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This version was published on April 1, 2008
Medical Care Research and Review, Vol. 65, No. 2, 232-252 (2008)
DOI: 10.1177/1077558707312494
© 2008 SAGE Publications

Nurse Aide Agency Staffing and Quality of Care in Nursing Homes

Nicholas G. Castle

University of Pittsburgh, Pittsburgh, Pennsylvania

John Engberg

RAND, Pittsburgh, Pennsylvania

Aiju Men

University of Pittsburgh, Pittsburgh, Pennsylvania

Data from a large sample of nursing homes are used to examine the association between use of nurse aide agency staff and quality. Agency use data come from a survey conducted in 2005 (N = 2,840), and the quality indicators come from the Nursing Home Compare Web site. The authors found a nonlinear relationship between nurse aide agency levels and quality; however, in general, higher nurse aide agency levels were associated with low quality. The results have policy and practice implications, the most significant of which is that use of nurse aide agency staff of less than 14 full-time equivalents per 100 beds has little influence on quality, whereas nurse aide agency staff of more than 25 full-time equivalents per 100 beds has a substantial influence on quality.

Key Words: nurse aides • agency • quality


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Home page
 Journal of Applied GerontologyHome page
N. G. Castle
Nursing Home Caregiver Staffing Levels and Quality of Care: A Literature Review
Journal of Applied Gerontology, August 1, 2008; 27(4): 375 - 405.
[Abstract] [PDF]