This is a two-part blog series about staffing issues in skilled nursing. A subsequent blog post will present recommendations for improving SNF employee retention.
Despite the steep costs of nursing home care, substantial regulatory oversight, and the potential of penalties for unnecessary readmissions, the quality of care in our nation’s nursing homes is not adequate. Few would disagree that staffing pressures and challenges make a big contribution and need to be addressed; it is generally believed that less turnover, higher retention rates, and more staff are related to better resident outcomes.
The Magnitude of the SNF Turnover Problem
Excessive turnover of skilled nursing staff is especially problematic. “Low job satisfaction and high staff turnover prevail throughout the nursing home industry, driving costs up and quality down (Tilden et al, 2012).” Turnover rates for clinical care in nursing homes range from 55-75% with CNAs (Certified Nurse Assistants) having turnover rates which in some cases are nearly 100% (Barbera, 2014).
Factors Associated with Turnover
As mentioned above, one of the factors associated with the high cost of post-acute care is excessive turnover. Barbera (2014) summarized several factors associated with turnover in nursing homes. She indicated that facilities with higher turnover tend to be for-profit homes and offer lower levels of pay and poorer benefits. Other characteristics associated with facilities with higher turnover were staffing and work conditions. They included heavy workload, poor staffing, issues with working conditions, and work schedules not in keeping with the employee’s wishes or needs. Several other turnover-related factors related to employee characteristics. They were feelings of having little control, insufficient role clarity, feeling under-appreciated, being younger (older employees were more satisfied), and length of experience (employees with less experience were more likely leave after a short time).
Three Results of Excessive Turnover in Skilled Nursing
There are three general issues related to turnover according to a recent study by Tilden et al. (2012). These include direct costs, indirect costs, and quality of care.
A subsequent blog post will present recommendations for improving SNF employee retention.
Contact HealthStream to speak to a solutions expert learn more about our courses related to staff turnover in healthcare.
Barbera, E. F. (2014). The keys to reducing turnover in long-term care. McKnight’s. Retrieved from http://www.mcknights.com/the-world-according-to-dr-el/the-keys-to-reducing-turnover-in-long-term-care/article/333071/
Tilden, V. P., Thompson, S. A., Gajewski, B. J., & Bott, M. J. (2012). End-of-life care in nursing homes: The high cost of staff turnover. Nursing Economics, 30, 163-166.
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