Decline in turnover linked to better quality of care in nursing homes

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Nursing home providers should consider implementing innovative strategies to retain workers after a new study found that low staff turnover was consistently associated with better quality of care, the researchers said.

“While these actions are difficult – especially as nursing homes navigate the COVID-19 pandemic, they are clearly warranted if we seek improved quality of care for nursing home residents” , Qing Zheng, Ph.D., lead author and health economist at research firm Abt Associates, said McKnight Long Term Care News Monday.

The results were published Saturday in the Journal of the American Geriatrics Society. The study authors also include Evan Schulman, director of the Division of Nursing Homes for the Centers for Medicare & Medicaid Services; Christianna S. Williams Ph.D. and Alan J. White, Ph.D., both of whom work for Abt Associates, a federal contractor. The study was funded by CMS under a research contract.

Investigators used payroll-based log data for more than 13,600 nursing homes from October 2018 to September 2019 to compare staff turnover measures to nursing home quality measures and star ratings .

Overall, they found that average annual staff turnover rates were about 44% for registered nurses and 46% for all nurses. Annual turnover rates for both groups were lower among care homes with higher star ratings.

The researchers said the pattern was consistent across star rating levels. They found that the average annual turnover rate for total nurses was 53.4% ​​in 1-star nursing homes, while it was 40.7% for 5-star facilities.

They also found that nursing staff turnover rates were lower in nonprofit, smaller, hospital and rural nursing homes. The data also showed a consistent relationship between higher turnover and a lower likelihood of having higher grades across all domains.

“Compared to facilities with low total nursing turnover, nursing homes with high total nursing turnover were 16 percentage points more likely to have a one-star rating, 10.5 percentage points more likely to have two stars, but 20.3 percentage points less likely to have five stars, after adjusting for other factors that may affect their star rating,” the researchers wrote.

They said their findings confirm an association between staffing levels and quality, and shed new light on the importance of staff consistency.

“Publicly reporting on these nursing home turnover measures motivates nursing homes to focus on staff retention and reducing turnover,” Zheng said. McKnight’s.

“Suppliers need to monitor and analyze this data and their revenue metrics over time. As our study shows, higher turnover measures are consistently associated with lower quality of care,” Zheng added. “Given these findings, providers should consider implementing innovative strategies to retain staff and reduce turnover, which will ultimately lead to improved quality of care for nursing home residents.”


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