Nursing Home Compare Star Rating and Daily Direct-Care Nurse Staffing During Hurricane Irma

Dylan J. Jester PhD, MPH, Lindsay J. Peterson PhD, Kali S. Thomas PhD, MA, David M. Dosa MD, MPH, Ross Andel PhD

Abstract

Objectives

Nursing homes (NHs) are affected by major hurricanes and other natural disasters. To mitigate adverse effects of a major hurricane, NHs often increase their direct-care nurse staffing levels to meet the needs of their residents. However, the quality rating of the NH may affect the resources available to obtain and retain staff. This data brief provides estimates of direct-care nurse staffing levels by quality star rating during Hurricane Irma.

Design

Retrospective cohort study from September 3, 2017, to September 10, 2017.

Setting and Participants

570 Florida NHs that sheltered in place during Hurricane Irma.

Methods

We stratified NHs by their NH Compare overall quality star rating and then measured change in direct-care nurse staffing levels for registered nurses, licensed practical nurses, and certified nursing assistants.

Results

We found that the NH Compare overall star rating was positively associated with a greater staffing level response during Hurricane Irma among registered nurses, licensed practical nurses, and certified nursing assistants. This change was largest for 5-star facilities and smallest for 1-star facilities.

Conclusions and Implications

Higher-quality NHs may be more responsive and have the resources to be more responsive, to increased needs during a natural disaster. Our findings may serve as a platform for ongoing discussion on the role of the federal, state, and local governments in ensuring minimum staffing standards during natural disasters.