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  1. Alvarez, M. Raymond DHA
  2. Kerr, Bernard J. Jr EdD
  3. Burtner, Joan EdD
  4. Ledlow, Gerald PhD
  5. Fulton, Larry V. PhD


Use of outsourced nurses is often a stop gap measure for unplanned vacancies in smaller healthcare facilities such as long-term acute-care hospitals (LTACHs). However, the relationship of utilization levels (low, medium, or high percentages) of nonemployees covering staff schedules often is perceived to have negative relationships with quality outcomes. To assess this issue, the authors discuss the outcomes of their national study of LTACH hospitals that indicated no relationship existed between variations in percentage of staffing by contracted nurses and selected outcomes in this post-acute-care setting.