2. This report was produced by the Federal Interagency Forum on Aging Related Statistics. For more information visit the Forum’s web site at www.agingstats.gov or call 301-458-4460

32. MODELING THE OUTCOMES OF NURSING HOME CARE Rohrer and Hogan, Soc Sci Med 24(3) 1987 290 VA NH pts - 243 remaining Are the number of minutes of nursing care associated with outcomes when case mix is controlled?

33. Results of Regression Analysis of Outcome RUG (R -square=.71, N=234) LPN/Aides -.005 Psychosocial -.002 Basic.005 MD notes -.159 RN.013 Initial RUG.475 Rehab n.s.

34. CONCLUSIONS The amount of nursing care is associated with outcome functional status. Non-RN time is associated with better outcomes RN time is associated with worse outcomes (ameliorative) Rehab service was not associated with outcomes (constrained range?)

35. ORGANIZATIONAL PREDICTORS OF OUTCOMES OF LONG-STAY NURSING HOME RESIDENTS Rohrer et al, Soc Sci Med, 1993 10 nursing homes, 32 units, 872 cases Measures job assignment vs flexible duties hierarchy (number of levels of supervision) closeness of supervision (RNs/nonRNS) pace (discharges/beds) workload (percent heavy care residents) initial and outcome functioning

36. REGRESSION RESULTS (R-Square=.74) Job assignment 0.068 Hierarchy 0.153 Closeness of supervision n.s. Pct heavy care 0.207 Pace 1.044 Hierarchy x pace -1.074 Initial functioning 0.743

37. CONCLUSIONS Residents get worse: under strict job assignment tall hierarchies / large organizations where workload is heavy when pace is fast Residents get better: in large organizations when pace is fast Contingency theory applies - optimal structure depends on circumstances