Image of male nurse pushing senior woman in a wheelchair in nursing facility

Staffing is a key factor in determining a nursing home’s quality of care, according to new state-by-state analysis from advocacy group Families for Better Care.

The organization graded each state’s overall quality of nursing home care based on eight metrics, from the Kaiser Health Foundation, the Centers for Medicare & Medicaid Services and state long-term care ombudsman programs. Families for Better Care touts this as the first report of its kind.

“States whose nursing homes staffed at higher levels ranked far better than those with fewer staffing hours,” said Brian Lee, executive director of FBC and former Florida long-term care ombudsman. This finding supports what many stakeholders have been saying for years, Lee noted.

Alaska, Hawaii and Maine scored among the nation’s best for nursing homes, and all earned “A” grades in all staffing categories, such as direct care staffing hours and registered nurse hours. Alaska was ranked No. 1 in the nation overall. Rhode Island came in at No. 2, followed by New Hampshire.

The lowest-ranking states were Texas, Louisiana and Indiana.

While the FBC rankings provide a potentially valuable source of nursing home quality information, the list also underscores the complexities of the long-term care sector. For example, Indiana and Maine are ranked on opposite ends of the FBC list, but both states are among the most dangerous for nursing home workers, according to another recent study. Alaska was also No. 1 on the Genworth 2013 Cost of Care Survey, for having the most expensive average nursing home costs annually.