Staff Turnover Connected to Nursing Home Quality

Findings show the significance of staff turnover as it directly impacts nursing home (NH) quality for residents.

Researchers calculated turnover measures for nursing staff as well as administrators by utilizing auditable staffing data from the Centers for Medicare & Medicaid Services (CMS) Payroll Based Journal (PBJ) system.

Data was extracted from 13,631 NHs that submitted complete staffing data through PBJ for 2018 (Q3) through 2019 (Q4). Turnover rate was identified by gaps in days worked by eligible employees.

Researchers also utilized CMS’ Care Compare Website in January 2020 to correlate staff turnover measures to nursing home quality measures and star ratings.

Study results showed mean annual turnover rates were approximately 44% for registered nurses and 46% for total nurse staff.

Despite half of NHs experiencing zero administrator turnover, on average 1 administrator left each NH during this period.

According to researchers, rates of turnover varied greatly across NHs resulting in higher turnover rates in for-profit and larger nursing homes and ultimately higher turnover was consistently linked with lower quality of care.

“In January 2022, CMS started posting turnover measures on Care Compare to allow consumers to use this information in their assessment of nursing home quality and to motivate nursing homes to implement innovative strategies to retain staff,” said study authors. “While these actions are challenging, they are nonetheless warranted for improving the quality of care for nursing home residents.”

Reference:
Zheng Q, Williams CS, Shulman ET, White AJ. Association between staff turnover and nursing home quality—evidence from payroll-based journal data. J Am Geriatr Soc. Published online May 7, 2022. doi:10.1111/jgs.17843