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Agency staffing is linked to worse resident outcomes, yet providers’ reasons for use and implications remain limited, especially in assisted livings. Using 2023 Ohio survey data, the study analyzes patterns of agency use and administrators’ concerns, highlighting substitution duration and key operational factors driving adoption, then calls for workforce investment to reduce agency reliance.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/agency-staff-utilization-in-nursing-homes-and-assisted-livings-patterns-and-concerns/424149/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/agency-staff-utilization-in-nursing-homes-and-assisted-livings-patterns-and-concerns/424149.png","ImageObject",300,407,{"name":92,"@type":93},"Adam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why do nursing homes and assisted livings use staffing agencies?","Question",{"text":113,"@type":114},"Since 2020, direct care worker shortages have pushed providers to turn to staffing agencies. The study finds agency use is common for hard-to-fill shifts, last-minute call-offs, employee departures, and periods of increased occupancy.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How frequently is agency staff used in nursing homes versus assisted livings?",{"text":118,"@type":114},"Nearly 68% of nursing homes and 38% of assisted livings used agency staff. Over 55% of nursing homes and 39% of assisted livings reported using agency staff as a substitute for more than 4 weeks.",{"name":120,"@type":111,"acceptedAnswer":121},"What are the main concerns administrators report about agency staff?",{"text":122,"@type":114},"Administrators most commonly cite costs, lack of dedication to building, negative effects on morale of directly employed staff, insufficient time for learning residents’ care plans, and lack of knowledge of building policies and procedures.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},424149,1790795131,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":81,"preview_page_count":4},1374404737137,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Innovation in Aging, 2025, Vol. 9, No. S2 791  \nAbstract citation ID: igaf122.2684  \nAGENCY STAFF UTILIZATION IN NURSING HOMES  \nAND ASSISTED LIVINGS: PATTERNS AND CONCERNS  \nPatrick Mese, Kennedy Berner, and John Bowblis, Miami University, Oxford, Ohio, United States  \nSince 2020, long-term care providers have been faced with a shortage of direct care workers. As a result, many nursing homes (NH) and assisted livings (AL) have turned to staffing agencies.  \nAgency staffing is believed to be associated with worse resident outcomes, but our understanding of how and why providers use agency staff, and the implications of their use is limited, especially in ALs. Using data from the 2023 Ohio Biennial Survey (> 90% response rate), NHs andALs that utilized agency staff for nursing aides or personal care aides during the year were identified. Nearly 68% of NHs and 38% of ALs utilized agency staff. NHs andALs are more likely to use agency staff for hard-to-fill weekend and overnight shifts (NHs: 77%, ALs: 60%), filling in for last-minute call-offs (78%, 67%), when an employee leaves employment (76%, 64%) or is vacationing (55%, 44%), and when there is an increase in occupancy (59%, 27%). Over 55% of NHs and 39% of ALs reported using agency staff as a substitute for a directly employed aide for over 4 weeks. The most common serious concern among administrators regarding agency staff are costs, lack of dedication to building, negatively impacting the morale of directly employed staff, inadequate time to know residents’ care plans, and lack of knowledge of building policies and procedures.  \nInvestment in the long-term care workforce is necessary to reduce the use of agency staff. This study provides important insights that help direct these investments.","cbCaiuyz510eaOvP","https://ap.wps.com/l/cbCaiuyz510eaOvP","pdf",710647,"English","# Abstract\n## Background and Rationale\n## Data and Methods\n## Usage Patterns\n## Administrator Concerns and Implications\n## Workforce Investment Recommendation","[{\"question\":\"Why do nursing homes and assisted livings use staffing agencies?\",\"answer\":\"Since 2020, direct care worker shortages have pushed providers to turn to staffing agencies. The study finds agency use is common for hard-to-fill shifts, last-minute call-offs, employee departures, and periods of increased occupancy.\"},{\"question\":\"How frequently is agency staff used in nursing homes versus assisted livings?\",\"answer\":\"Nearly 68% of nursing homes and 38% of assisted livings used agency staff. Over 55% of nursing homes and 39% of assisted livings reported using agency staff as a substitute for more than 4 weeks.\"},{\"question\":\"What are the main concerns administrators report about agency staff?\",\"answer\":\"Administrators most commonly cite costs, lack of dedication to building, negative effects on morale of directly employed staff, insufficient time for learning residents’ care plans, and lack of knowledge of building policies and procedures.\"}]","Agency Staff Utilization in Nursing Homes and Assisted Livings: Patterns and Concerns | PDF",1790633117]