EXHIBIT 5.

Effect Of California Staffing Mandate On Changes In Nurse Staffing And Skill Mix In California Hospitals, Compared To Matched Hospitals In States Without A Similar Staffing Policy, 1997–2008

	Staffing (RN hours per patient day)		Skill mix (RNs as percent of all nursing staff)
	Announcement effect	Implementation effect	Announcement effect	Implementation effect
Change in California hospitals	0.25***	1.00****	<1	2
Change in matched hospitals	0.09	0.43****	<1	2
Difference in effect between California  hospitals and matched hospitals	0.16	0.57****	0.40	−0.20

source Authors’ analysis. notes The announcement effect represents the change in the period 2002–03. The implementation effect is the effect beyond that of the announcement period. Beta coefficients are from separate ordinary least squares fixed-effects regression models estimating the effects of California’s staffing mandate on staffing and skill mix using a propensity score–matched comparison group of hospitals in states other than California. Staffing is registered nurse (RN) hours per adjusted patient day. Skill mix is the proportion of registered nurses among all licensed nurses (registered nurses plus licensed vocational nurses). An expanded version of this exhibit, with coefficients and standard errors for differences between California and all comparison groups, appears in the Appendix (see Note 17 in text).

^***p < 0.01

^****p < 0.001