How to Reduce Nurse Turnover at Your Facility

Nursing staff turnover rates in the U.S. are frightening. While hospitals get the most attention, there is a troubling lack of research into how this is impacting nursing homes. This can be quite frustrating for the facilities providing care for this country’s 1.3 million residents. We’ll examine the statistics and factors surrounding this critical issue and provide some solutions to help reduce nurse turnover.

Nurse Turnover Statistics

The Centers for Medicare and Medicaid Services (CMS) research has shown that higher nursing staff turnover rates are associated with lower quality of care. So much so, CMS started to include this data in their Nursing Home Five-Star Quality Rating System. With data now being collected from over 15,000 nursing homes and made public, more studies and statistics specific to nursing home staff turnover are finally emerging.

The Long-Term Care Community Coalition (LTCCC) publishes regular alerts and reports on nursing home staffing based on the data received from CMS’s mandatory reporting requirements. LTCCC has provided a summary of findings based on nursing staff turnover in their analysis.

Nursing home facilities across the country had:

• an overall nursing staff turnover rate of 53.3%
• a registered nurse (RN) staff turnover rate of 51.9%
• significantly lower staffing on weekends

To put the nursing home staff turnover rate into perspective, it’s almost double that of the hospital nursing staff turnover rate of 27.1%. Nursing facilities must replace over half of their nursing staff each year. These dire turnover rates come with a hefty price to patients, nursing staff, and facilities alike.

Cost of Nurse Turnover

The financial cost of nurse staff turnover at nursing home facilities is challenging to estimate due to a lack of data, but there is attrition data provided for hospital nurses. For instance, the average cost of turnover for a bedside RN is $40,038, resulting in as much as $6.5 million in losses per year. Each percent change in RN turnover costs or saves the average hospital $270,800 annually. While nursing home staff salaries are less than hospital staff salaries, it’s reasonable to speculate that nursing home staff turnover costs are also prohibitive.

The non-financial cost of nursing turnover directly affects residents. Quality of care and quality of life are essential principles of resident care. A high staff turnover rate harms nursing home residents, according to a report by the National Consumer Voice for Quality Long-Term Care advocacy group.

The report concludes that nursing homes with high nursing staff turnover rates experience:

• poorer health outcomes for residents
• higher rates of nursing homes cited for resident abuse
• higher rates of substantiated resident complaints to CMS
• decreased overall CMS Five-Star Ratings

How to Reduce Nurse Turnover

We’ve reviewed the statistics and costs associated with nursing staff turnover at nursing homes. Now it’s time to discuss possible solutions that can help your residence.

1. Identify the Primary Cause of Nurse Turnover at Your Facility

Nursing staff turnover is a complex issue with multiple contributing factors. Poor working conditions, low pay and lack of benefits, and a demanding role are common reasons for high staff turnover in nursing homes. Work with your nurse management team and engage your nursing staff to determine which causes impact your facility the most to develop and prioritize effective strategies.

2. Protect Your Nursing Staff From Burnout

Burnout among nurses is often associated with high attrition rates. By mitigating or preventing the causes of burnout, your facility can improve turnover by creating a workplace where your residents thrive and your nurses succeed. Supporting nursing innovation, nurse-friendly schedules, education and training, and a positive work culture are burnout solutions that retain happy and healthy nurses, providing a great return on investment.

3. Provide Manageable Workloads

Your staff must consistently do more work with fewer resources when nurse turnover rates are high and poor staffing ensues. This can quickly become a vicious cycle leading to more turnover. Your facility can preserve your current staff and ensure your residents receive the care they deserve by utilizing innovative technology to manage float pool nurses. This gives your nurse leaders the confidence and autonomy to manage the schedule while providing the nursing staff the flexibility they desire.

4. Offer Competitive Wages and Benefits

Consider researching competitors to see if your staff pay and benefits packages are competitive and provide adequate security. When staff work hard and long hours without equitable payment or a means to provide themselves or their family with health insurance, it can create feelings of being unappreciated and undervalued. If your facility can’t pay a high salary, small incentives or staggered salary increases can help keep employees engaged and decrease nursing turnover.

5. Provide Transformational Leadership

The American Nurses Association (ANA) defines the transformational nurse leader as a nurse who inspires their fellow nurses to achieve success by helping them to develop their strengths and by including them in their greater vision. Transformational leadership improves registered nurses’ communication, motivation, and retention rates. It is much easier for nursing staff to persevere through challenging work situations when they have a positive relationship with leadership and are engaged in their workplace.

6. Adopt an Employee-First Culture

Nursing facilities can help reduce nursing turnover and improve resident care if they adopt an employee-first (person-centered) culture, according to a report from the International Council on Active Aging. Employee-first culture recognizes staff as the facility’s most significant asset, encourages and appreciates employees, includes them in decision-making, prioritizes people over profits, focuses on employee wellness, and has managers accountable to employees.

Need Staffing to Help Fill Shifts?

Trying to prevent nurse turnover and burnout during a staffing crisis can be challenging. We’re here to help. Partner with IntelyCare today to learn more about the many ways we can help you fill your empty shifts with well-trained nursing professionals.