Nursing home quality, staffing, and malpractice paid-losses

J Health Care Finance. 2011 Fall;38(1):1-10.


Litigation activity against Florida's nursing home providers increased dramatically over the past two decades. This has been a significant concern for policy makers and nursing home administrators as they attempt to balance the realities of negligent behavior with its impact on the overall cost and quality of long-term care. This study uses Medicare Cost Report data and OSCAR (Online Survey, Certification, and Reporting) data for Florida's nursing facilities over a five-year period from 2001 to 2005 to examine the effect of quality and staffing on malpractice paid-losses. The results from the multiple regression analyses indicate that staffing levels are strongly associated with paid-losses for malpractice claims. Nursing homes with higher registered nurse to resident ratios are less likely to experience malpractice paid-losses. In contrast, higher nursing assistant to resident ratios are significantly related to higher probability of malpractice paid-losses. The effect of total deficiency on malpractice is not significant. These findings suggest that increases in more skilled nurse staffing are associated with lower likelihood of nursing home malpractice paid-losses. However, nursing homes need to balance the overall cost and quality of their facilities related to staffing and malpractice litigations.

MeSH terms

  • Florida
  • Humans
  • Insurance, Liability / economics
  • Insurance, Liability / trends
  • Liability, Legal / economics
  • Long-Term Care / economics*
  • Long-Term Care / legislation & jurisprudence
  • Long-Term Care / standards
  • Malpractice / economics*
  • Malpractice / legislation & jurisprudence
  • Medicaid / economics
  • Medicaid / statistics & numerical data
  • Medicare / economics
  • Medicare / statistics & numerical data
  • Multivariate Analysis
  • Nursing Homes / economics*
  • Nursing Homes / legislation & jurisprudence
  • Nursing Homes / standards
  • Nursing Staff / economics
  • Nursing Staff / standards
  • Nursing Staff / statistics & numerical data
  • Personnel Staffing and Scheduling / economics*
  • Personnel Staffing and Scheduling / legislation & jurisprudence
  • Personnel Staffing and Scheduling / standards
  • Quality of Health Care / economics*
  • Quality of Health Care / standards
  • Regression Analysis
  • United States