Changes in Nursing Staff Levels and Injury-Related Emergency Department Visits among Assisted Living Residents with Alzheimers Disease and Related Dementias.

The study cannot show that adding registered nurse hours caused fewer injury-related emergency department visits because it observed existing staffing patterns. Nursing staff hours and resident census were reported by assisted living administrators, so staffing levels may be inaccurate. The analysis did not measure functional status, frailty, or dementia severity, so residents with different needs may have been in communities with different staffing. Alzheimer's disease and related dementias were identified from Medicare claims flags, which may have misclassified some residents. The findings come from Ohio assisted living communities with 25 or more beds and from 2007 to 2015, before the pandemic staffing shortages. The significant finding was limited to registered nurse hours; total nursing hours were not significant, and the association was not significant for emergency visits that led to hospital admission.

The article is listed as supported by non-U.S. government and NIH extramural research. No author conflict-of-interest declaration is provided in the supplied text.

Do not read the 53% lower risk as proof that adding RN hours prevents injury-related emergency department visits. The study was observational, total nursing hours showed no significant association, and staffing data came from administrator reports.