{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:14:32Z","timestamp":1777457672873,"version":"3.51.4"},"reference-count":42,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2014,3,1]],"date-time":"2014-03-01T00:00:00Z","timestamp":1393632000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2014,3,1]],"date-time":"2014-03-01T00:00:00Z","timestamp":1393632000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Nursing Studies"],"published-print":{"date-parts":[[2014,3]]},"DOI":"10.1016\/j.ijnurstu.2013.10.007","type":"journal-article","created":{"date-parts":[[2013,10,14]],"date-time":"2013-10-14T12:00:54Z","timestamp":1381752054000},"page":"409-417","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":51,"title":["The effects of RN staffing hours on nursing home quality: A two-stage model"],"prefix":"10.1016","volume":"51","author":[{"given":"Hyang Yuol","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary A.","family":"Blegen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlene","family":"Harrington","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0005","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1093\/geront\/34.6.775","article-title":"Do for-profit and not-for-profit nursing homes behave differently?","volume":"34","author":"Aaronson","year":"1994","journal-title":"The Gerontologist"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0010","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1111\/j.1475-6773.2006.00647.x","article-title":"Improving quality assessment through multilevel modeling: the case of Nursing Home Compare","volume":"42","author":"Arling","year":"2007","journal-title":"Health Services Research"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0015","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/00001786-200404000-00010","article-title":"Relationship of nursing personnel and nursing home care quality","volume":"19","author":"Bostick","year":"2004","journal-title":"Journal of Nursing Care Quality"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0020","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.jamda.2006.01.024","article-title":"Systematic review of studies of staffing and quality in nursing homes","volume":"7","author":"Bostick","year":"2006","journal-title":"Journal of American Medical Director Association"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0025","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1093\/geront\/43.2.175","article-title":"Variations in hospitalization rates among nursing home residents: the role of facility and market attributes","volume":"43","author":"Carter","year":"2003","journal-title":"The Gerontologist"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0030","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1097\/00005650-200210000-00005","article-title":"Nursing homes with persistent deficiency citations for physical restraints use","volume":"40","author":"Castle","year":"2002","journal-title":"Medical Care"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0035","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1177\/0733464808321596","article-title":"Nursing home caregiver staffing levels and quality of care: a literature review","volume":"27","author":"Castle","year":"2008","journal-title":"Journal of Applied Gerontology"},{"issue":"6","key":"10.1016\/j.ijnurstu.2013.10.007_bib0040","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1097\/MLR.0b013e31820fbca9","article-title":"Caregiver staffing in nursing homes and their influence on quality of care using dynamic panel estimation methods","volume":"49","author":"Castle","year":"2011","journal-title":"Medical Care"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0045","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1111\/j.1475-6773.2007.00704.x","article-title":"The influence of staffing characteristics on quality of care in nursing homes","volume":"42","author":"Castle","year":"2007","journal-title":"Health Services Research"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0050","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1093\/geront\/48.4.464","article-title":"Further examination of the influence of caregiver staffing levels on nursing home quality","volume":"48","author":"Castle","year":"2008","journal-title":"The Gerontologist"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0055","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1080\/08959420802070130","article-title":"The influence of agency staffing on quality of care in nursing homes","volume":"20","author":"Castle","year":"2008","journal-title":"Journal of Aging & Social Policy"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0060","series-title":"Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes, Phase II Report","author":"Center for Medicare and Medicaid Services (CMS)","year":"2001"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0065","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/00001786-200701000-00012","article-title":"Nursing staffing and resident outcomes in nursing homes: weight loss and dehydration","volume":"22","author":"Dyck","year":"2007","journal-title":"Journal of Nursing Care Quality"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0070","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1177\/1077558703260122","article-title":"Nursing homes with persistent high and low quality","volume":"61","author":"Grabowski","year":"2004","journal-title":"Medical Care Research and Review"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0075","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0167-6296(02)00093-0","article-title":"Competitive spillovers across non-profit and for-profit nursing homes","volume":"22","author":"Grabowski","year":"2003","journal-title":"Journal of Health Economics"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0080","doi-asserted-by":"crossref","DOI":"10.1377\/hlthaff.W4.363","article-title":"Recent trends in state nursing home payment policies","author":"Grabowski","year":"2004","journal-title":"Health Affairs"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0085","series-title":"Nursing Home Staffing Standards in State Statutes and Regulations","author":"Harrington","year":"2010"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0090","series-title":"Nursing Facilities, Staffing, Residents and Facility Deficiencies, 1999 Through 2005","author":"Harrington","year":"2006"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0095","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1177\/107755879805500306","article-title":"Nursing facility staffing in the states: the 1991 to 1995 period","volume":"55","author":"Harrington","year":"1998","journal-title":"Medical Care Research and Review"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0100","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1177\/1077558703254692","article-title":"Nursing home staffing, turnover, and case mix","volume":"60","author":"Harrington","year":"2003","journal-title":"Medical Care Research and Review"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0105","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1111\/j.1475-6773.2006.00641.x","article-title":"Nurse staffing levels and Medicaid reimbursement rates in nursing facilities","volume":"42","author":"Harrington","year":"2007","journal-title":"Health Services Research"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0110","first-page":"5","article-title":"Achieving improvement through nursing home quality measurement","volume":"23","author":"Harris","year":"2002","journal-title":"Health Care Financing Review"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0115","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1093\/geront\/35.2.172","article-title":"Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS)","volume":"35","author":"Hawes","year":"1995","journal-title":"The Gerontologist"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0120","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/00000446-200511000-00028","article-title":"RN staffing time and outcomes of long-stay nursing home residents: pressure ulcers and other adverse outcomes are less likely as RNs spend more time on direct patient care","volume":"105","author":"Horn","year":"2005","journal-title":"American Journal of Nursing"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0125","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1097\/00005650-200012000-00003","article-title":"Influence of facility characteristics on use of antipsychotic medication in nursing homes","volume":"12","author":"Hughes","year":"2000","journal-title":"Medical Care"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0130","series-title":"Keeping Patients Safe: Transforming the Work Environment of Nurses","author":"Institute of Medicine","year":"2003"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0135","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1097\/00005650-199906000-00006","article-title":"Stability of nursing home quality indicators over time","volume":"37","author":"Karon","year":"1999","journal-title":"Medical Care"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0140","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1111\/j.1475-6773.2007.00803.x","article-title":"The staffing-outcomes relationship in nursing homes","volume":"43","author":"Konetzka","year":"2008","journal-title":"Health Services Research"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0145","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1097\/00005650-200410000-00008","article-title":"Which organizational characteristics are associated with increased management of depression using antidepressants in US nursing homes?","volume":"42","author":"Lapane","year":"2004","journal-title":"Medical Care"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0150","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1111\/j.0887-378X.2004.00309.x","article-title":"Driven to tiers: socioeconomic and racial disparities in the quality of nursing home care","volume":"82","author":"Mor","year":"2004","journal-title":"Milbank Quarterly"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0155","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1093\/geront\/30.3.293","article-title":"Designing the national resident assessment instrument for nursing homes","volume":"30","author":"Morris","year":"1990","journal-title":"The Gerontologist"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0160","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1093\/geront\/46.1.74","article-title":"Nursing home staffing standards: their relationship to nurse staffing levels","volume":"46","author":"Mueller","year":"2006","journal-title":"The Gerontologist"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0165","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1093\/geront\/44.1.24","article-title":"Nursing home quality, cost, staffing, and staff mix","volume":"44","author":"Rantz","year":"2004","journal-title":"The Gerontologist"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0170","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1475-6773.2004.00225.x","article-title":"Relationship of nursing home staffing to quality of care","volume":"39","author":"Schnelle","year":"2004","journal-title":"Health Services Research"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0175","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1046\/j.1532-5415.2003.51459.x","article-title":"The Minimum Data Set weight-loss quality indicator: does it reflect difference in care process related to weight loss?","volume":"51","author":"Simmons","year":"2003","journal-title":"Journal of American Geriatrics Society"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0180","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnurstu.2011.02.014","article-title":"The relationship between nurse staffing and quality of care in nursing homes: a systematic review","author":"Spilsbury","year":"2011","journal-title":"International Journal Nursing Studies"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0185","series-title":"Report to the Chairman, Subcommittee on Health and Long-Term Care, Select Committee on Aging, House of Representatives. Medicare and Medicaid: Stronger Enforcement of Nursing Home Requirements Needed","author":"U.S. General Accounting Office (GAO)","year":"1987"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0190","series-title":"Nursing Homes Quality: Prevalence of Serious Problems, While Declining, Reinforces Importance of Enhanced Oversight \u2013 Report to Congressional Requesters GAO-03-561","author":"U.S. General Accounting Office","year":"2003"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0195","series-title":"Nursing Homes: Efforts to Strengthen Federal Enforcement Have Not Deterred Some Homes from Repeatedly Harming Residents. GAO-07-241","author":"U.S. Government Accountability Office","year":"2007"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0200","series-title":"Nursing Homes: Addressing the factors underlying Understatement of Serious Care Problems Requires Sustained CMS and State Commitment. GAO-10-70","author":"U.S. Government Accountability Office","year":"2009"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0205","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/00004010-200404000-00004","article-title":"Nurse staffing patterns and quality of care in nursing homes","volume":"29","author":"Weech-Maldonado","year":"2004","journal-title":"Health Care Management Review"},{"key":"10.1016\/j.ijnurstu.2013.10.007_bib0210","first-page":"107","article-title":"The development and testing of nursing home quality indicators","volume":"16","author":"Zimmerman","year":"1995","journal-title":"Health Care Financing Review"}],"container-title":["International Journal of Nursing Studies"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0020748913002824?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0020748913002824?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T13:27:32Z","timestamp":1758115652000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0020748913002824"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,3]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,3]]}},"alternative-id":["S0020748913002824"],"URL":"https:\/\/doi.org\/10.1016\/j.ijnurstu.2013.10.007","relation":{},"ISSN":["0020-7489"],"issn-type":[{"value":"0020-7489","type":"print"}],"subject":[],"published":{"date-parts":[[2014,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The effects of RN staffing hours on nursing home quality: A two-stage model","name":"articletitle","label":"Article Title"},{"value":"International Journal of Nursing Studies","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijnurstu.2013.10.007","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2013 Elsevier Ltd. Published by Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]}}