Personal Care Aide Turnover in Residential Care Settings: An Assessment of Ownership, Economic, and Environmental Factors

Abstract
Turnover among personal care aides is a chronic problem facing long-term-care industries. High turnover leads to high recruitment and training costs and to the potential for substandard care. Studies in nursing homes have found environmental factors to be more important than economic factors in predicting turnover rates, but no studies have been done in an assisted living setting or have considered the effects of the physical environment and location of the facility. This study assesses the importance of a variety of factors on turnover among personal care aides, using a two-part model. The results show that certain ownership and environmental factors (facility type, chain ownership, and attractiveness of the neighborhood)are important predictors of turnover. Although adequate economic compensation is undoubtedly important in attracting and retaining qualified staff, the results identify facility characteristics that may indicate a greater level of turnover as well as greater potential for improvement through interventions to reduce turnover.