Nurses' Transitions Into and Out of the Home Health Sector.

Area of Science:

• Healthcare Workforce Dynamics
• Nursing Economics
• Public Health Policy

Background:

• Growing demand for home health services necessitates a stable nursing workforce.
• Existing evidence suggests potential instability and shrinkage in the home health nursing sector.
• Registered nurses (RNs) and licensed practical/vocational nurses (LPN/LVNs) are essential for delivering home health care.

Purpose of the Study:

• To analyze the transitions of RNs and LPN/LVNs into and out of the home health sector.
• To compare turnover rates in home health versus the hospital sector.
• To assess the rate of entry into home health from other healthcare and non-healthcare fields.

Main Methods:

• Utilized Current Population Survey (CPS) monthly data from January 2003 to June 2023.
• Compared turnover rates between the home health and hospital sectors.
• Calculated the predicted probability of nurses entering home health from alternative employment sectors.

Main Results:

• Home health sector exhibited consistently and significantly higher turnover rates than the hospital sector.
• The predicted probability of nurses entering home health from any other sector was consistently low, at or below 1%.
• High turnover coupled with minimal new entrants indicates a potential workforce deficit.

Conclusions:

• The home health nursing workforce is characterized by high turnover and low entry rates.
• These workforce trends pose significant risks to the sustainability of nationwide home health services.
• Urgent strategies are needed to improve retention and recruitment in the home health nursing sector.