Staffing is key to predicting nursing home quality of life

Quality of life (QOL) incorporates various aspects of residents’ lives, including their relationships with staff, social engagement, and food enjoyment. QOL is less frequently studied than quality of care, which is an equally important long-term care quality measurement. To understand facility predictors of QOL, this study examined a broad range of facility factors and found that facilities that invested in more activity staff and registered nurse (RN) hours had higher QOL scores over time than facilities with fewer activity staff and/or RN hours. 

Minnesota is one of only two states in the country with a state-wide survey to interview nursing home residents to assess their quality of life. In 2006, Minnesota created the performance-based incentive payment program (PIPP) as an alternative to standard pay-for-performance quality improvement programs. Participation in PIPP was one of the factors examined by study authors.

QOL predictor scores consist of six components: satisfaction with environment (e.g. privacy), personal attention from staff, food enjoyment, social engagement (e.g. activity participation), negative mood and positive mood.

“Our study shows facilities who put an emphasis on activity staff and RN hours saw an improvement in their quality of life scores,” said Tetyana Shippee, Ph.D., lead author and assistant professor in the University of Minnesota School of Public Health. “These investments can pay off when it comes to attracting new customers, so it’s important for facilities to recognize this and make organizational changes.”

Other key findings:

  • Larger care facilities housing more residents with health problems showed a significant association with lower QOL.
  • Nursing home nonprofit status (compared to for-profit status) was associated with higher QOL scores.
  • For every additional hour residents spent with activity staff each day, there was a 9-point increase in facility social engagement score and 8-point increase in meal enjoyment score.
  • Facilities that participated in PIPP showed improvements in their QOL scores over time.

“Minnesota is a national leader in setting policy standards for nursing home quality of life and quality of care,” said Shippee. “The finding that participation in PIPP helped improve facility QOL scores is relevant for other states as they work to improve care for their nursing home residents.”

University of Minnesota.

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