.affiliation: Department of Economics and Scripps Gerontology Center, Miami University, Oxford, Ohio.
authors.forename: John R
authors.initials: JR
authors.lastname: Bowblis
mesh_terms: D006801:Humans; D009735:Nursing Homes; D010561:Personnel Staffing and Scheduling; D012424:Rural Population; D012947:Social Work; D000068217:Social Workers; D000078329:Workforce