title: Nursing home staff turnover: impact on nursing home compare quality measures.
abstract: OBJECTIVE
  We used data from a large sample of nursing homes to examine the association between staff turnover and quality.
  
  
  METHODS
  The staff turnover measures came from primary data collected from 2,840 nursing homes in 2004 (representing a 71% response rate). Data collection included measures for nurse aides, licensed practical nurses, and registered nurses. We examined 14 indicators of care quality that came from the Nursing Home Compare Web site.
  
  
  RESULTS
  We found that reducing turnover from high to medium levels was associated with increased quality, but the evidence was mixed regarding the quality improvements from further lowering turnover to low levels.
  
  
  CONCLUSIONS
  Our investigation shows that the relationship between turnover and quality might not be linear. Nevertheless, in general, high turnover is associated with poor quality.
authors.affiliation: Graduate School of Public Health, University of Pittsburgh, A610 Crabtree Hall, 130 DeSoto Street, Pittsburgh, PA 15261, USA. CASTLEN@Pitt.edu
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Castle
authors.forename: John
authors.initials: J
authors.lastname: Engberg
authors.forename: Aiju
authors.initials: A
authors.lastname: Men
mesh_terms: D006801:Humans; D009735:Nursing Homes / Q000592:standards; D009740:Nursing Staff / Q000600:supply & distribution*; D017063:Outcome Assessment, Health Care / Q000592:standards; D010558:Personnel Loyalty; D010561:Personnel Staffing and Scheduling; D019984:Quality Indicators, Health Care; D014481:United States; D000078329:Workforce