title: Turnover begets turnover.
abstract: OBJECTIVE
  This study examined the association between turnover of caregivers and turnover of nursing home top management. The top managers examined were administrators and directors of nursing, and the caregivers examined were registered nurses, licensed practical nurses, and nurse aides.
  
  
  METHODS
  The data came from a survey of 419 nursing facilities and the Online Survey, Certification, and Reporting system. Multinomial logistic regression analyses were used to examine the association between turnover of nursing home top management and turnover of caregivers.
  
  
  RESULTS
  A 10% increase in top management turnover is associated (p <.05) with a 21% increase in the odds that a facility will have a high turnover rate of nurse aides and is associated (p <.05) with an 8% decrease in the odds that a facility will have a low turnover rate of nurse aides. A 10% increase in top management turnover is associated (p <.1) with a 30% increase in the odds that a facility will have a high turnover rate for registered and licensed practical nurses.
  
  
  CONCLUSIONS
  This study provides preliminary evidence that the turnover of top managers may have an important influence on caregiver turnover in nursing homes.
authors.affiliation: Health Policy and Management, University of Pittsburgh, PA 15261, USA. castleN@Pitt.edu
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Castle
mesh_terms: D017028:Caregivers; D003625:Data Collection; D006801:Humans; D016015:Logistic Models; D009740:Nursing Staff; D010558:Personnel Loyalty; D010563:Personnel Turnover; D012866:Skilled Nursing Facilities; D014481:United States