Workforce Retention and Wages in Nursing Homes: An Analysis of Managerial Ownership

Owner-managers are administrators that hold significant equity interests in the facility they operate. We examine how the presence of owner-managers is related to the workforce outcomes of retention and wages in nursing homes (NHs). Using a sample of for-profit NHs in Ohio from 2005 to 2015, multivariate regression analysis compares workforce outcomes in facilities operated by owner-managers to salaried managers. On average, owner-managed NHs have higher workforce retention rates, with larger effects among chain-affiliated NHs. Better retention is not achieved through higher wages, as we do not find higher wages at owner-managed NHs. Further qualitative studies are warranted to identify the exact mechanisms which lead to owner-managers having better staff retention rates. Plausible mechanisms include greater autonomy to allocate resources and create policies that foster a work environment that achieves better retention while maintaining financial sustainability.