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Correspondence: Address correspondence to Nicholas G. Castle, Graduate School of Public Health, University of Pittsburgh, A610 Crabtree Hall, 130 DeSoto Street, Pittsburgh, PA 15261. E-mail: CASTLEN{at}Pitt.edu
Purpose: We used data from a large sample of nursing homes to examine the association between staff turnover and quality. Design and Methods: The staff turnover measures came from primary data collected from 2,840 nursing homes in 2004 (representing a 71% response rate). Data collection included measures for nurse aides, licensed practical nurses, and registered nurses. We examined 14 indicators of care quality that came from the Nursing Home Compare Web site. Results: We found that reducing turnover from high to medium levels was associated with increased quality, but the evidence was mixed regarding the quality improvements from further lowering turnover to low levels. Implications: Our investigation shows that the relationship between turnover and quality might not be linear. Nevertheless, in general, high turnover is associated with poor quality.
Key Words: Nursing homes • Quality • Turnover • Staffing • Report cards
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