Measuring Caregiver Retention in Nursing Homes

Gerontologist. 2021 Jun 2;61(4):e118-e128. doi: 10.1093/geront/gnab012.


Background and objectives: Retention of nursing home caregivers is examined. This represents the concept of continuously employing the same caregivers in the same facility for a defined period of time. In this research, several measures of caregiver retention are examined and the utility of these measures for practitioners and policy makers is discussed.

Research design and methods: A survey of nursing home administrators conducted in 2016 was used to collect staffing data from 2,898 facilities. This was matched with Nursing Home Compare and the Certification and Survey Provider Enhanced Reporting data. The association of four measures of retention for each of three types of caregivers with six quality indicators was examined.

Results: The descriptive statistics show rates of retention at 5 years for nurse aides (NAs), registered nurses (RNs), and licensed practical nurses to be low. The regression estimates show some support for the relationship that high caregiver retention is associated with better overall quality. The relationship was strongest for NAs and RNs. Support was also found for the notion that different measures of retention were more/less associated with quality. The 3- and 5-year retention measures had the strongest associations with the quality indicators.

Discussion and implications: The findings presented provide some evidence that caregiver retention may be an important metric that can be used as a means of improving quality of care in nursing homes. However, the findings also show practitioners and policy makers should be more nuanced in the use of caregiver retention metrics.

Keywords: Nursing homes; Quality; Retention; Stability; Staffing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Caregivers*
  • Humans
  • Nursing Assistants*
  • Nursing Homes
  • Personnel Staffing and Scheduling
  • Quality of Health Care
  • United States
  • Workforce