A gloved nurse counts money in her hands
Credit: lakshmiprasad/Getty Images Plus

Paying certified nursing assistants higher hourly wages should mean less turnover, but it shouldn’t be the only solution skilled nursing operators rely on, researchers say. 

Non-wage factors are important in keeping turnover lower, the researchers found.

While new study results show a “significant relationship” between CNA retention and wage growth, they don’t show the same effects with licensed practical nurses and registered nurses. And might not have commensurate influence anyway.

“[A] dollar increase in CNA wages (a 7% increase from current mean wages of $14.09) is associated with only 1.8 percentage points reduction in CNA turnover in our facility fixed effects regressions, suggesting that it is difficult to achieve substantial reduction in turnover by small increases in wages,” authors Hari Sharma, Ph.D. and Lili Xu wrote. 

The findings have implications for the policies operators may implement to address high turnover among nursing home nurses. But increasing wages to that select group shouldn’t be the sole strategy, they wrote. 

“While offering competitive wages paid to direct care workers is a necessary step to strengthen the workforce in crisis, especially for low wage earners like CNAs, our results, together with previous literature on the relationship between wages and turnover, suggest that increasing wages alone will not be sufficient to reduce turnover among all types of nursing home staff,” they concluded. 

“Non-wage factors including improving work environment, a culture that empowers staff, as well as fringe benefits such as health insurance should be considered along with higher wages,” they added. 

The findings were published Saturday in Innovation in Aging. University of Iowa researchers used hourly wage and turnover data among CNAs, licensed practical and registered nurses between 2013 and 2017 from nearly 400 nursing homes in the state.

Data revealed that the average hourly wage was $27 for RNs, $21.60 for LPNs and $14.10 for CNAs from 2013 and 2017. Average turnover rates were 46% for RNs, 44.4% for LPNs and 64.7% for CNAs during the same time period.