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a Department of Health Policy and Administration, The Pennsylvania State University, University Park
b Department of Risk, Insurance and Healthcare Management, Temple University, Philadelphia, Pennsylvania
c Bio Med Gerontology Health, Brown University, Providence, Rhode Island
d Department of Marketing and Management, University of Alabama, Tuscaloosa
Correspondence: Diane Brannon, PhD, Department of Health Policy and Administration, The Pennsylvania State University, 116 Henderson Building, University Park, PA 16802. E-mail: F8Z{at}psu.edu.
Decision Editor: Laurence G. Branch, PhD
Purpose: This article examines factors that distinguish nursing facilities with very high and very low nursing assistant turnover rates from a middle referent group, exploring the possibility that high and low turnover are discrete phenomena with different antecedents. Design and Methods: Data from a stratified sample of facilities in eight states, with directors of nursing as respondents (N = 288), were merged with facility-level indicators from the On-Line Survey Certification of Automated Records and county-level data from the Area Resource File. Multinominal logistic regression was used to identify factors associated with low (less than 6.6% in 6 months) and high (more than 64% in 6 months) turnover rates. Results: With the exception of registered nurse turnover rate, low turnover and high turnover were not associated with the same factors. Implications: Future studies of facility turnover should avoid modeling turnover as a linear function of a single set of predictors in order to provide clearer recommendations for practice.
Key Words: Nursing assistant turnover • Staff turnover
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