Dylan J Jester1, Kali S Thomas2,3, Lindsay J Peterson1, David M Dosa2,3,4,5, Ross Andel1, Kathryn Hyer1. 1. Florida Policy Exchange Center of Aging, School of Aging Studies, University of South Florida, Tampa, Florida, USA. 2. Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA. 3. School of Public Health, Brown University, Providence, Rhode Island, USA. 4. Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA. 5. Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA.
Abstract
OBJECTIVES: To examine the effect of Hurricane Irma on staff-related financial expenditures and daily direct-care nurse staffing levels. DESIGN: Retrospective cohort study. SETTING: September 3-24, 2017 in the state of Florida, United States. Hurricane Irma made landfall on September 10, 2017. PARTICIPANTS: Six hundred and fifty-three nursing homes (NHs), 81 evacuated facilities, and 572 facilities that sheltered-in-place. MEASUREMENTS: This study used data from Payroll-Based Journaling (PBJ), Certification and Survey Provider Enhanced Reports (CASPER), and Florida's health providers' emergency reporting system. PBJ provided estimates of daily direct-care nurse staffing levels for registered nurses, licensed practical nurses, and certified nursing assistants. CASPER reported facility-level characteristics such as profit status, chain membership, and special care unit availability. Florida's emergency reporting system identified evacuation status during Hurricane Irma. Linear mixed-effects models were used to estimate the unique contribution of evacuation status on daily staffing increases over time from September 3 to 10. RESULTS: Among all facilities, we found significant increases in staffing for licensed practical nurses (p = 0.02) and certified nursing assistants (p < 0.001), but not for registered nurses (p = 0.10) before Hurricane Irma made landfall. From 1 week before landfall to 2 weeks after landfall (September 3-24), an additional estimated $2.41 million was spent on direct-care nurse staffing. In comparison to facilities that sheltered-in-place, evacuated facilities increased staffing levels of all nurse types (all p < 0.001). At landfall, evacuated facilities spent an estimated $93.74 on nurse staffing per resident whereas facilities that sheltered-in-place spent $76.10 on nurse staffing per resident. CONCLUSION: NHs face unprecedented challenges during hurricanes, including maintaining adequate direct-care nurse staffing levels to meet the needs of their residents. NHs that evacuated residents had an increase in direct-care nurse staffing that was greater than that seen in NHs that sheltered-in-place.
OBJECTIVES: To examine the effect of Hurricane Irma on staff-related financial expenditures and daily direct-care nurse staffing levels. DESIGN: Retrospective cohort study. SETTING: September 3-24, 2017 in the state of Florida, United States. Hurricane Irma made landfall on September 10, 2017. PARTICIPANTS: Six hundred and fifty-three nursing homes (NHs), 81 evacuated facilities, and 572 facilities that sheltered-in-place. MEASUREMENTS: This study used data from Payroll-Based Journaling (PBJ), Certification and Survey Provider Enhanced Reports (CASPER), and Florida's health providers' emergency reporting system. PBJ provided estimates of daily direct-care nurse staffing levels for registered nurses, licensed practical nurses, and certified nursing assistants. CASPER reported facility-level characteristics such as profit status, chain membership, and special care unit availability. Florida's emergency reporting system identified evacuation status during Hurricane Irma. Linear mixed-effects models were used to estimate the unique contribution of evacuation status on daily staffing increases over time from September 3 to 10. RESULTS: Among all facilities, we found significant increases in staffing for licensed practical nurses (p = 0.02) and certified nursing assistants (p < 0.001), but not for registered nurses (p = 0.10) before Hurricane Irma made landfall. From 1 week before landfall to 2 weeks after landfall (September 3-24), an additional estimated $2.41 million was spent on direct-care nurse staffing. In comparison to facilities that sheltered-in-place, evacuated facilities increased staffing levels of all nurse types (all p < 0.001). At landfall, evacuated facilities spent an estimated $93.74 on nurse staffing per resident whereas facilities that sheltered-in-place spent $76.10 on nurse staffing per resident. CONCLUSION: NHs face unprecedented challenges during hurricanes, including maintaining adequate direct-care nurse staffing levels to meet the needs of their residents. NHs that evacuated residents had an increase in direct-care nurse staffing that was greater than that seen in NHs that sheltered-in-place.
Authors: Sarah B Laditka; James N Laditka; Sudha Xirasagar; Carol B Cornman; Courtney B Davis; Jane V E Richter Journal: Am J Public Health Date: 2008-01-02 Impact factor: 9.308
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Authors: David Dosa; Kathryn Hyer; Kali Thomas; Shailender Swaminathan; Zhanlian Feng; Lisa Brown; Vincent Mor Journal: J Am Med Dir Assoc Date: 2011-08-31 Impact factor: 4.669
Authors: Kali S Thomas; David Dosa; Kathryn Hyer; Lisa M Brown; Shailender Swaminathan; Zhanlian Feng; Vincent Mor Journal: J Am Geriatr Soc Date: 2012-09-24 Impact factor: 5.562
Authors: Lindsay J Peterson; Joseph June; Nazmus Sakib; Debra Dobbs; David M Dosa; Kali S Thomas; Dylan J Jester; Kathryn Hyer Journal: J Am Med Dir Assoc Date: 2020-03-07 Impact factor: 4.669
Authors: David Dosa; Zhanlian Feng; Kathy Hyer; Lisa M Brown; Kali Thomas; Vincent Mor Journal: Disaster Med Public Health Prep Date: 2010-09 Impact factor: 1.385
Authors: Julianne Skarha; Lily Gordon; Nazmus Sakib; Joseph June; Dylan J Jester; Lindsay J Peterson; Ross Andel; David M Dosa Journal: JAMA Health Forum Date: 2021-11-24