Organizational and environmental effects on voluntary and involuntary turnover

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BACKGROUND: There are few studies of voluntary and involuntary turnover in the nursing home literature. Previous research in this area has focused mainly on the linear effects of individual and organizational characteristics on total turnover. PURPOSES: The purpose of this study was to examine both linear and nonlinear effects of organizational and environmental conditions on voluntary and involuntary nursing home staff turnover. METHODOLOGY/APPROACH: We analyzed both primary and secondary data on 854 nursing homes in six states. A negative binomial regression model was used to study both linear and curvilinear effects of organizational and environmental factors on voluntary and involuntary turnover among registered nurses, licensed practical nurses, and nurse aides. FINDINGS: Staffing levels and deficiency citations were the organizational characteristics most consistently linked with turnover among all nurse types. Links were also found between unemployment and type of location (urban or rural) and turnover, indicating that the economic environment is influential for retention. PRACTICE IMPLICATIONS: The results of this study support the notion that policy makers need to consider both the organization and the environment when evaluating the nature of nursing home staff turnover. The findings also offer further evidence that the antecedents of voluntary and involuntary turnover are not necessarily the same. © 2007 Lippincott Williams & Wilkins, Inc.

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Health Care Management Review

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