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How Can High Turnover Rate Indicate Poor Care in a Nursing Home?

Published on Jul 8, 2022 by Thomas Law Offices.

nursing home employees

The 10% rule is often cited as an indicator of good company health. When employee retention rates reach 90% or higher, a company can generally be considered a good place to work. The healthcare industry typically averages slightly higher turnover rates than other sectors. This has been particularly true since the onset of the COVID-19 pandemic. In 2021, national staffing and retention reports showed that U.S. hospitals averaged an employee turnover rate of just under 20%.  

A study published last year gave a dismal picture of nursing home staff retention rates. Turnover rates were even higher than we previously believed. Data showed that the mean staff turnover rate across 15,645 examined nursing homes was 128%, with some facilities experiencing turnover rates of more than 300%. Without question, residents suffered the fatal consequences of these shocking statistics.

Nursing home abuse and neglect is a critical issue in Louisville, the state of Kentucky, and the nation as a whole. If you or a loved one was victimized by abuse, neglect, or exploitation in a long-term care facility, reach out to Thomas Law Offices for experienced and compassionate legal guidance from a Louisville nursing home abuse attorney.     

Nursing Home Turnover Rate Statistics

The above-cited study began in July 2016 and was published in March 2021 in Health Affairs, a health policy journal. Daily staffing data was collected and examined by researchers from Harvard Medical School and other health policy research institutions. The study investigated 15,645 facilities across the country and a total of 492 million staff shifts. 

The following are a few key takeaways from the research report:

  • Annual turnover rates for total nursing staff were approximately 128% (mean) and 94% (median).
  • Low wages, long hours, and strenuous job duties were cited as factors contributing to staffing issues.
  • Already-existent staffing issues were compounded by the COVID-19 pandemic.
  • High turnover rates made it more difficult to curb the spread of infection, and thousands of nursing home residents were killed by the virus as a result.
  • Registered nurses had the lowest retention rates. RNs are also among the highest-paid and most skilled nursing home employees.
  • There was a correlation between the rank of nursing homes on the Medicare nursing home compare list and staff retention rates. Higher-ranked nursing homes experienced lower turnover rates and vice versa. 
  • Chain and for-profit institutions had the highest turnover rates. 

The Increased Costs of High Turnover Rates 

How can a high turnover rate indicate poor care in a nursing home? There are almost innumerable ways in which high turnover rates negatively affect the ability of a long-term care facility to properly do what it is supposed to do—provide high-quality care to residents. Here are some of the most noticeable effects:

Health Costs to Residents

When nursing homes are understaffed or constantly re-staffed with new workers, residents’ physical health and emotional wellbeing worsen. The health cost to residents in a nursing home with high turnover rates may involve: 

  • Poorer healthcare treatment outcomes
  • Higher rates of resident death
  • Less effective control of spreading infection
  • Less time spent with each resident
  • Diminished emotional health in patients 
  • Greater likelihood that patients will suffer malnutrition, bedsores, falls, dehydration, self-neglect, elopement, and other consequences of neglect

There is a direct connection between high turnover rates and substandard quality of healthcare. But nursing home residents also suffer in other ways. Many people don’t realize the emotional and psychological impact that being cared for by repeatedly new strangers can have. Residents may struggle to overcome the difficulties of: 

  • Receiving care from staff members who are overworked, underpaid, and under severe stress
  • Losing the emotional connection they had with former staff they came to trust
  • Being subjected to medical mistakes and communication errors during staff transition periods
  • Possibly being exposed to underqualified staff or individuals with a problematic history

Financial Costs to the Nursing Home

When there is a constantly rotating cycle of new employees, the standard of care given to residents unfailingly declines. This means that residents suffer more injuries, illnesses, and poorer treatment outcomes. As a result, more expenses need to be devoted to more and more treatments for patients. These treatments are costly. From a strictly business perspective, this doesn’t make good sense for care facilities.

New employee hiring and training can also monopolize funds when turnover rates are high. Employee replacement costs can be significant, including all aspects of the job posting, search, recruitment, interviewing, hiring, onboarding, and training process. Sign-on bonuses and benefits can add to the expense.   

When a higher percentage of funds is allotted to continual and repeated medical treatments and employee training, less money can be devoted to other areas. Food quality, recreational activities, facility maintenance, common area equipment, classes and workshops, and other non-medical offerings may be reduced or eliminated as a result. This is just one more way that high turnover rates lead to poor care in a nursing home setting.        

Emotional and Physical Costs to Staff

It’s difficult for seasoned employees to get used to working with an endless stream of new, undertrained, and sometimes underqualified colleagues. When retention rates are low, facilities may relax their hiring standards in order to simply meet the numbers for minimum staffing requirements.  

This takes a physical toll on many employees who are required to spend extra time training newcomers and helping them become acclimated. Communication can be difficult among employees who haven’t yet spent much time together, and this can be emotionally taxing as well. 

With high turnover rates, experienced employees can face challenges such as:

  • Working overtime to take part in hirings or trainings
  • Working extra hours during periods of understaffing
  • Allowing new employees to shadow them on tasks
  • Filling in when new staff lack the knowledge or experience to complete tasks alone
  • Working alongside new staff who are less efficient and less productive
  • Constantly adapting to new styles of communication and workload balance
  • Being a part of a facility that has low care standards and fails to meet patient needs

Get Legal Help After Nursing Home Abuse 

We have successfully represented clients in taking legal action against nursing homes that prioritized business needs over the care of residents. Our attention to every case is devoted, confidential, and focused on the individual needs of each injured victim we serve. We are ready to listen to your experiences and offer expert guidance to help you attain justice and recovery. Contact us to schedule a free case evaluation to discuss your case

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Tad Thomas - Trial Lawyer

Tad Thomas

Managing Partner

Tad Thomas has dedicated his practice to representing plaintiffs in various types of civil litigation, including personal injury, business litigation, class actions, and multi-district litigation.

After graduating with his law degree in 2000 from Salmon P. Chase College of Law at Northern Kentucky University, Mr. Thomas immediately opened his own private practice and began representing injury victims.

In 2011, Thomas Law Offices was established in Louisville, Kentucky. Over the past decade, Mr. Thomas has expanded his firm and now has offices in three additional locations: Cincinnati, Ohio, Columbia, Missouri, and Chicago, Illinois. He is also a frequent lecturer on topics like trial skills and ethics and technology.

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