For the main analysis of nursing home staffing, the Center for Public Integrity downloaded the 2012 Medicare cost reports for skilled nursing facilities. The Center extracted data about the number of resident days and the number of hours paid according to staffing position and divided the total number of hours paid by the number of resident days to get an average daily level of staffing by position, as well as total staffing. From there the Center connected the results of that calculation with 2012 data it had downloaded from the Nursing Home Compare website and calculated which dataset reported the higher staffing level for each direct care position, and for total staffing.
The Center modeled its analysis on a recommendation from Charlene Harrington, professor emeritus of nursing at the University of California, San Francisco, and on a peer-reviewed article by Bita Kash, Catherine Hawes and Charles Phillips that appeared in the August 2007 edition of The Gerontologist. The Center used data from the Centers for Medicare and Medicaid Services to calculate the number of standard survey inspections for each year from 2008 to 2012, and used Nursing Home Compare to compute the difference in the number of nursing homes in those two years.
For the piece on homes that ‘do staffing right,’ the Center identified those homes which received a 5-star overall rating from Nursing Home Compare and which had less than a 10 percent difference between the staffing levels from Nursing Home Compare and the daily average calculated through the cost reports for each staffing position, and for total staffing.