Research Article
Nursing HomesHigh Nursing Staff Turnover In Nursing Homes Offers Important Quality Information
- Ashvin Gandhi ([email protected]) is an assistant professor at the University of California Los Angeles Anderson School of Management, in Los Angeles, California.
- Huizi Yu is an undergraduate student at the University of California Los Angeles.
- David C. Grabowski is a professor of health care policy at Harvard Medical School, in Boston, Massachusetts.
Abstract
Nursing staff turnover has long been considered an important indicator of nursing home quality. However, turnover has never been reported on the Nursing Home Compare website, likely because of the lack of adequate data. On July 1, 2016, the Centers for Medicare and Medicaid Services began collecting auditable payroll-based daily staffing data for US nursing homes. We used 492 million nurse shifts from these data to calculate a novel turnover metric representing the percentage of hours of nursing staff care that turned over annually at each of 15,645 facilities. Mean and median annual turnover rates for total nursing staff were roughly 128 percent and 94 percent, respectively. Turnover rates were correlated with facility location, for-profit status, chain ownership, Medicaid patient census, and star ratings. Disseminating facilities’ nursing staff turnover rates on Nursing Home Compare could provide important quality information for policy makers, payers, and consumers, and it may incentivize efforts to reduce turnover.
