The purpose of this study was to determine the extent to which registered nurse (RN) staffing patterns influenced nursing home quality. Based upon extensive literature review, a model for nursing home quality was developed. Using data from reports of 455 Medicare-certified skilled nursing facilities, structural, process, and outcome factors thought to influence quality were entered into the model and analyzed using ordinary least squares regression. A small, though statistically significant, proportion of the variance in quality nursing home care was explained by the equation. A positive, significant relationship existed between nursing home quality and the ratio of RN hours to licensed vocational nurse (LVN) hours per resident day.