Table. Nursing Home Clinicians Per 1000 Medicare-Certified, Occupied Beds by Clinician Type and Place of Service.

	Year of Part B Medicare Fee-for-Service Billing				P Value for Trenda	Relative Percent Change, 2012-2015b
	2012	2013	2014	2015
Nursing home clinicians, No.	33 218	33 316	33 357	33 087	.97	−0.4
Nonspecialist	28 091	27 608	27 002	26 230	.39	−6.6
Nursing home specialist	5127	5708	6355	6857	.009	33.7
Nursing home clinicians per 1000 occupied beds, mean (95% CI)	24.70 (23.82 to 25.58)	24.90 (23.96 to 25.84)	24.93 (23.97 to 25.90)	24.99 (24.01 to 25.97)	.68	1.2
Nonspecialist	21.35 (20.55 to 22.16)	21.15 (20.29 to 22.00)	20.70 (19.85 to 21.55)	20.41 (19.56 to 21.26)	.09	−4.4
Nursing home specialist	3.35 (3.06 to 3.64)	3.76 (3.45 to 4.06)	4.23 (3.89 to 4.58)	4.58 (4.19 to 4.96)	<.001	36.7
Nursing Home Specialists per 1000 Occupied Beds, Mean (95% CI)
Clinician type
Physician	1.11 (0.98 to 1.23)	1.22 (1.09 to 1.34)	1.31 (1.17 to 1.45)	1.37 (1.23 to 1.51)	.004	23.4
Advanced practitioner	2.24 (2.02 to 2.46)	2.54 (2.30 to 2.78)	2.92 (2.64 to 3.20)	3.21 (2.90 to 3.51)	<.001	43.3
Place of service
Post–acute care	1.47 (1.29 to 1.64)	1.68 (1.49 to 1.86)	1.85 (1.61 to 2.08)	2.00 (1.75 to 2.26)	<.001	36.1
Long-term care	0.73 (0.63 to 0.83)	0.81 (0.70 to 0.91)	0.92 (0.82 to 1.03)	0.90 (0.79 to 1.01)	.007	23.3
Post–acute care and long-term care	1.16 (1.01 to 1.30)	1.27 (1.11 to 1.43)	1.46 (1.29 to 1.63)	1.67 (1.48 to 1.86)	<.001	44.0

^aTo test for statistical significance of the trends, linear regression was used to model the number of clinicians (or the number of clinicians per 1000 occupied nursing home beds) in each hospital referral region (n = 305) as a function of year.

^bRelative percent change in the number of clinicians per 1000 occupied Medicare-certified beds from 2012 to 2015.