CNA Turnover Linked to Scheduling Choices, Staff Stability, Optimal Hours Worked

Part-time certified nursing assistants (CNAs) play a crucial role in providing patient care at skilled nursing facilities mired with staffing shortages, and yet they face high turnover rates. 

Washington State University analyzed the impact of scheduling decisions on part-time CNA turnover, addressing three key research questions related to hours worked and coworker variability.

The study utilized data encompassing 6,221 part-time CNAs across 157 facilities in the United States over a 26-month period. The findings identified two scheduling levers that operators can potentially use to influence turnover.


The study revealed a “U-shaped relationship” between hours worked and turnover – meaning too few hours or too many hours worked impacted turnover. Initially, as hours worked increased, turnover decreased. However, after a certain threshold, further increases in hours led to an increase in turnover.

The study suggests that there is an optimal range of hours worked that minimizes turnover, emphasizing the importance of balancing workload for part-time CNAs.

Moreover, high coworker variability was associated with increased turnover among part-time CNAs, suggesting that a consistent scheduling of coworkers supported a stable and familiar work environment, which in turn contributed to lower turnover rates.


The study’s findings also suggest that high coworker variability, including changes to coworker schedules, exacerbates the negative effects of long working hours on turnover.

Researchers said that managers can leverage scheduling decisions to reduce CNA turnover by carefully managing the hours worked, and that the simultaneous implementation of increased hours worked and consistent coworker scheduling can be an effective strategy in reducing turnover.

“These findings suggest that managers may be able to leverage part-time CNA scheduling to reduce turnover, improving both the quality and cost of care,” researchers wrote. “Specifically, we demonstrate that managers can reduce CNA turnover by increasing hours worked, scheduling coworkers together consistently and doing both simultaneously.”

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