Document Type

Master's Culminating Experience

Publication Date



Background: Long-term care facilities provide a wide range of services over a sustained period of time to people of all ages with functional limitations and chronic conditions. Nursing homes provide 24 hour nursing care support and long-term housing.

Objectives: The purpose of this study is to explore the relationships among nursing home ownership, care processes and quality outcomes in Medicare- and Medicaid-certified nursing homes in Ohio.

Methods: This is a descriptive study that uses the Centers for Medicare and Medicaid Services’ (CMS) Minimum Data Set (MDS). There were 198 Medicare and Medicaid certified nursing homes located in Southwest Ohio included in this study. Results: The data analysis revealed that non-profit nursing homes provide more licensed nursing staff and Certified Nursing Assistant (CNA) hours per resident per day than for–profit facilities (p < 0.001). Higher levels of licensed nursing staff and CNA care had no influence on quality outcomes or five star rating measures

Conclusions: This study demonstrates that nursing home ownership plays a significant role in nursing staff care and quality of care outcomes. When nursing staff care hours reach state legislation minimum required level, there is no significant impact on quality outcome measures. Quality of care outcomes are not determined by nursing staffing alone. Pressure ulcer prevalence rates, typically use as a quality measure may not be sensitive to differences in staffing hours.