Date of Conferral



Doctor of Healthcare Administration (D.H.A.)


Health Services


Miriam K. Ross


The aging population in the United States has resulted in an increased need for quality nursing home care, which includes a stable nursing staff and reduced workforce instability. The purpose of this quantitative correlational study was to examine the relationship between direct care nursing staff turnover rates for RNs, licensed vocational nurses (LVNs), and certified nursing assistants (CNAs) concerning workload, absenteeism, and number of beds in Texas nursing homes. The relational coordination theory provided the theoretical framework for understanding the underlying issues and communication needs that may relate to staff turnover. Secondary data from 11,336 direct resident care nursing staff RNs, LVNs, and CNAs from 439 nursing homes were obtained from the 2017 Long Term Care Nurse Staffing Study survey for 2017 by the Texas Center for Nursing Workforce Studies. Results of multiple linear regression analysis indicated a significant relationship between RN turnover, absenteeism, and number of beds. The regression analysis also indicated a significant relationship between LVN and CNA turnover and number of beds. These results demonstrated that absenteeism and number of beds were significant predictors of nursing staff turnover. Results may be used by nursing home administrators to decrease nursing staff turnover and improve quality of care in nursing homes leading to positive social change.