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The purpose of this study was to identify patterns of nurse staffing and skill mix and estimate the impact of these patterns on rehospitalization and emergency department (ED) visits in nursing home (NH) residents. We also estimated the relative contribution of unique staffing patterns on variations in hospital and ED use rates. Retrospective secondary data analysis at the facility level, using administrative data. Data from Medicare/Medicaid certified NHs in the 2018 Certification and Survey Provider Enhanced Reporting System