Nursing home staffing requirements and input substitution: effects on housekeeping, food service, and activities staff

Objective: To study the effect of minimum nurse staffing requirements on the subsequent employment of nursing home support staff.

Data sources: Nursing home data from the Online Survey Certification and Reporting (OSCAR) System merged with state nurse staffing requirements.

Study design: Facility-level housekeeping, food service, and activities staff levels are regressed on nurse staffing requirements and other controls using fixed effect panel regression.

Data extraction method: OSCAR surveys from 1999 to 2004.

Principal findings: Increases in state direct care and licensed nurse staffing requirements are associated with decreases in the staffing levels of all types of support staff.

Conclusions: Increased nursing home nurse staffing requirements lead to input substitution in the form of reduced support staffing levels.