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Methods for Identifying Facilities and Communities with Shortages of Nurses, Technical Report
 

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Figure 4 is a map of the United States displaying the RNs per 100,000 population in 2004 for the fifty states and District of Columbia.  The states are color-coded to reflect ranges of the RNs per 100,000 population ratio.  States colored in white had the lowest RN per capita ratios (608 to 760).  These states included Idaho, Nevada, California, Utah, Arizona, New Mexico, Texas, and Oklahoma.  States colored in black had the highest RN per capita ratios (1,200 to 2,260).  These states included North Dakota, South Dakota, New Hampshire, and Massachusetts.  States with ratios of 1,000 to 1,200 RNs per 100,000 were colored in red, and these states were Alaska, Nebraska, Minnesota, Iowa, Missouri, Ohio, Pennsylvania, Delaware, Rhode Island, Vermont, and Maine.  States with ratios of 860 to 1,000 RNs per 100,000 were colored in orange.  These states included Oregon, Montana, Kansas, Wisconsin, Michigan, Illinois, Indiana, Kentucky, Tennessee, Mississippi, North Carolina, West Virginia, Maryland, New Jersey, New York and Connecticut.  States with ratios of 760 to 860 RNs per 100,000 were colored in yellow, and included Hawaii, Washington, Wyoming, Colorado, Arkansas, Louisiana, Alabama, Georgia, Florida, South Carolina, and Virginia.  The U.S. average of 848 is printed in text below the map.

Figure 5 is a map of the United States displaying the percent change in RNs per 100,000 population between 2000 and 2004 for the fifty states and District of Columbia.  The states are color-coded to reflect ranges of percent change.  States colored in white experienced a reduction of up to 6% in RNs per capita.  These states were Idaho, Louisiana, Florida, Maryland, Delaware, Connecticut, Rhode Island and Massachusetts. States colored in black had the largest increases in RNs per capita, ranging from 20% to 40%.  These states were Alaska and New Hampshire.  States experiencing an increase of 10% to 20% in RNs per capita were colored in red, and included Maine, Ohio, Indiana, Georgia, Mississippi, Nebraska, Utah and Nevada.  States experiencing an increase of 6% to 10% were colored in orange.  These states included Washington, Oregon, California, Montana, Arizona, New Mexico, North Dakota, South Dakota, Oklahoma, Texas, Minnesota, Illinois, Michigan, Kentucky, Tennessee, Alabama, Virginia, New York, and Vermont.   States experiencing an increase of 0% to 6% were colored in yellow.  These included Hawaii, Wyoming, Colorado, Kansas, Wisconsin, Iowa, Missouri, Arkansas, South Carolina, North Carolina, West Virginia, Pennsylvania, and New Jersey.  The U.S. average of 6.8% is printed in text below the map.

Figure 12 is a bar graph presenting the distribution of nursing recruitment difficulty scores predicted by an ordered probit model for hospitals, home health agencies, long term care facilities, and public health agencies.  The y-axis of the graph reflects the percentage of facilities predicted to have the scores listed on the x-axis.  The predicted scores along the x-axis are –4.85, -4.35, -3.85, -3.35, -2.85, -2.35, -1.85, -1.35, -0.85, -0.35, 0.15, 0.65, 1.15, 1.65, and More.  The bars for hospitals are colored green, the bars for home health agencies are colored yellow, the bars for long-term care facilities are colored red, and the bars for public health are colored light orange.   The percentages reflected for hospitals are: –4.85 = 1.5%, -4.35 = 4.6%, -3.85 = 24.6%, -3.35 = 50.8%, -2.85 = 12.3%, -2.35 = 6.2%.  There are no bars for hospitals at higher values.  The percentages reflected for home health agencies are: –4.85 = 5.1%, -4.35 = 3.8%, -3.85 = 24.1%, -3.35 = 24.1%, -2.85 = 19.0%, -2.35 = 12.7%, -1.85 = 6.3%, -1.35 = 2.5%, -0.85 = 1.3%, -0.35 = 0%, and 0.15 = 1.3%.  There are no bars for home health agencies at higher values. The percentages reflected for long-term care facilities are: –4.85 = 2.3%, -4.35 = 6.3%, -3.85 = 20.3%, -3.35 = 22.7%, -2.85 = 21.1%, -2.35 = 14.8%, -1.85 = 10.2%, -1.35 = 1.6%, 0.65 = 0.8%.  There are no bars for long-term care facilities at the values of –0.85, -0.35, 0.15, or higher than 0.65.  The percentages reflected for public health agencies are: –4.85 = 7.5%, -4.35 = 9.4%, -3.85 = 13.2%, -3.35 = 15.1%, -2.85 = 13.2%, -2.35 = 18.9%, -1.85 = 3.8%, -1.35 = 3.8%, -0.35 = 1.9%, 0.15 = 1.9%, 0.65 = 1.9%, 1.15 = 1.9%, 1.65 = 1.9%, and More = 5.7%.  There are no bars for public health agencies at the values of –0.85.  A black arrow is overlaid over the bar graph pointing to the approximate point reflecting a value of 3 on the x-axis.  The arrow illustrates that the starting point for having difficulty recruiting RNs is a score greater than –3.  The visual point made by the graph is that a higher percentage of long-term care facilities and public health agencies (compared to home health agencies and hospitals) fall to the right of the arrow, meaning that they are more likely to have difficulty recruiting RNs.

Figure 13 is a scatterplot showing the relationship between the predicted nursing recruitment difficulty score based on an ordinary least squares (OLS) regression model containing only community variables and the predicted nursing recruitment difficulty score based on an OLS model containing both community and facility variables for hospitals in North Carolina. A line is shown on the plot that represents the formula relating the two predicted scores. The slope of the line indicates that there is a positive relationship between the two scores. The R-squared statistic for the line is shown on the chart. The R-squared value of 0.2351 indicates that the predicted nursing recruitment difficulty score based on only community variables explains only 23.51% of the variation in the predicted nursing recruitment difficulty score based on both community and facility variables. This suggests that adding facility variables to the prediction models substantially changes the predicted nursing recruitment difficulty scores for hospitals.

Figure 14 is a scatterplot showing the relationship between the predicted nursing recruitment difficulty score based on an ordinary least squares (OLS) regression model containing only community variables and the predicted nursing recruitment difficulty score based on an OLS model containing both community and agency variables for home health agencies in North Carolina. A line is shown on the plot that represents the formula relating the two predicted scores. The slope of the line indicates that there is a positive relationship between the two scores. The R-squared statistic for the line is shown on the chart. The R-squared value of 0.4935 indicates that the predicted nursing recruitment difficulty score based on only community variables explains only 49.35% of the variation in the predicted nursing recruitment difficulty score based on both community and agency variables. This suggests that adding agency variables to the prediction models substantially changes the predicted nursing recruitment difficulty scores for home health agencies.

Figure 15 is a scatterplot showing the relationship between the predicted nursing recruitment difficulty score based on an ordinary least squares (OLS) regression model containing only community variables and the predicted nursing recruitment difficulty score based on an OLS model containing both community and facility variables for long term care facilities in North Carolina. A line is shown on the plot that represents the formula relating the two predicted scores. The slope of the line indicates that there is a positive relationship between the two scores. The R-squared statistic for the line is shown on the chart. The R-squared value of 0.6251 indicates that the predicted nursing recruitment difficulty score based on only community variables explains only 62.51% of the variation in the predicted nursing recruitment difficulty score based on both community and facility variables. This suggests that adding facility variables to the prediction models moderately changes the predicted nursing recruitment difficulty scores for long term care facilities.

Figure 16 is a scatterplot showing the relationship between the predicted nursing recruitment difficulty score based on an ordinary least squares (OLS) regression model containing only community variables and the predicted nursing recruitment difficulty score based on an OLS model containing both community and agency variables for public health agencies in North Carolina. A line is shown on the plot that represents the formula relating the two predicted scores. The slope of the line indicates that there is a positive relationship between the two scores. The R-squared statistic for the line is shown on the chart. The R-squared value of 0.7903 indicates that the predicted nursing recruitment difficulty score based on only community variables explains only 79.03% of the variation in the predicted nursing recruitment difficulty score based on both community and agency variables. This suggests that adding agency variables to the prediction models substantially changes the predicted nursing recruitment difficulty scores for home health agencies.