Long-term care patient assessment. Evaluation of a methods effect.

Evaluation of a long-term care patient classification instrument in use in the Veterans Administration revealed that the levels of functional ability used in such instruments can influence their abilities to explain use of nursing time and reliability between raters. Specifically, a three-level scale that combines patients who require supervision with those who require help does not explain use of LPN and nurse's aide personal care time as well as does a four-level scale or a three-level scale that combines patients who require supervision with those who are independent. These findings should be considered in designing and applying patient assessment instruments.