Ownership Matters

Not-for-Profit Chain Nursing Homes Have Higher Utilization of Agency Nursing Staff

Bibliographic Data

ID13775316
AuthorsRohit Pradhan (0009-0006-3762-7212, Texas State University, San Marcos, TX, USA), Akbar Ghiasi (0000-0002-1477-4985, University of the Incarnate Word, San Antonio, TX, USA), Gregory N Orewa (0000-0002-3519-7902, University of Texas at San Antonio, San Antonio, TX, USA, corresponding author), Shivani Gupta (0000-0003-3690-8902, University of Houston – Clear Lake, Houston, TX, USA), Ganisher Davlyatov (0000-0001-9410-9696, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA), Brad Beauvais (0000-0003-3085-5379, Texas State University, San Marcos, TX, USA), Robert Weech-Maldonado (0000-0002-5005-0909, University of Alabama at Birmingham, Birmingham, AL, USA)
Year2024
Volume61
Pages469580241292170-469580241292170
Publication date2024-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueINQUIRY The Journal of Health Care Organization Provision and Financing (JOURNAL)
Journal identifiersISSN: 0046-9580 • E-ISSN: 1945-7243
PublisherSAGE Publishing (PUBLISHER • US)
DOI10.1177/00469580241292170
PMID39417836
OpenAlexW4403509796
LanguageEN
Citations received1
References cited37

Nursing homes (NHs) have long struggled with nurse shortages, leading to a greater reliance on agency nurses. The purpose of this study was to examine the impact of NH ownership on agency nurse utilization. Data were derived from multiple sources, including the Payroll-Based Journal and NH Five-Star Facility Quality Reporting System (n: 38,550 years: 2020-2022). A 2-part logistic regression model with 2-way fixed effects (state and year) was used to assess the association of ownership and agency nurse utilization. Model 1 compared facilities with and without agency nurse use, while Model 2 focused on NHs using agency nurses, examining high utilization (top 10%). The dependent variables were agency nurse utilization ratios for registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs). The primary independent variable was ownership/chain affiliation: for-profit chain (FPC), for-profit independent (FPI), not-for-profit chain (NFPC), and not-for-profit independent (NFPI). Model 1 showed that NFPC facilities had higher odds of using agency RNs (OR = 1.65), LPNs (OR = 1.53), and CNAs (OR = 1.38) compared to NFPI facilities (all P P < .001). Model 2 indicated that NFPC, FPC, and FPI facilities were more likely to be high utilizers (top 10%) of agency nurses, with NFPC facilities having the highest odds across all categories. Pairwise comparisons showed that NFPC had the highest utilization of agency RNs and LPNs compared to other ownership groups. These results highlight the significant impact of NH ownership on staffing practices, suggesting that ownership type influences agency nurse utilization

Agency (philosophy · Business · Certification · Economics · Logistic regression · Management · Nursing Assistant · Nursing homes · Odds · Sociology · Employment and Welfare Studies · Geriatric Care and Nursing Homes · Global Health Workforce Issues · Medicine · Nursing