Staff Turnover and Quality of Care in Nursing Homes

Castle, Nicholas G.; Engberg, John

doi:10.1097/01.mlr.0000163661.67170.b9

Cited by 346 publications

(288 citation statements)

References 35 publications

(64 reference statements)

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“…Family members often threaten legal action to get adequate care for their family members (Johnson, Dobalian, Burkhard, Hedgecock, & Harman, 2004). Staff are dissatisfied, and turnover is very high (Castle, 2005(Castle, , 2006. Long-term care institutions are plagued with challenges that may negatively affect residents' QoL, such as high staff turnover, rigid schedules, and routines that minimize personal choice.…”

Section: Introductionmentioning

confidence: 99%

Plotting the Course of Well-Being

Wilby

Stryker²,

Hyde³

et al. 2016

Sage Open

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Persons above age 80 comprise the fastest growing segment of the U.S. population, and it is estimated that one in four will need long-term care due to increased disabilities and illness. A major concern for residents, families, and providers is to ensure care that "allows the resident to maintain or attain their highest practicable physical, mental and psychosocial wellbeing." The challenge is measuring a subjective concept such as well-being. The Eden Alternative is a current initiative aimed at improving the quality of life and well-being of long-term care residents. The initiative consists of providing long-term care environments that emphasize person-directed decision making and well-being. The purpose of this study was to explore the psychometric properties of the Eden Alternative Well-Being Assessment Tool (EAWBAT). There are three assessment tools designed to measure the well-being of elders (residents), family members of residents, and employees working in the longterm care environments. The sample consisted of 237 residents, 430 employees, and 134 family members from seven Eden Alternative organizations throughout the United States. Factor analysis was completed to identify the underlying structure in these data for elders, employees, and families. Reliability statistics were computed for each scale. Reliability statistics ranged from .876 (employee assessment tool) to .949 (family assessment tool), indicating the potential of the EAWBAT to measure the well-being of residents residing in long-term care environments, employees supporting them, and their family members.

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Section: Introductionmentioning

confidence: 99%

Plotting the Course of Well-Being

Wilby

Stryker²,

Hyde³

et al. 2016

Sage Open

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“…Several studies have asserted that nurse turnover in nursing homes are associated with lowquality care (Bostick et al 2006;Castle and Engberg 2005;Collier and Harrington 2008), although most studies find no statistically significant relationship and fail to account for the fact that nursing turnover is endogenous. In this paper, we use IV estimation to address the endogeneity of nurse turnover on mortality and quality of care.…”

Section: Resultsmentioning

confidence: 99%

“…While a few studies have found that higher nurse turnover can lead to worse quality, the vast majority of studies do not find a statistically significant relationship (Castle and Anderson 2011;Castle and Engberg 2005;Castle et al 2007;Lerner et al 2011;Thomas et al 2013). The lack of using causal identification by the current literature may explain why most studies find statistically insignificant effects.…”

Section: Conceptual Model Of Turnover and Nursing Home Qualitymentioning

confidence: 99%

The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession

Antwi¹,

Bowblis²

2016

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in ABSTRACTWe estimate the causal effect of nurse turnover on mortality and the quality of nursing home care with a fixed effect instrumental variable estimation that uses the unemployment rate as an instrument for nursing turnover. We find that ignoring endogeneity leads to a systematic underestimation of the effect of nursing turnover on mortality and quality of care in a sample of California nursing homes. Specifically, 10 percentage point increase in nurse turnover results in a facility receiving 2.2 additional deficiencies per annual regulatory survey, reflecting a 19.3 percent increase. Not accounting for endogeneity of turnover leads to results that suggest only a 1 percent increase in deficiencies. We also find suggestive evidence that turnover results in lower quality in other dimensions and may increase mortality. An implication of our mortality results is that turnover may be a mechanism for the procyclicality of mortality rates. JEL Classification Codes: I11, J21, E24

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“…There is some evidence supporting the potential importance of compensation for recruiting and retaining a stable workforce. With the low wages and benefits, nursing homes find it difficult to compete with fast-food restaurants and other low-wage service sectors and the turnover rates are high [63,126], which are associated with poor quality of care [123,[127][128][129]. Since AB1629 changed payment incentives to encourage and reward nursing homes to invest more in direct care labor, we expect to see nursing homes increasing staffing levels and/or wages.…”

Section: Nursing Home's Investment In Labormentioning

confidence: 99%

Medicaid Reimbursement and the Quality of Nursing Home Care: A Case Study of Medi-Cal Long-Term Care Reimbursement Act of 2004 in California

Xing¹,

Mukamel²,

Glance³

et al. 2016

WHM

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2013ii Biographical SketchThe author was born in Shanghai, China. She attended Shanghai Second Medical This dissertation provides evidence that linking Medicaid reimbursement rate to each NH's own expenditures and incentivizing NHs to invest in direct care were effective ways in achieving quality improvement. Refinements of current Medi-Cal reimbursement policy might be needed to encourage NHs to make larger investments. However, maximizing NHs' spending on direct care cannot be relied on as the only policy strategy to improve quality of care. vii Contributors and Funding SourcesThis work was supervised by a dissertation committee consisting of Professors

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Staff Turnover and Quality of Care in Nursing Homes

Abstract: These findings are significant because the belief that staff turnover influences quality is pervasive. The cross-sectional results are only able to show associations, nonetheless, few empirical studies in the literature have shown this relationship.

Cited by 346 publications

References 35 publications

Plotting the Course of Well-Being

Plotting the Course of Well-Being

The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession

Medicaid Reimbursement and the Quality of Nursing Home Care: A Case Study of Medi-Cal Long-Term Care Reimbursement Act of 2004 in California

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