The Effect of Nurse Aide Retention on Ohio's Nursing Home Resident Care Experience Scores: A Facility-Level Analysis.

This study examined whether certified nurse aide (CNA) retention was positively related to nursing home (NH) resident care experiences at the organizational-level. The 2017 Ohio Biennial Survey of Long-Term Care Facilities and the 2017 Ohio Nursing Home Resident Satisfaction Survey provided the key variables. Quartiles of CNA retention (0-48%, 49-60%, 61-72%, 73-100%) were created from the analysis sample (N = 667). Regression analyses clustered NHs within counties and controlled for structural characteristics, financial resources, empowered managers, resilience, quality of work-life, resident, and community characteristics. NHs in Quartile 3 of CNA retention had higher environment scores by 1.36 percentage points compared to Quartile 1 ( p < .05). NHs in Quartile 4 had lower facility culture scores by 1.31 percentage points than NHs in Quartiles 1-3 ( p < .05); this pattern repeated when Quartiles 3 and 4 were compared on other outcomes. Future research should explore NHs with very high CNA retention to improve understanding of the measure.