Retention and Turnover

McKnight’s had an interesting article on the importance of staff retention. Less complaints and better quality of care when staff turnover is low. Administrator and DON turnover was significantly associated with an increase in both total complaints and substantiated complaints. Staff retention matters at the top of the managerial chain just as much as it does on the frontlines. Higher CNA retention rates and family satisfaction scores were significantly associated with fewer total complaints and substantiated complaints.

“Leadership instability has been found to be significantly associated with high turnover of direct care workers, which influences the overall quality of care. Similarly, NHA stability is associated with a higher CNA retention rate as well as a fewer number of deficiencies. Although the current concerns around nursing home quality will require an array of solutions, the influence of management stability is certainly critical in decreasing the number of complaints.”

The Centers for Medicare & Medicaid Services also began tracking and publicly reporting administrator turnover early in 2022. At the time, the agency said reduced administrator turnover can provide “leadership stability” and direction and may help staff “provide care more consistently or effectively to residents.”

Nursing homes with higher administrator and DON turnover were more likely to be in a group of facilities with 6 or more substantiated complaints, as were those with lower CNA retention and lower family and resident satisfaction scores. That means that not only were complaints made, but that upon investigations, state surveyors documented actual deficiencies in care.