ABSTRACT
An appropriate number of qualified staff is a key factor contributing to quality of care and quality of life for nursing home residents. While much of the literature focuses on the importance of adequate nursing ratios, this descriptive study is the first to focus on the social services staff ratio. Nationally representative survey results from over 1,000 nursing home social services directors reveal that the mean number of residents per full-time equivalent social worker in the United States is 89.3 and the median is 79 residents (note that this figure includes both long-term and subacute residents). Furthermore, although the federal government requires nursing homes with more than 120 beds to employ 1 full-time qualified social worker to meet resident psychosocial needs, when asked their opinion, the majority of respondents indicated that 1 full-time social worker could handle 60 or fewer long-term care residents or 20 or fewer subacute care residents. Nursing home characteristics helped to explain the variation in social services directors' opinions. These findings suggest that the federal policy related to social services staffing should be revisited. Policy makers would benefit from reliable and current data regarding social service staffing. Research is needed to understand the relationship between social services staffing and resident outcomes.
Subject(s)
Nursing Homes/organization & administration , Health Care Surveys , Health Facility Size , Health Policy , Humans , Logistic Models , Long-Term Care , Odds Ratio , Personnel Staffing and Scheduling , Quality of Life , Social Adjustment , Social Work , Subacute Care/organization & administration , United States , WorkforceABSTRACT
OBJECTIVE: To determine the percentage of nursing home (NH) social services (SSs) departments that screen at-risk residents for depression. To report characteristics of SS departments that "usually or always" are involved in depression screening. DESIGN: Cross-sectional, nationally representative survey. SETTING: NHs. PARTICIPANTS: 1,071 Nursing Home Social Service Directors. MEASUREMENT: Survey. RESULTS: Over two-thirds (68.5%) of the SS directors reported that their department was "usually" or "always" involved in screening at-risk residents for depression. Preliminary findings from this exploratory study indicate the odds of screening for depression increased if the SS director had a degree in social work; if the NH was part of a chain; and by U.S. region. NHs in the Northeast were less likely, and those in the Midwest and West were more likely, than their southern counterparts to head up SSs departments that screen for depression. CONCLUSIONS: Future research and clinical practice related to NH depression screening and treatment should include social workers. SS staff, especially those educated in social work, can be an important resource to NH staff, residents, and family members. The federal government holds NHs responsible for psychosocial care, including psychosocial depression care.
