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Evaluation of the Minnesota Safe Patient Handling Act: trends in workers’ compensation indemnity claims in nursing home workers before and after enactment of the law
  1. Christina E Rosebush1,
  2. Brian Zaidman2,
  3. Katherine E Schofield3,
  4. Darin J Erickson4,
  5. Breca Tschida5,
  6. Marizen Ramirez1,
  7. Patricia M McGovern1
  1. 1 Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
  2. 2 Research and Statistics, Minnesota Department of Labor and Industry, Saint Paul, Minnesota, USA
  3. 3 Department of Mechanical and Industrial Engineering, University of Minnesota Duluth, Duluth, Minnesota, USA
  4. 4 Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
  5. 5 Workplace Safety Consultation, Minnesota Department of Labor and Industry, Saint Paul, Minnesota, USA
  1. Correspondence to Christina E Rosebush, Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; rose0611{at}


Objectives The 2007 Minnesota Safe Patient Handling Act aims to protect healthcare workers from injuries caused by lifting and transferring patients. The effectiveness of the law in nursing homes is unknown. This policy evaluation measured changes in patient handling injuries before and after the law was enacted. Additionally, it assessed whether effects of the law were modified by facility levels of staffing and retention.

Methods Workers’ compensation indemnity claims for years 2005–2016 were matched to annual direct care productive hours and facility characteristics (eg, profit status, hospital affiliation and region) for all Medicaid-certified nursing homes in Minnesota. Trends in patient handling claims were analysed using negative binomial regression with generalised estimating equations. The primary predictors were time period, staff hours per resident day and staff retention.

Results The patient handling indemnity claim rate declined by 25% in years 4–6 and 38% in years 7–9 following enactment of the law. Claims for all other injuries and illnesses declined by 20% in years 7–9 only. Associations between time period and patient handling claims did not vary by levels of staffing or retention. However, independent of time, facilities with annual retention ≥75% (vs <65%) had a 17% lower patient handling claim rate.

Conclusions Results suggest the law reduced patient handling claims in nursing homes. However, claim rates were elevated in facilities with low worker retention and those that were non-profit, not hospital-affiliated or in a non-metro area. Facilities with these characteristics may benefit from targeted state grants and consultation efforts.

  • health and safety
  • musculoskeletal
  • healthcare workers

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  • Contributors CR, BZ and BT designed the study. CR and BZ drafted and revised the paper. DE supported the statistical analysis and revised the paper. KS, MR and PMMcG interpreted the results and revised the paper.

  • Funding This research was supported by a Pilot Projects Research Grant, Midwest Center for Occupational Health and Safety, Education and Research Center (T42OH008434) funded through National Institute for Occupational Safety and Health, Centers for Disease Control, Department of Health and Human Services.

  • Disclaimer The contents of this effort are solely the responsibility of the authors and do not necessarily represent the official view of National Institute for Occupational Safety and Health, the University of Minnesota, the Minnesota Department of Labor and Industry or other associated entities.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was determined to be exempted from review by University of Minnesota Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The Minnesota Department of Human Services maintains the Minnesota Nursing Home Report Card Data. These data can be obtained upon request. The Brown University Center for Gerontology and Healthcare Research holds the LTCfocus data. These data can be downloaded online ( The Minnesota Department of Labor and Industry holds the Minnesota workers’ compensation data. These data are unavailable as they are considered private data on individuals as defined in Minnesota Statutes, section 13.02, subdivision 12 and section 176.231, subdivision 8.