4.5 Article

High Nursing Staff Turnover In Nursing Homes Offers Important Quality Information

Journal

HEALTH AFFAIRS
Volume 40, Issue 3, Pages 384-391

Publisher

PROJECT HOPE
DOI: 10.1377/hlthaff.2020.00957

Keywords

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Funding

  1. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health [P2CHD041022]
  2. National Institute on Aging, National Institutes of Health [P01AG032952]

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Nursing staff turnover is an important quality indicator for nursing homes. Recent data collection has allowed for the calculation of turnover rates, which were found to be correlated with facility location, ownership status, patient census, and star ratings. Disseminating this information could provide valuable insights for policymakers, payers, and consumers.
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.

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