How Does Rurality Influence the Staffing of Social Service Departments in Nursing Homes?

Abstract

Purpose of the Study: Social service departments in nursing homes (NHs) are staffed by qualified social workers (QSWs) and paraprofessionals. Due to greater workforce challenges in rural areas, this article aims to describe the staffing levels and composition of these departments by rurality. Design and Methods: Certification and Survey Provider Enhanced Reports data from 2009 to 2015 are used to examine the effect of rurality on social service staffing using random-effects linear panel regressions. Results: The average NH employed 1.8 full-time equivalents (FTEs), with approximately two thirds of social services staffed by QSWs. Large NHs had more staff, but employed fewer staff hours per resident day. Staffing levels were lower and QSWs made up a smaller percentage of staff in rural areas. Implications: National trends indicate variability in staffing by NH size and degree of rurality. Very low staffing within rural NHs is a concern, as staff may have less time to respond to residents' needs and these NHs may utilize fewer QSWs.