Unemployment
Sean Shenghsiu Huang, Ph.D., Georgetown University
Sean Shenghsiu Huang, Ph.D., Georgetown University

A booming economy may be detrimental to nursing home residents, according to new study released Friday.

Georgetown University Medical Center researchers came to that conclusion by scouring data from 2001 to 2015. They found that higher unemployment rates are associated with notable improvements in the quality of nursing home care. But when that rate drops, so does care quality, with residents more likely to suffer pressure ulcers, be physically restrained or have significant weight loss, according to the study, published this week in the Gerontologist.

Given the nature of nursing home care, with many residents covered by Medicare and Medicaid, the results are not a surprise, said Sean Shenghsiu Huang, Ph.D., assistant professor in the Department of Health Systems Administration at GUMC’s School of Nursing & Health Studies.

“When the economy is good, nursing homes have little flexibility to raise wages and benefits to attract nursing staff to work for them,” he told McKnight’s, adding that other business sectors have the ability to raise prices and pass higher costs to consumers, but nursing homes do not.

This news comes as the unemployment rate in the U.S. fell to a 49-year low in September and October. Past studies have shown that staffing levels impact quality of care, and “if you connect the dots,” Huang said, it’s easy to see hypothesize that low unemployment rates spell poorer staffing ratios and worse quality.

Researchers came to their conclusions by studying data from several sources, including state’s annual recertification records of all Medicare and Medicaid certified nursing homes, along with county-level unemployment rates from the Bureau of Labor Statistics. Data studied included two economic expansions and contractions.

The takeaway for nursing home leaders, Huang said, is to pay closer attention to health deficiencies when unemployment rates are low, as they are now. It may be worthwhile to invest in managerial approaches that can lower turnover, such as better involvement of nursing staff in decision-making, and more autonomy for nursing home administrators, he said.

Huang also urged federal and state legislators to find ways to improve compensation and benefits for nursing homes, given that three-quarters of residents are funded by Medicare and Medicaid.

“Policymakers and researchers have long been concerned about nursing home quality, and this study suggests strong action is needed now,” he said.