+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The costs of turnover in nursing homes

The costs of turnover in nursing homes

Medical Care 47(10): 1039-1045

Turnover rates in nursing homes have been persistently high for decades, ranging upwards of 100%. To estimate the net costs associated with turnover of direct care staff in nursing homes. DATA AND SAMPLE: Nine hundred two nursing homes in California in 2005. Data included Medicaid cost reports, the Minimum Data Set, Medicare enrollment files, Census, and Area Resource File. We estimated total cost functions, which included in addition to exogenous outputs and wages, the facility turnover rate. Instrumental variable limited information maximum likelihood techniques were used for estimation to deal with the endogeneity of turnover and costs. The cost functions exhibited the expected behavior, with initially increasing and then decreasing returns to scale. The ordinary least square estimate did not show a significant association between costs and turnover. The instrumental variable estimate of turnover costs was negative and significant (P = 0.039). The marginal cost savings associated with a 10% point increase in turnover for an average facility was $167,063 or 2.9% of annual total costs. The net savings associated with turnover offer an explanation for the persistence of this phenomenon over the last decades, despite the many policy initiatives to reduce it. Future policy efforts need to recognize the complex relationship between turnover and costs.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 056276484

Download citation: RISBibTeXText

PMID: 19648834

DOI: 10.1097/mlr.0b013e3181a3cc62

Related references

The Costs of Turnover in Nursing Homes. Medical Care 47(10): 1039-1045, 2009

Reflecting on Turnover Costs in Nursing Homes. Medical Care 47(10): 1037-1038, 2009

Reflecting on turnover costs in nursing homes. Medical Care 47(10): 1037-1038, 2009

Stayers, leavers, and switchers among certified nursing assistants in nursing homes: a longitudinal investigation of turnover intent, staff retention, and turnover. Gerontologist 51(5): 597-609, 2012

Patient turnover in homes for the aged and nursing homes. Sykepleien. Fag 80(6): 33-35, 1992

Overworked RNs, social workers cause high nursing assistant turnover in nursing homes. Data Strategies & Benchmarks 3(4): 55-56, 1999

Modelling the nursing homes system: bed growth, patient turnover and the availability of nursing home places. Australian Health Review 10(4): 282-289, 1986

Nursing personnel turnover rates turned over: potential positive effects on resident outcomes in nursing homes. Gerontologist 26(1): 70-76, 1986

The costs of nurse turnover, part 2: application of the Nursing Turnover Cost Calculation Methodology. Journal of Nursing Administration 35(1): 41-49, 2005

Nursing assistant turnover in nursing homes and need satisfaction. Journal of Gerontological Nursing 15(6): 24-30, 1989

The determinants of nursing home costs in Nebraska's proprietary nursing homes. Socio-Economic Planning Sciences 18(3): 171-177, 1983

An analysis of vacancy rates, turnover, and wages among nursing occupations in New York state hospitals, nursing homes, and diagnostic and treatment facilities. Journal of the New York State Nurses' Association 25(3): 20-27, 1994

Analyses of space available in homes and day centers for the aged, as well as nursing homes for elderly people, in the FRG. Booking and occupation rate in homes and nursing homes for the aged. Aktuelle Gerontologie 8(6): 341-345, 1978

The impact of turnover in nursing homes. American Journal of Nursing 114(9): 69-70, 2014

Employee turnover in nursing homes. American Journal of Nursing 73(2): 288-290, 1973