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Is Nurse Aide Retention Associated with Nursing Home Quality?

Kennedy, Katherine A
http://orcid.org/0000-0002-4853-9318
http://rave.ohiolink.edu/etdc/view?acc_num=miami1618591173416498

Abstract Details

2021, Doctor of Philosophy, Miami University, Population and Social Gerontology.
Nursing home aides provide the bulk of direct care in the nations' nursing homes. Despite their importance nursing homes often experience low retention rates of these critical workers. Although it would make sense that job stability would be important, relatively few studies have assessed the association between quality and retention. Seven studies of retention consistently showed quality improvements associated with higher nurse aide retention. The current study advances knowledge by modeling the retention-quality relationship, using many measures that have not been examined in previous studies. With a sample of Ohio nursing homes (n=690) from the 2017 Biennial Survey of Long-Term Care Facilities, nurse aide retention rates were grouped into four categories based on quartiles (Low: 0-48%, Medium: 49-60%, High: 61-72%, Very high: 73% and above). Dependent variables on quality were derived from the 2017 Ohio Nursing Home Resident Satisfaction Survey, 2017 Automated Survey Processing Environment, and 2017 Care Compare Archives. Structural characteristics, financial resources, staffing and management, aggregate resident characteristics, retention practices, and county characteristics were used in the analysis. High retention facilities had better resident care experience scores than low retention facilities. Compared to low retention facilities, high retention received 30% fewer total allegations, substantiated and unsubstantiated allegations, as well as fewer total complaints. Similarly, at the annual recertification survey, facilities with high nurse aide retention outperformed low retention by 25% or more: they received 1.69 fewer deficiencies and 11.44 fewer points on the deficiency score. High retention facilities also received significantly fewer deficiencies compared to the very high retention facilities. The odds of having 3-, 4-, or 5-star overall ratings and survey star ratings for high retention facilities were 2.22 and 2.42 times the odds of low retention facilities respectively. The quality star rating and the long-stay MDS measures were not associated with retention. A somewhat unexpected finding was that very high retention was not the best performing category. To improve quality, targeted policies and research are needed to improve working conditions, provide targeted supports to low retention facilities, and understand what retention practices are meaningful and effective.
Bob Applebaum (Committee Chair)
John Bowblis (Committee Co-Chair)
Jane Straker (Committee Member)
Katy Abbott (Committee Member)
Amy Roberts (Committee Member)
129 p.
Gerontology
Nursing homes; skilled nursing facility; quality of care; quality of life; resident satisfaction; citations; deficiency; deficiency score; complaints; patient-reported outcomes; long-term care; staffing; retention; staff stability; turnover; CNA; STNA

Recommended Citations

Citations

  • Kennedy, K. A. (2021). Is Nurse Aide Retention Associated with Nursing Home Quality? [Doctoral dissertation, Miami University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=miami1618591173416498

    APA Style (7th edition)

  • Kennedy, Katherine. Is Nurse Aide Retention Associated with Nursing Home Quality? 2021. Miami University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=miami1618591173416498.

    MLA Style (8th edition)

  • Kennedy, Katherine. "Is Nurse Aide Retention Associated with Nursing Home Quality?" Doctoral dissertation, Miami University, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=miami1618591173416498

    Chicago Manual of Style (17th edition)

miami1618591173416498
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© 2021, all rights reserved.
This open access ETD is published by Miami University and OhioLINK.