The impact of organizational and environmental factors on staffing in home health care.

Home health care agencies are experiencing changes in staffing demands. I evaluated the staffing patterns of such agencies and investigated the impact of organizational and environmental factors on staffing. Disproportionate stratified random sampling, based on type and region of agency, was used to select Visiting Nurse Associations and hospital-based agencies. Seventy-three percent responded to the mail survey, 120 and 156, respectively.) On average, the majority of staff nurses and supervisors in individual agencies had associate degrees or diplomas. Nursing experience and medical-surgical nursing experience were of greater importance than having a B.S.N. or home health care experience for potential nursing applicants. Type, size, and age of agency and types of services provided had relatively little impact on staffing patterns. However, the director's degree was associated with the percentage of staff nurses and supervisors by educational degree. Competition had little impact on staffing patterns, although the extent of rural service area and Medicare involvement were related to educational backgrounds of nurses and hiring preferences.