Turnover Matters


A new study shows the ongoing high turnover and unsafe staffing in nursing homes cause quality of care issues. The lack of efficient and effective communication among health care providers cause failures in recognizing significant changes of condition and the need for additional care. Investigators found that physicians had difficulty talking with staff about residents’ care needs because staff couldn’t recognize or explain what the exact problem was. But that is their job purpose.

The Journal of the American Medical Directors Association published the findings in the May issue. Researchers found that physicians struggle to know their care team. Researchers said the findings stressed the importance of consistent and ongoing communication and collaboration between the two groups.


Unsafe staffing levels are the main cause. The lack of time causes nursing staff to forget or get diverted from following up physician’s orders. This leads to frustration, burn-out, and even less collaboration.

“Temporary workers to fill in vacancies would complicate communication because they would not know the residents, the care team and the physician. Temporary workers would not usually communicate with the physician. Also, they did not write reports when they were not familiar with the electronic record or were not authorized to access it.”
Approximately 1.5 million health care workers lost their jobs during the early days of the pandemic. Most of those jobs returned but staffing was unsafe and insufficient before the pandemic.

Average nursing home staff turnover is 128% annually, with some facilities seeing turnover reach 200% to 300% per year; Registered nurses (RNs) had the highest turnover rate at 140.7%. Certified nursing assistants (CNAs) at 129.1%. Licensed practical nurses at 114.1% (LPNs).