A new report published in the Dec. 7 issue of The Gerontologist shows that in a good economy, the care at U.S. nursing homes falls because it’s harder to attract and keep staff. For the study, the researchers examined data from 2001 through 2015, including employment statistics and state annual re-certification of all Medicare- and Medicaid-certified nursing homes (about 15,000) in the United States. The analysis revealed a link between higher unemployment rates and better quality of care at nursing homes.
“During economic downturns, many people are willing to take positions with work environments they may not prefer because there aren’t many options,” said principal investigator Sean Shenghsiu Huang. “But when the economy is good, there are plenty of employment opportunities, and taking a nursing home job may not be that attractive,” added Huang, an assistant professor at Georgetown University’s School of Nursing and Health Studies, in Washington, D.C.
The U.S. unemployment rate fell to a 49-year low in September and October, which means it could be challenging for nursing homes to maintain adequate staff levels, Huang and his colleagues said in a Georgetown news release.
During periods of high unemployment, nursing homes had better health regulation compliance [or there is less regulatory enforcement], the findings showed. Also, nursing home residents were less likely to have bedsores, be physically restrained or have significant weight loss — all measures of quality of care.
When unemployment rates were low, nursing homes had fewer staff members, higher employee turnover and lower staff retention rates, the researchers found.
Most nursing home care is provided by nurses and aides, so maintaining an adequate and stable workforce is important for delivering high-quality care, according to the study authors. For example, high turnover of staff inhibits the ability of nursing homes to consistently assign staff to the same resident, a practice that is associated with quality care. However, nursing homes have high turnover rates. Given today’s low unemployment rates, it will be challenging to maintain or even attempt to lower the turnover rates, say the investigators.