8287684 Changes in the prevalence of nursing home best practices for supporting worker, safety, health, and wellbeing in three U.S. states

<h3>Objective</h3> Our objective was to assess the prevalence of best practices to support worker safety, health, and well-being under the Total Worker Health framework in U.S. nursing homes. A validated measure of Total Worker Health practices was used for the survey. <h3>Material and Methods</h3> The first survey wave was done in 2018-2019, and a follow-up contacting original respondents was completed in 2024. All nursing homes caring for adults with at least 30 beds in California, Ohio, and Massachusetts were eligible for the original sample. The original mixed-mode survey had a 23.8% response rate (N=569), but subsequent analysis found no differential response based on observable characteristics. The follow-up survey had a lower response rate, 11.7% (N=63 of 537 remaining nursing homes). Directors of Nursing were the intended respondents in each organization as they have the requisite skills and knowledge to complete the survey on behalf of the organization. <h3>Results</h3> Overall, DONs reported relatively high levels of best practices for worker health and well-being. There was remarkable stability in the average and median scores for the five domains: leadership commitment; participation; policies program and practices that foster supportive working conditions; comprehensive and collaborative strategies; and adherence to federal and state regulations and ethical norms. These results held true even when using the entire sample average from 2019 rather than only the matched nursing homes. DONs also reported a slightly easier time recruiting and retaining qualified employees. However, the same $20 incentive resulted in a much lower response rate. <h3>Conclusion</h3> A 5-year follow-up survey found no significant changes in the manager-reported working conditions of U.S. nursing homes. Survey incentives for DONs might need to be increased to obtain response rates similar to previous surveys.