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Turnover of Nurses High at Nursing Homes Across the United States

THURSDAY, March 11, 2021 -- Turnover of nurses at nursing homes is high throughout the United States and varies considerably across facilities and states, according to a report published in the March issue of Health Affairs.

Ashvin Gandhi, Ph.D., from the University of California Los Angeles, and colleagues calculated the percentage of hours of nursing staff care that turned over annually at each of 15,654 facilities. The authors used data from 492 million nurse shifts collected by the Centers for Medicare & Medicaid Services on payroll-based daily staffing for U.S. nursing homes.

The researchers found that for total nursing staff, the mean and median annual turnover rates were about 128 and 94 percent, respectively. The highest mean turnover rate was 140.7 percent for registered nurses, followed by 114.1 percent for licensed practical nurses and 129.1 percent for certified nursing assistants. Turnover rates varied considerably by facility, with some facilities having turnover rates in excess of 300 percent. Turnover also varied considerably by state, with the highest median turnover rates in total nursing staff seen in Oklahoma, Montana, and Kansas (165.1, 148.9, and 144.8 percent, respectively) and the lowest seen in Hawaii, Connecticut, and New Jersey (39.3, 53.1, and 58.6 percent, respectively). There were correlations observed for turnover rates with facility location, for-profit status, chain ownership, Medicaid patient census, and star ratings.

"Moving forward, publicly available nursing staff turnover data may help incentivize changes to reduce turnover while providing valuable new information for consumers, policy makers, payers, and other stakeholders," the authors write.

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