ABSTRACT
Synthesizing information from a number of research studies, we present the evidence that higher staffing levels and higher minimum staffing standards improve actual staffing levels and quality of care. Although nursing home staffing standards and actual staffing vary widely, low staffing levels and limited staffing resources are found in Canada, the UK, and the US, especially in for-profit nursing homes and large chains, while staffing levels are higher in Germany, Norway, and Sweden. New policy approaches are needed in countries where nursing homes are largely privatized to ensure adequate nurse staffing levels and nursing home quality of care that include: setting minimum staffing standards; setting minimum wages and benefits for workers; supporting the unionization and professionalization of workers; supporting consumer advocacy and ombudsman organizations; establishing greater financial transparency and accountability, and setting limits on profits and administrative expenses.
