A blueprint for reducing turnover among nursing assistants: a Louisiana study

For decades, various exposes and reports have painted an unflattering portrait of the nursing home industry across the nation. Nursing homes in Louisiana have endured their fair share of publicity and criticism. The industry in this state has been accused of being preoccupied with profits rather than quality resident care. And, while there is much debate as to the validity of this complaint, there is solid agreement that competent and stable nursing assistants are the key to quality resident care. Unfortunately, the annual turnover rate of these essential employees ranges from 50% to 400%, nationally. This research identified the factors most responsible for the rate of turnover of nursing assistants employed in Louisiana nursing homes. Based upon the results of this study, pay, benefits, workload, and employee-employer relations, are not related to turnover. The analysis revealed that only three issues are associated with turnover--the number of beds, the number of beds per registered nurse, and the number of beds per social service worker. The message is clear: nursing home administrators must be very careful in stretching such resources. The number of beds assigned to an RN, and, in particular, the number of beds per social service worker are management issues that, if overextended, risk the turnover of nursing assistants.