Nursing home social services directors' opinions about the number of residents they can serve

Mercedes Bern-Klug, Katherine W.O. Kramer, Peggy Sharr, Inez Cruz

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


An appropriate number of qualified staff is a key factor contributing to quality of care and quality of life for nursing home residents. While much of the literature focuses on the importance of adequate nursing ratios, this descriptive study is the first to focus on the social services staff ratio. Nationally representative survey results from over 1,000 nursing home social services directors reveal that the mean number of residents per full-time equivalent social worker in the United States is 89.3 and the median is 79 residents (note that this figure includes both long-term and subacute residents). Furthermore, although the federal government requires nursing homes with more than 120 beds to employ 1 full-time qualified social worker to meet resident psychosocial needs, when asked their opinion, the majority of respondents indicated that 1 full-time social worker could handle 60 or fewer long-term care residents or 20 or fewer subacute care residents. Nursing home characteristics helped to explain the variation in social services directors' opinions. These findings suggest that the federal policy related to social services staffing should be revisited. Policy makers would benefit from reliable and current data regarding social service staffing. Research is needed to understand the relationship between social services staffing and resident outcomes.

Original languageEnglish (US)
Pages (from-to)33-52
Number of pages20
JournalJournal of Aging and Social Policy
Issue number1
StatePublished - Jan 2010
Externally publishedYes


  • Long-term care
  • Psychosocial
  • Social services
  • Social work
  • Staffing ratios

ASJC Scopus subject areas

  • Demography
  • Gerontology
  • Life-span and Life-course Studies


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