title: Dietary Service Staffing Impact Nutritional Quality in Nursing Homes.
abstract: To examine the relationship between dietary service staff and dietary deficiency citations in nursing homes (NHs).
  
  
  
  2007-2011 Online Survey and Certification and Reporting data for 14,881 freestanding NHs were used to examine the relationship between dietary service staff and the probability of receiving a dietary service-related deficiency citation. An unconditional logit model with random effects was employed.
  
  
  
  Findings suggest that higher staffing levels for dietitians (odds ratio [OR] = .955; p < .01), dietary service personnel (OR = .996; p < .01), and certified nursing assistants (CNAs; OR = .981; p < .05) decrease the likelihood of receiving a dietary service deficiency citation.
  
  
  
  Higher levels of dietary service and CNA staffing levels have the potential to improve the quality of nutritional care in NHs. Findings help substantiate the Centers for Medicare and Medicaid Services' proposed rules for more stringent Food and Nutrition Services in the NH setting and signify the need for further research relative to the impact of dietary service staff on nutritional and clinical outcomes.
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Smith
authors.affiliation: 2 U.S. Department of Veterans Affairs Medical Center, Providence, RI, USA.|3 Brown University, Providence, RI, USA.
authors.forename: Kali S
authors.initials: KS
authors.lastname: Thomas
authors.affiliation: 4 University of Regina, Saskatchewan, Canada.
authors.forename: Shanthi
authors.initials: S
authors.lastname: Johnson
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.
authors.forename: Hongdao
authors.initials: H
authors.lastname: Meng
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hyer
mesh_terms: D004045:Dietary Services / Q000592:standards*; D006707:Homes for the Aged; D006801:Humans; D009728:Nursing Assistants; D009735:Nursing Homes; D064686:Nutritionists; D009753:Nutritive Value; D014481:United States; D000078329:Workforce
keywords: deficiency citations; nursing homes; nutrition