Residential Services Research Articles

Effectiveness of residential treatment services for veterans with substance use disorders: A propensity score matching evaluation

BackgroundPrior reviews of substance use disorder (SUD) treatment have found mixed support for residential level of care but are limited by methodology problems and the ethical concerns of randomizing patients with severe SUD to lower levels of care. MethodsThe present study is the first to use a large archival SUD residential sample with a matched comparison group and one-year follow-up period to examine the benefits of residential treatment provided to adults clinically assessed as warranting SUD residential care. We used propensity score matching in our sample (N = 6177) of veterans with a SUD who were screened and accepted for Veterans Affairs (VA) SUD residential treatment between January 1st, 2019 and June 30th, 2019. ResultsWe found evidence that VA SUD residential treatment saves veteran lives with an average 66% all-cause mortality risk reduction during the study period (b = −1.09, exp(b) = 0.34, p <0.001). Medium-to-large residential pre- to post-treatment self-reported mental health and SUD symptom improvements (|SMDrobust| = 0.54–0.93) were sustained by one-year post-screening. These residential treatment improvements were significantly larger than estimated counterfactual outcomes across self-reported SUD and stress disorder symptoms at one-year post-screening (ps <0.001). We found mixed behavioral, service utilization, and other self-reported mental health outcomes. ConclusionsWe conclude that VA SUD residential treatment is an effective level of care for veterans warranting residential care particularly for SUD symptom improvements and reductions in mortality risk.

Research on the role of residential hotels in rural tourism in the context of big data

Abstract The development of residential hotels has new practical significance in today’s rural tourism which is heating up and getting more and more attention and development. This paper constructs a service quality evaluation system for residential hotels based on SERVQUAL service quality model and introduces gray correlation analysis and multiple linear regression to analyze the role and influence of residential hotels on rural tourism development. Taking the data of residential hotels in Province S as the research sample, the gray correlation degree and service quality gap of residential hotel service quality were verified, and the interaction between them was verified by regression analysis under different fixed effects. The results show that the gray correlation of safety in the service quality of residential hotels is the highest at 0.7812, the gap of service quality advantage is 0.46 points higher than the mean value of rural tourism tourists’ expectations, and the explanatory degree of the service quality of residential hotels to the development of rural tourism reaches 72.4% in all dimensions. The development of rural tourism can be boosted by improving service quality in residential hotels and meeting the expectations of tourists regarding rural tourism.

How Canadian caregivers of persons living with dementia are managing in a fragmented system

People living with dementia (PLWD) often need many different health and social services throughout their journey, and navigating and accessing these services can be challenging due to a lack of integration in dementia care. PLWD often rely on caregivers, usually family members, to help them navigate the system and access the care and services they need. The importance of better co-ordination and integration of health, community, and residential dementia services has been highlighted in the World Health Organization’s (WHO) global action plan on the public health response to dementia and Canada’s National Dementia Strategy, however a widespread, robust plan for integrated care for PLWD has yet to be implemented. This leaves caregivers with the task of seeking out and accessing services on their own. The Alzheimer Societies across Canada aim to help caregivers navigate and access services by providing information, education, and support in system navigation to caregivers. In this study, we explored the experiences of caregivers accessing health and social services for their loved ones with dementia, and the role that the Alzheimer Society played in this journey. This work has been informed and guided by members the Alzheimer Society of Canada’s People with Lived Experience Advisory Group.&#x0D; We conducted semi-structured interviews with 34 caregiver clients of the Alzheimer Society across Canada in the Fall of 2022. Interviews were completed by phone or video conference and lasted between 20 and 73 minutes (mean=32 minutes). Participants were all caregivers of a PLWD and ranged in age from 42-89 (mean age= 63 years). There were 10 men, 23 women, and one non-binary person in our sample (caregiver spouse=18, caregiver child=15, caregiver sibling=1). Interviews were recorded and transcribed verbatim. Deductive coding, based on the interview questions, was used to identify themes.&#x0D; Experiences accessing health and social services varied widely among participants based on geographic location, disease progression or symptoms, existing social support and self-advocacy skills, and finances. Many caregivers had trouble accessing the services that they needed and found the system to be difficult to navigate. In many cases, the Alzheimer Society played an important role in making caregivers aware of the health and community services available and provided guidance on how to access those services in a timely way. Some participants, however, found that despite being provided with information and education, they continued to struggle due to a lack of access to quality care in the community (e.g. adult day programs, respite, and long-term care). Some participants experienced such extreme distress at being unable to access the care they needed for the PLWD, that they experienced physical and mental health issues themselves. &#x0D; The Alzheimer Society and similar organizations help to make up for the lack of an integrated care system for PLWD, however, there remain large gaps in the ability of caregivers to access timely, adequate care. Fragmented, disjointed, and difficult to access care can have negative consequences for PLWD and their caregivers, and action is needed to further support the development of integrated dementia care services across Canada.&#x0D;

Analysis of the relationship between metro ridership and built environment: A machine learning method considering combinational features

Limited studies have examined the relationship between combinational features of the built environment and metro ridership. In this study, we applied the gradient boosting regression tree (GBRT) to explore the non-linearity effects for metro commuter ridership and non-commuter ridership, respectively. The results show that the number of bus stops is an important predictor of urban metro commuter ridership, whereas residential and community services, road density, and leisure and entertainment are important predictors of urban metro non-commuter ridership. Based on the partial dependence plots generated by GBRT, the results confirm that combinational features of the built environment have a larger impact on commuter ridership (e.g., high-high level road density-life services on the destination side). Combinational features at a higher level exhibit a more substantial influence on commuter ridership, whereas combinational features at a lower level demonstrate a greater impact on non-commuter ridership.

“CAREGIVING IS TEAMWORK...” INFORMATION SHARING IN HOME CARE FOR OLDER ADULTS WITH DISABILITIES IN THE COMMUNITY

Abstract Direct care workers provide assistance with daily activities to persons with disabilities. Direct care workers are well positioned to recognize and share information about care gaps and changes in function and behaviors but are often viewed as unskilled and excluded from interdisciplinary care team interactions. We conducted 11 semi-structured interviews with administrators (n=5), nurses (n=3), and direct care workers (n=3) from home care agencies (“residential service agencies” in Maryland) to understand information sharing between direct care workers, family caregivers, and clinicians in home care delivery for older adults with disabilities, including those living with dementia. Thematic analysis was completed by the research team. Leveraging Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model, a human factors framework, respondents highlighted aspects of information sharing across (1) work systems, (2) processes, and (3) dementia-related adaptations. Work system characteristics relevant to information sharing included the utilization of electronic management systems and patient portals to communicate within agencies and with clinicians and using multiple methods to gather information about client goals and preferences (e.g., assessments, client profiles). Process characteristics include collaborations between families and residential service agency staff to deliver optimal care. Direct care workers did not report differences in coordinating care for persons living with dementia, however they reported dementia-related adaptations like an increased need to establishing and sustaining strong relationships with family members and communicating with clinicians during medical visits. Findings highlight the care demands experienced by direct care workers and support calls to better coordinate information sharing between interdisciplinary care teams.

INTERROGATING THE SKILLED NURSING STAYS OF HOMELESS AND SERIOUSLY ILL OLDER ADULTS

Abstract The culture change movement has fostered an intentional move away from restrictive ethos of care in hospitals, post-acute rehabilitation, and skilled nursing. However, for the millions in the United States who are uninsured, Medicaid-insured, or dual-eligible are less likely to access ‘deinstitutionalized’ healthcare environments. This presentation presents findings from a constructivist grounded theory study, Research and Supportive Care at Later-life for Unhoused People (RASCAL-UP), on the role of skilled nursing in the experiences of palliative care patients with histories of homelessness. Through provider interviews (n=30), field observations (n=12), and longitudinal chart documentation of a subset of homeless palliative care patients with stays in skilled nursing (n=13), this presentation will reflect on major findings: (1) barriers to skilled nursing entry; (2) successes and challenges in transitioning into skilled nursing residence; (3) acts of resistance to (re)institutionalization; and (4) discharge options and outcomes. Results showcase a need to fill the residential service gap between supportive housing and skilled nursing care and policy change that incentivizes consumer-directed practices for all.

Analisis Sarana, Prasarana , dan Utilitas Umum pada Dinas Perumahan dan Kawasan Permukiman serta Pertanahan Kabupaten Deli Serdang

The implementation of the internship program which took place on 16 January-16 February 2022 at the housing and residential areas and land services of Deli Serdang district was packaged with the concept of 1) problem solving by students taking part in the internship program after carrying out the problem identification stage and 2) implementing a series of training activities by the housing and residential areas and defense services for students taking part in the internship program. The methods used in this internship program are summarized in three stages, namely 1) preparation stage, 2) implementation stage, and 3) evaluation stage which includes making a final report. This skills internship program is effective as a place for students to practice the knowledge they have absorbed in lectures directly in the workplace, increase students' insight and experience, improve students' skills and competencies in certain areas of expertise through various training, and equip students with skills that can be utilized. after graduating from college. Through the implementation of this skills internship program, students are not only required to do work practice at partner companies where they do internships. Students are also trained to be able to work and collaborate in teams and be effective in improving skills and competencies in certain areas of expertise.

Simple solutions first—energy savings for domestic hot water through flow restrictors

Domestic hot water production is the second most important energy use in the European residential sector, nowadays accounting for 14% of the sector’s total final energy consumption. Despite its importance, the energy efficiency improvement rates for domestic hot water are lower than for other residential energy services, hence calling for energy-saving measures. One key measure is to install flow restrictors. Their advantages are the low upfront cost, easy installation, and suitability for integration into energy efficiency programs. Focusing on flow restrictors, this paper presents different methods for quantifying the energy savings using ex-ante and ex-post approaches: deemed savings (DES), dedicated measurements (DMs), and monthly and yearly billing analysis (SMBA and ABA). These methods were tested using information based on measurements (water flow, temperatures), historical billing analysis, a survey among inhabitants, and interviews with field experts. While measurements made at individual faucets or showerheads show significant water savings (20% and 33% respectively), energy savings associated with hot water production in the boiler (final energy) are significantly lower (around 10%) but far from being negligible. The main reasons for the difference are thermal losses related to hot water distribution in central heating systems, usages not affected by flow restrictors, and inhabitants removing them. We conclude that flow restrictors offer promising potential for short- to medium-term implementation. Given the simplicity of this solution, we recommend including it systematically in energy efficiency programs, as well as implementing a ban on fixtures with flow rates beyond a predefined level.

Implementation and evaluation of a nurse-led intervention to augment an existing residential aged care facility outreach service with a visual telehealth consultation: stepped-wedge cluster randomised controlled trial

BackgroundUp to 75% of residents from residential aged care facilities (RACF) are transferred to emergency departments (ED) annually to access assessment and care for unplanned or acute health events. Emergency department presentations of RACF residents can be both expensive and risky, and many are unnecessary and preventable. Processes or triage systems to assess residents with a health event, prior to transfer, may reduce unnecessary ED transfer. The Aged Care Emergency (ACE) service is a nurse-led ED outreach service that provides telephone support to RACF nurses regarding residents’ health events. This service is available Monday to Friday, 8am to 4 pm (ED ACE hours). The primary objective of this study was to assess whether the augmentation of the phone-based ED ACE service with the addition of a visual telehealth consultation (VTC) would reduce RACF rate of ED presentations compared to usual care. The secondary objectives were to 1) monitor presentations to ED within 48 h post VTC to detect any adverse events and 2) measure RACF staff perceptions of VTC useability and acceptability.MethodsThis implementation study used a stepped wedge cluster randomised controlled trial design. Study settings were four public hospital EDs and 16 RACFs in two Local Health Districts. Each ED was linked to 4 RACFs with approximately 350 RACF beds, totalling 1435 beds across 16 participating RACFs. Facilities were randomised into eight clusters with each cluster comprising one ED and two RACFs.ResultsA negative binomial regression demonstrated a 29% post-implementation reduction in the rate of ED presentations (per 100 RACF beds), within ED ACE hours (IRR [95% CI]: 0.71 [0.46, 1. 09]; p = 0.122). A 29% reduction, whilst not statistically significant, is still clinically important and impactful for residents and EDs. A post-hoc logistic regression demonstrated a statistically significant 69% reduction in the probability that an episode of care resulted in an ED presentation within ED ACE hours post-implementation compared to pre-implementation (OR [95% CI]: 0.31 [0.11, 0.87]; p = 0.025).ConclusionFindings have shown the positive impact of augmenting ACE with a VTC. Any reduction of resident presentations to a busy ED is beneficial to healthcare overall, but more so to the individual older person who can recover safely and comfortably in their own RACF.Trial registrationAustralian New Zealand Clinical Trials Registry (ID ACTR N12619001692123) (02/12/2019) https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378629andisReview=true

Job satisfaction and regulation in the aged care sector: staff perspectives

BackgroundThe quality of care provided in residential aged care facilities is largely dependent on the job satisfaction of employees and the organisational framework and systems that they provide care in. This study aimed to explore aged care staff perceptions of job satisfaction, regulation of the sector and the Royal Commission into Aged Care Quality and Safety.MethodsA cross-sectional survey conducted in 2019-early 2020 with staff employed in various roles at residential aged care services in Australia. The study specific survey collected views and experiences about working in the aged care sector as well as information about their role.ResultsA total of 167 aged care staff completed the survey of which 71% worked in a direct care role. Most participants indicated they thought they were doing a worthwhile and important job (98%), were proud to work in the sector (94%) and found the job personally rewarding (94%). However, participants also reported feeling emotionally drained by the work (37%) and fatigued by having to face a day of work (30%). 72% of participants felt the Royal Commission would lead to improvements in the care provided to residents.ConclusionAged care staff have an overall positive feeling towards their work. Additional support including increasing skills to deliver high-quality care, creating a supportive work environment to reduce job stressors and changes to the way the sector is regulated, are likely to lead to improved care.

An environmental scan of residential treatment service provision in Ontario

BackgroundOntario has one of the highest rates of substance-related harms in Canada. Residential treatment programs in the province provide a variety of in-house treatment services to support the needs of individuals with substance use disorders (SUD). However, these programs are not standardized, often varying in the type, quality, and availability of services offered, including evidence-based interventions such as Opioid Agonist Treatment (OAT). Local treatment systems are also rather fragmented and complex to navigate, creating barriers for potential services users to identify and make informed choices on available treatment options.MethodsBetween May to August 2023, we conducted an environmental scan to capture available information on all publicly-funded residential treatment programs in Ontario using the ConnexOntario service portal, a government-funded, health services information platform. Data were captured on organization name, geographical location, program description, program type (residential addictions treatment or supportive recovery programs), eligibility criteria, target population, the program’s OAT policies, number of available beds, minimum and maximum length of stay, projected wait times, funding source, and associated fees for program admission. Data were extracted and organized by geographic region, and findings were presented descriptively.ResultsA total of 102 residential addiction treatment programs and 36 residential supportive recovery programs in Ontario were identified. The scan noted substantial regional variations in program availability and wait times, along with a lack of programs tailored to unique populations such as women, youth, and Indigenous peoples. There is also a paucity of publicly-available information on program offerings, including detailed specifics on OAT policies within residential treatment programs that are crucial to ensuring that the services being offered are safe and grounded in evidence-based practice.ConclusionsFindings from the scan highlight notable gaps in program types, offerings, and availability among residential treatment programs in the province, including a lack of standardization on OAT policies across programs. Efforts should be made to ensure access to treatment-specific program information relevant to potential service users and to enhance coordinated access to residential treatment services in the province.

Supplemental Material for The Availability of Dialectical Behavior Therapy in Partial Hospitalization and Residential Services for Borderline Personality Disorder: An Exploratory Longitudinal Study of the National Mental Health Services Survey From 2014 to 2021

Supplemental Material for The Availability of Dialectical Behavior Therapy in Partial Hospitalization and Residential Services for Borderline Personality Disorder: An Exploratory Longitudinal Study of the National Mental Health Services Survey From 2014 to 2021

CARE PROVIDERS IN THERAPEUTIC RESIDENTIAL SERVICE AND THEIR EXPERIENCES: Analysis of scientific production

Therapeutic Residential Service targets patients discharged after long-term hospitalization through the mediation of the care providers. The aim of this research was to identify the scientific production of the last ten years on the subject. A search on the Biblioteca Virtual em Saúde - Psicologia Brasil (BVS-Psi), Scielo, and CAPES Periódicos database was conducted using the following terms in Portuguese: “cuidador” and “residência terapêutica”. A total of 15 texts were analyzed considering its year of publication, category, type of study, instruments and materials, results, and gaps. The results show a higher prevalence of studies in 2011 a lower in 2010, 2015 and 2017. Most of the papers (81,25%) are empirical studies and used semi-structured interviews (45,45%). It was observed that being a care provider brings the experience of ambiguous feelings with moments of satisfaction and dissatisfaction. Physical and emotional overwhelming, and lack of support, supervision, training and continued education permeate the care providers experience. As for the gaps, it is noticeable the recommendation and justification of more studies on these professionals and the promotion of hearing and caring to their benefit. It is expected that this research contributes to stress the importance of considering the processes of mental health of the care providers, valuing the roles performed by them.

'Through a kaleidoscope': A Foucauldian discourse analysis of Belgian policy regarding patients with a migration background and depression in general practices.

A higher prevalence of depression is found among patients with a migration background within the Belgian population. Nevertheless, this group is underrepresented in ambulant and residential mental health care services. Since general practitioners (GPs) have a crucial gatekeeping role, this led some researchers to investigate the possibility of a provider bias influencing GPs' assessment and referral of depressed patients with a migration background. However, GPs' accounts may be influenced by wider professional discourses present at the policy level, which are inevitably linked to institutions regulating the conduct of GPs. Therefore, this study applied a Foucauldian discourse analysis (a) to identify broader professional discourses in Belgian policy documents regarding patients with a migration background and depression in general practices, (b) to examine how patients with a migration background are discursively positioned and (c) to investigate which different balances of power in the relationship between GPs and patients with a migration background are demonstrated in the identified discourses. We identified three recurring discourses: (a) the othering discourse, (b) the health literacy discourse, and (c) the person-centred discourse. Our analysis demonstrated that the former two discourses illustrate the perpetuation of a biomedical discourse. While the last discourse is aligned with a counter-discourse associated with the person-centred care model in health care. Consequently, our analysis demonstrated the construction of a contradictory discursive framework throughout the various policy documents on which GPs might rely when speaking about patients with a migration background suffering from depression.

Award for Distinguished Professional Contributions to Applied Research: Jennifer C. Wolff.

This award is given to a psychologist whose research has led to important discoveries or developments in the field of applied psychology. "Jennifer C. Wolff serves multiple roles as a licensed psychologist in Massachusetts and Rhode Island. She is an associate professor at The Warren Alpert Medical School of Brown University, a staff psychologist at Rhode Island Hospital and Bradley Hospital, and director of the Adolescent Mental Health Collaborative. Dr. Wolff's program of research involves three primary aims: (a) delineating social, cognitive, and affective mechanisms underlying adolescent psychopathology; (b) translating these findings into treatments; and (c) implementing these treatments in real-world settings. She focuses on emotional and behavioral dysregulation as well as suicide prevention. Her current projects include large-scale data collection in the inpatient setting and improving routine practices and quality of care in inpatient and community settings. She also investigates the use of technology in dissemination and implementation research. Dr. Wolff has pioneered a cognitive behavioral therapy program for inpatient adolescents that includes scaling to train hospital staff. She is an active member of the American Psychological Association, the Association for Behavioral and Cognitive Therapies, and the Division 53 Special Interest Group for Acute, Intensive, and Residential Services. She has served as a peer reviewer/ad hoc reviewer and has authored or coauthored several articles and book chapters. Dr. Wolff's work demonstrates an exceptional combination of clinical practice and applied research and is therefore well-deserving of this distinguished award." (PsycInfo Database Record (c) 2024 APA, all rights reserved).

발달장애인의 거주 서비스 욕구와 지원방안에 관한 연구

The purpose of this study is to identify and propose the needs of people with developmental disabilities for residential services and the necessary support measures in order for them to live an independent life in the community. To this end, focus group interviews were conducted with 5 parents with developmental disabilities.&#x0D; The main fi ndings are as follows. First, in relation to caring for children with developmental disabilities, it was found that they are facing difficult situations due to challenging behaviors, poor health care, maladaptation to new environments and changes in circumstances, and conflicts within the family. Second, as a housing support service necessary for the independent life of people with developmental disabilities, the introduction of a national responsibility system for people with developmental disabilities, the development of a standard manual to promote communication, the strengthening of lifelong education for each level, the strengthening of income security, and the expansion of specialized medical services were proposed. Therefore, based on the results of these studies, we proposed the policy and practical implications necessary for the self-reliance of the local communities of the developmental people.

‘It’s about having that knowledge, tino rangatiratanga!’ Understanding structural barriers to accessing aged residential care services among older Māori in New Zealand

ABSTRACT New Zealand’s older Indigenous people (Māori) are underserved and underrepresented as consumers of aged residential care services (ARC). This study seeks to ascertain, from the perspectives of older Māori and whānau (family), the influence of structural factors that impact the process of seeking aged residential care. This study used a qualitative Kaupapa Māori research approach. In-depth interviews were undertaken with older Māori (n = 30) and whānau members (n = 18). Interviews were audio recorded and transcribed with themes identified using thematic analysis. Structural barriers related to ‘Navigation’ and ‘Service design and locality’ were identified by older Māori and whānau which provide insight into the oppressive nature of structural racism and highlighting various factors that affect older Māori and whānau access to ARC. Equity approaches that focus on optimising Māori access to ARC are needed in order to move ARC services towards equity. ARC services provide an important service for older New Zealanders. Our findings challenge and disrupt the universalistic nature that underpin New Zealand health structures. Health decision-makers should consider these findings to address the powerful and damaging effects structural racism has that compromise older Māori and whānau uptake and access to ARC services.

‘We became their beginning, their middle and their end’

AbstractBackgroundCommunicating with people with severe/profound intellectual disabilities is essential for person‐centred, rights‐based support. Despite a proliferation of research around COVID‐19, there is a dearth of evidence exploring its impact on communication with people with severe/profound intellectual disabilities. This study aimed to explore disability support staff experiences of communicating with people with severe/profound intellectual disabilities through the COVID‐19 pandemic.MethodsA qualitative descriptive study was undertaken. A purposive sample of six disability support staff who supported people with severe/profound intellectual disabilities through the pandemic in four Irish residential services participated in online, semistructured interviews. Data were analysed thematically.FindingsSix themes were generated including unwavering commitment; running on empty; being a safe haven; empathic understanding; heightened sensitivity and new insights. Participants discussed the impact of COVID‐19 on communicating with people they support, the contextual challenges, how these were managed/overcome and new learning that emerged. Although communication challenges did present because of COVID‐19 restrictions, communication remained a priority.ConclusionsDespite the challenges experienced by disability support workers, their unwavering commitment to ensuring the well‐being of people with severe/profound intellectual disabilities was identified. This was a small‐scale qualitative study but highlights areas warranting further research and makes recommendations for practice and service planning.

Education and employment status among young adults three years after entering residential substance use treatment. A longitudinal data-linkage study

ABSTRACT Aims This study aims to investigate three-year follow-up among young adults who entered residential substance use disorder (SUD) treatment with regard to outcomes related to education, work and mortality. Methods Participants who entered residential SUD treatment between 2011 and 2016 aged 16–29 years were included in the study. In this study, we used data from the electronic health records of the treatment facility of the participants and linked these with data from nationwide registries. The data included de-identified, person-level information on patient demographics, crime, treatment use and socioeconomic factors. The primary outcome was education and employment status, analyzed using logistic regression. Results At the follow-up, two-fifths of the sample were in education or employment, half were receiving welfare benefits and the annual income level was low. 3.6% of the sample had died. Those who were in education or work were less likely to have post-treatment convictions and to use residential SUD treatment services than those who were not. Conclusion Being in education or employment and not engaging in crime or severe substance use can create a life situation that helps to sustain recovery. There is a need to establish SUD treatment for young adults that includes education- and employment-focused interventions.

The Association of Organizational, Environmental, and Staffing Characteristics of Residential Care Facilities and the Risk Rating of Statutory Notifications: A Cross-Sectional Study in Ireland.

Safety incidents (SIs) are an indicator of quality in health and social care services. Safety incident research has largely focused on acute health care settings. We aimed to examine the association of organizational, environmental, and staffing characteristics of residential care facilities (RCFs) and severity of regulatory SI notifications. This was a retrospective analysis of SI notifications to the regulator for social care in Ireland received in 2018 and 2019. The mean risk rating of SI notifications for each RCF was used as the outcome. Regression analysis was conducted for the association of RCF characteristics (beds, staff to bed ratio, staff full-time equivalent (FTE), nurse to bed ratio, nurse FTE, number of RCF operated by the service provider, non-statutory or statutory provider) and the outcome, separately for nursing homes and residential disability services. A total of 53,268 SI notifications were received. One thousand nine hundred RCFs were operational during the period: 594 (31.3%) for RCF-Nursing home and 1304 (68.7%) for RCF-Disability. For nursing homes, in the most adjusted model, the number of RCF operated by a provider ( β coefficient [95% confidence interval] = 0.508 [0.223-0.793]) was positively associated with mean risk rating of SI. For disability services, the following characteristics were positively associated in the most adjusted model: beds (0.081; 0.060-0.101), staff to bed ratio (0.068; 0.017-0.120), nurse to bed ratio (0.356; 0.044-0.667), staff FTE (0.029; 0.015-0.042), and number of RCF operated by a provider (0.067; 0.050-0.084). Various modifiable organizational, environmental, and staffing characteristics and severity of SI notifications were associated in this study, most of which were related to RCF-Disability. Policymakers and providers of social care services should be cognizant of the relationship of these characteristics and severity of SI, when designing and planning residential care.