The Long-Term Care Workforce Retention Crisis: Causes and Consequences of Frontline Worker Turnover

Detailed data on private providers of long-term residential services for persons with developmental disabilities permit investigation of the causes and consequences of frontline worker turnover for the same establishments. The endogeneity of turnover with compensation and consequence variables is accounted for in the estimation. Turnover is determined by client characteristics, frontline-worker compensation, and establishment characteristics. Higher turnover increases state-reimbursed training expenditures and workers’ compensation costs. Our findings indicate that policies to reduce turnover through wage subsidization may be effective and that agencies are unlikely to reduce turnover on their own; the resultant costs are either tolerably small or borne by others.