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Certified nursing assistants working in long-term care say job satisfaction and emotional well being are bigger factors in turnover rates than how much money they make, a new study finds.

While previous studies showed turnover rates of 23% to 36%, this investigation found a leave-the-LTC-setting rate of 5.85%, and a leave-to-another-facility turnover rate of 8.4%, said researchers from Rice University, the University of Pittsburgh and Baylor College of Medicine.

The investigators categorized study participants as either: stayers (CNAs who held the same job one year after the survey); leavers (CNAs who left the LTC industry altogether); or switchers (CNAs who spent 30 hours per week in the role but switched to another facility a year after the survey).  The researchers said leavers were more likely than switchers to cite health problems as the reason for leaving a facility, while switchers were more likely than leavers to quite a job to seek other opportunities. Switchers were more likely than the stayers to report greater emotional distress, lower job satisfaction and less respect for their supervisor, even though the groups were similar in terms of paid leave and health insurance.

“As baby boomers age, it’s critical for the U.S. to have a stable, long-term care workforce,” said study co-author and Rice professor Vikas Mittal, Ph.D. “Staff turnover in this industry increases the financial burden of caring for elders and interferes with the quality of care. Through our study, we see that to increase the retention of these workers, administrators should address low job satisfaction among employees and provide health insurance.”

The study will be published in an upcoming issue of The Gerontologist.The research was funded by the Jewish Healthcare Foundation of Pittsburgh, the Pennsylvania Department of Labor and Industry, the Heinz Endowments, the University of Pittsburgh Research Council and the National Institute of Nursing Research.