nurses aid shortage issues and their causes

Providers also face problems with retention of nurse aide staff. Available data indicate nurse aide turnover in nursing homes and home health care agencies is much higher than the labor force in general (13 to 18 percent) or the service workforce (20 percent).22 Annual turnover rates among aides working in nursing homes are reported to be from about 40 percent to more than 100 percent. In 1998, a survey sponsored by AHCA of 12 nursing home chains found 94-percent turnover of nurse aide positions.

A recent national study of home health care agencies identified a 28-percent turnover rate among aides in 2000, up from 19 percent in 1994.

Lower Wages, Fewer Benefits, and Difficult Work Conditions Linked to Nurse Aide Turnover

Studies have cited low wages and few benefits as factors contributing to nurse aide turnover. Our analysis of national wage and employment data from BLS indicates that, on average, nurse aides receive lower wages and have fewer benefits than workers generally; this is particularly true for those working in nursing homes and home health care.25 In 1999, the national average hourly wage for aides working in nursing homes was $8.29, compared to $9.22 for service workers and $15.29 for all workers.

For aides working in home health care agencies, the average hourly wage was $8.67, and for aides working in hospitals, $8.94. Aides working in hospitals are much more likely than aides in nursing homes and home health care to have employer-provided health and retirement benefits.

Aides in nursing homes and home health care are similar to other service workers in that they are less likely to have employer-provided health insurance or pension coverage than workers in general. Most nursing homes and home health care agencies do not offer pension coverage, and only 21 to 25 percent of aides in these settings are covered.

Comprehensive national data on nurse aide turnover are not available, and caution must be used when comparing turnover rates from different studies. While nurse aide turnover rates are typically the number of nurse aides that have left a facility divided by the total number of nurse aide positions, there is no standard method for calculating turnover and methods used in different studies vary. It is generally agreed that staff who leave after a very short tenure on the job contribute most to high turnover rates.

Some nurse aide positions may turn over several times during a given year, while others may not turn over for several years.

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