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. 2013 Apr;53(2):211-21.
doi: 10.1093/geront/gns082. Epub 2012 Aug 30.

The relationships among licensed nurse turnover, retention, and rehospitalization of nursing home residents

Kali S Thomas  1 , Vincent Mor, Denise A Tyler, Kathryn Hyer
Affiliations

The relationships among licensed nurse turnover, retention, and rehospitalization of nursing home residents

Kali S Thomas et al. Gerontologist. 2013 Apr.

Abstract

Purpose: Individuals receiving postacute care in skilled nursing facilities often require complex, skilled care provided by licensed nurses. It is believed that a stable set of nursing personnel is more likely to deliver better care. The purpose of this study was to determine the relationships among licensed nurse retention, turnover, and a 30-day rehospitalization rate in nursing homes (NHs).

Design and methods: We combined two data sources: NH facility-level data (including characteristics of the facility, the market, and residents) and the Florida Nursing Home Staffing Reports (which provide staffing information for each NH) for 681 Florida NHs from 2002 to 2009. Using a two-way fixed effects model, we examined the relationships among licensed nurse turnover rates, retention rates, and 30-day rehospitalization rates.

Results: Results indicate that an NH's licensed nurse retention rate is significantly associated with the 30-day rehospitalization rate (est. = -.02, p = .04) controlling for demographic characteristics of the patient population, residents' preferences for hospitalization, and the ownership characteristics of the NH. The NHs experiencing a 10% increase in their licensed nurse retention had a 0.2% lower rehospitalization rate, which equates to 2 fewer hospitalizations per NH annually. Licensed nurse turnover is not significantly related to the 30-day rehospitalization rate.

Implications: These findings highlight the need for NH administrators and policy makers to focus on licensed nurse retention, and future research should focus on the measures of staff retention for understanding the staffing/quality relationship.

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Figures

Figure 1.
Figure 1.
Florida nursing homes licensed nurse retention, licensed nurse turnover, and 30-day rehospitalization rate (2002–2009).
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References

    1. Alexander J. A., Bloom J. R., Nuchols B. A. (1994). Nursing turnover and hospital efficiency: An organizational level analysis. Industrial Relations. 33, 505–520
    1. Bostick J. E., Rantz M. J., Flesner M. K., Riggs C. J. (2006). Systematic review of studies of staffing and quality in nursing homes. Journal of the American Medical Directors Association. 7, 366 37610.1016/j.jamda.2006.01.024 - PubMed
    1. Brannon D., Zinn J. S., Mor V., Davis J. (2002). An exploration of job, organizational, and environmental factors associated with high and low nursing assistant turnover. The Gerontologist. 42, 159–16810.1093/geront/42.2.159 - PubMed
    1. Cai S., Mukamel D. B., Veazie P., Katz P., Temkin-Greener H. (2011). Hospitalizations in nursing homes: Does payer source matter? Evidence from New York State. Medical Care Research and Review. 68, 559–57810.1177/1077558711399581 - PMC - PubMed
    1. Carter M. W., Porell F. W. (2003). Variations in hospitalization rates among nursing home residents: The role of facility and market attributes. The Gerontologist. 43, 175–19110.1093/geront/43.2.175 - PubMed

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