Nursing Home Staffing Variability and Quality: Assessing Alternative Measures of Daily Staffing Level Variation

Variability in daily nursing staffing levels is an important factor associated with nursing home quality and has led to calls to incorporate it in the Centers for Medicare and Medicaid’s staffing star rating calculation. This study assessed 6 distinct daily staffing level variation measures for their validity in explaining quality outcomes to determine an optimal variation measure for inclusion in the CMS staffing star rating.