Nursing Staff Leave SNFs at Higher Rate than CCRCs

Nursing homes this year experienced a higher rate of turnover for three positions — registered nurses (RNs), licensed practical nurses (LPNs) and certified nursing assistants (CNAs) — compared to continuing care retirement communities (CCRCs), according to a September report published by the Hospital & Healthcare Compensation Service (HCS).

HCS pulled from separate reports on CCRCs and nursing homes made available in June and July, respectively, to make the comparison. A CCRC, made up mostly of non-profit organizations with some for-profit, offer residents the option to “age in place,” having multiple aspects of the care continuum on one campus.

CNAs saw the highest increase in turnover, with nursing homes experiencing 51.4% and CCRCs 45.9%. LPNs and RNs saw a rate difference of less than one percent each.


In most cases, CCRCs paid their staff more. CNAs, for example, are paid 28 cents more per hour at a CCRC compared to a nursing home, according to the reports.

“There’s still a lot of work to do and [SNFs] can use what CCRCs are doing as kind of a blueprint,” said Dane Henning, director of public affairs for the National Association of Health Care Assistants (NAHCA). “About 58% of the CCRCs that were in that same poll, they offered hazard pay, appreciation pay, bonuses for anybody that was working with a COVID-positive patient.”

LPNs, who are hired for multiple roles within a facility including nursing supervisor, practical nurse or charge staff nurse, are paid more for all positions with the exception of one — charge staff nurses are paid 71 cents more on average at a nursing home.


RNs cover even more roles than LPNs within a nursing home, according to HCS data: infection preventionists, nursing supervisors, MDS coordinator, staff nurses, charge staff nurses, quality assurance staff could all have RN certification and training.

Nursing supervisors with RN certification make more in a skilled nursing facility compared to a CCRC, but only by $40 per year, reports show.

“CCRCs did see an increase in turnover, they just didn’t see that big of an increase [compared to] nursing homes,” explained Henning. “I think that there is perhaps a higher level of appreciation going on. That could also be through pay and it also could have to do with the culture; I’ve heard some very interesting things about how staff feel more welcomed, they feel like a part of the team, it’s more family-oriented to them.”

The report utilized input from 1,613 nursing homes and 545 CCRCs, providing compensation data on 229,100-plus employees.

More than half of participating nursing homes were for-profit facilities at 59.95%, while 40.05% were non-profit nursing homes.

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