Late last week, the Centers for Medicare & Medicaid Services announced that they will begin to post staff turnover data on the Medicare.gov Care Compare website.
In July, turnover will be incorporated into the Five Star Quality Rating calculations.
While this is bound to cause immediate alarm among providers, in the long run this is a positive development for the industry.
Staff turnover is an excellent way to measure what’s going on inside a facility. If the staff is fleeing, there’s a problem.
As the CMS memo on the subject put it, “lower turnover is associated with higher overall quality.” It offers several hypotheses why this might be so, including improved leadership by a consistent administrator, increased efficiency by staff familiar with policies and procedures, and the prevention of adverse outcomes through early recognition of changes in medical condition by staff who know their residents.
Attending to turnover has the potential to improve quality, reduce certain expenditures, and rehabilitate the public’s image of nursing homes. The asterisk on the title of this column, however, reflects the fact that the adjustment to this newly public data point is bound to be bumpy.
The reporting is starting in the middle of a pandemic that has had an outsized effect on residents and workers. The “problem” that employees are fleeing might be omicron as much as it is management and general working conditions. And the handling of COVID-19 has been dependent on numerous factors outside of facility control.
We can surmise that, initially, the published turnover rates will be astronomically high, such as those reported by Ashvin Gandhi, Huizi Yu, and David C. Grabowski in Health Affairs.
The only good news, from an industry perspective, is that virtually everyone’s numbers are going to be abysmal, particularly in areas with widespread illness in the community. The consumer will have little choice but to select among homes with poor staff retention.
Going forward, however, facilities that distinguish themselves from their competitors will have an edge.