Search
May 19, 2022

Association Between Staff Turnover and Nursing Home Quality – Evidence From Payroll-based Journal Data

Authors

Qing Zheng, Ph.D., Christianna S. Williams, Ph.D., and Alan J. White, Ph.D., Abt Global; and Evan T. Shulman, MS, Centers for Medicare & Medicaid Services

Staff turnover is considered an important indicator of nursing home quality. Abt Global used auditable staffing data from the Centers for Medicare & Medicaid Services (CMS) Payroll-Based Journal (PBJ) system to examine:

  • Turnover among nurse staff and administrators at 13,631 nursing homes.
  • The relationship between turnover and nursing home quality.

We calculated staff turnover measures and linked them to nursing home quality measures and star ratings published on CMS' Nursing Home Care Compare website. Mean annual turnover rates were about 44 percent for registered nurses and 46 percent for total nurse staff. On average, there was one administrator leaving each nursing home during the 12-month period, although about half of nursing homes had no administrator turnover. For-profit and larger nursing homes had higher turnover rates, and higher turnover was consistently associated with lower quality of care.


Read More

Health Policy & Systems in North America

National Association of Medicaid Directors (NAMD) Fall Conference 2026

Abt Global is a Sapphire sponsor of the NAMD 2026 Fall Conference. Find our Medicaid policy and data team at Booth 122.

Learn More
Event

Stronghold Federal MPJV Awarded GSA MAS

Stronghold Federal’s GSA MAS award gives agencies streamlined access to IT modernization, data, and systems integration services.

Learn More
News

Beyond the Red Flag: A Smarter Approach to Medicaid Program Integrity

How explainable, human-guided AI can help Medicaid programs focus on meaningful fraud signals, reduce noise, and act earlier.

Learn More
Blog

Advancing Whole-Person Health: Implementing and Monitoring the MAHA ELEVATE Model

Abt supports CMS in implementing and monitoring the MAHA ELEVATE Model to build evidence on functional and lifestyle medicine approaches to manage and improve chronic disease for Original Medicare beneficiaries.

Learn More
Project