Organizational correlates of the risk-adjusted pressure ulcer prevalence and subsequent survey deficiency citation in California nursing homes


  • Mary Ellen Dellefield

    1. VA San Diego Healthcare System, John A. Hartford Foundation Building Academic Geriatric, Nursing Capacity Scholar, 3350 La Jolla Village Drive, San Diego, CA 92161
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    • Research Nurse.

  • Support for this research was provided by AHRQ Dissertation Grant R03 HS10022-01. Support for preparation of the manuscript was provided by John A. Hartford Foundation's Building Academic Geriatric Nursing Capacity Scholarship Program. Dr. Charlene Harrington is acknowledged for her support and encouragement.

  • A version of this paper was presented at the 52nd Annual Scientific Meeting of The Gerontological Society of America, November 1999, San Francisco, CA. The author has been practicing in the service sector during the past 6 years.


Organizational correlates of the risk-adjusted pressure ulcer prevalence and subsequent deficiency citation in nursing homes are not known. The purpose of this study was to examine the relationships between these two outcomes and selected organizational variables, including total nurse staffing levels, specialization, centralization, nursing wages, and facility ownership. Secondary data analysis was conducted on a sample of 897 California nursing homes included in the 1996 On-line Survey Certification and Reporting system and the Office of Statewide Health Planning and Development financial disclosure reports of individual California nursing homes. Organizational variables explained a small amount of the variation (adjusted R2 = .04, p < .01). A higher PU prevalence was associated with lower licensed nurse centralization and facilities participating exclusively in the Medicaid program. Receipt of a deficiency was less likely in facilities having a higher total nurse staffing level (OR = .49, p < .001). It was more likely in facilities having a higher risk-adjusted PU prevalence (OR = 1.05, p < .001), more licensed nurses (OR = 2.74, p < .05), a size of 160 beds or more (OR = 1.93, p < .01), and survey teams from specific counties (OR ranging from 2.3 to 6.8, p < .05). © 2006 Wiley Periodicals, Inc. Res Nurs Health 29: 345–358, 2006