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Many nursing homes suffer from high rates of turnover, especially among staff providing direct care to residents. High levels of staff turnover can have deleterious effects on resident outcomes, ranging from mental status to clinical measures such as rates of bedsores and pain management. This study has two empirical objectives: (1) to examine the relationship between resident outcomes and staff turnover (including registered nurses, licensed practical nurses, and certified nursing assistants); and (2) to test two strategies (fixed effects and instrumental variables) to correct for endogeneity of turnover, providing an improved estimate of the effect of turnover on resident outcomes. The project employs data from the National Center for Health Statistics’ National Nursing Home Survey.

Laura D’Arcy
Sally Stearns

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