Authors
Williams JAR; Collins JE; Gandhi A; Yu H; Boden LI; Katz JN; Wagner GR; Sorensen G
Source
J Am Med Dir Assoc 2024 Mar; 25(3):403-407.e1
Abstract
Objectives: To assess whether a measure of leadership support for worker safety, health, and well-being predicts staff turnover in nursing homes after controlling for other factors. Design: This paper uses administrative payroll data to measure facility-level turnover and uses a survey measure of nursing home leadership commitment to workers. In addition, we use data from Medicare to measure various nursing home characteristics. Setting and Participants: Nursing homes with at least 30 beds serving adults in California, Ohio, and Massachusetts were invited to participate in the survey. The analysis sample included 495 nursing homes. Methods: We used a multivariable ordinary least squares model with turnover rate as the dependent variable. We used an indicator for nursing homes who scored above the median on the measure of leadership that supports worker safety, health, and well-being. Control variables include bed count (deciles), ownership (corporate/noncorporate × for-profit/not-for-profit), percent of residents on Medicaid, state, being in a nonmetropolitan county, and total nurse staffing per patient day in the 2 quarters before the survey. Results: The unadjusted turnover rate was lower for those nursing homes that scored higher on leadership commitment to worker safety, health, and well-being. After controlling for additional variables, greater leadership commitment was still associated with lower turnover but with some attenuation. Conclusions and Implications: We find that nursing homes with leadership that communicated and demonstrated commitment to worker safety, health, and well-being had relatively fewer nurses leave during the study period, with turnover rates approximately 10% lower than homes without. These findings suggest that leadership may be a valuable tool for reducing staff turnover.
Keywords
Health care workers; Total Worker Health; TWH; Worker safety; Nurses; Employee satisfaction; Occupational health; Cross sectional studies;
Author Keywords: Occupational health; nursing homes; turnover
Contact
Jessica A.R. Williams, PhD, Department of Health Policy and Management, Pennsylvania State University, 601D Ford Building, University Park, PA 16802
Document Type
Journal Article
Email Address
jarw@psu.edu
Funding Type
Cooperative Agreement
Identifying No.
Cooperative-Agreement-Number-U19-OH-008861
Source Name
Journal of the American Medical Directors Association
Performing Organization
Harvard University, Boston, Massachusetts
