Abstract
Turnover of personal care aides (PCAs) represents a major challenge to the provision of quality care in residential care facilities (RCFs). The purpose of this study was to explore the role of organizational and job characteristics in relation to turnover of PCAs. Using data derived from the 2010 National Survey of Residential Care Facilities (n = 2,170), weighted logistic regression analysis was used to examine organizational and job characteristics associated with facilities that reported turnover of PCAs. Results indicate that 64% of RCFs nationwide experienced PCA turnover. Among the organizational characteristics, smaller facility size, lower occupancy rate, and lower staffing levels of RNs and PCAs reduced the odds of turnover whereas for-profit ownership and shorter tenure of the administrator increased the odds of PCA turnover. Job characteristics including less than 75 hours of formal training and the availability of health insurance also increased the odds of facilities experiencing PCA turnover. These findings suggest that larger RCFs with higher nurse staffing levels, possibly reflecting a greater acuity of residents, are more likely to have turnover of PCAs. Results also highlight the importance of increased training and longer tenure of administrators as important factors related to PCA turnover. Given these differential findings compared to other long-term care settings, study implications include the need to tailor policy and practice interventions to recruit and retain PCAs in residential care.