[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-427766-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-427766-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","association-of-shift-patterns-with-overwork-turnover-and-care-quality-in-us-skilled-nursing-facilities","Association of Shift Patterns with Overwork, Turnover, and Care Quality in U.S. Skilled Nursing Facilities","","Workforce challenges such as turnover and staffing shortages persist in skilled nursing facilities (SNFs), making it essential to understand how shift structures affect stability and care quality. Using 2021 facility-level data that integrates Payroll-Based Journal, Nursing Home Care Compare quality measures, and Long-Term Care Focus characteristics, the study classifies SNFs by dominant shift type (8-hour, 12-hour, or mixed) and fits state fixed-effects linear regressions, adjusting for ownership, size, and case mix.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & Report",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/association-of-shift-patterns-with-overwork-turnover-and-care-quality-in-us-skilled-nursing-facilities/427766/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/association-of-shift-patterns-with-overwork-turnover-and-care-quality-in-us-skilled-nursing-facilities/427766.png","ImageObject",300,407,{"name":42,"@type":43},"Sophia Brooks","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-22","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"How did the study define the dominant shift in skilled nursing facilities?","Question",{"text":63,"@type":64},"Dominant shift was defined as the most frequent daily work hours for the majority of nurses (registered nurses, licensed practical nurses, and certified nurse assistants). Facilities were categorized as predominantly 8-hour, predominantly 12-hour, or mixed shifts.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What were the main workforce outcome differences across shift categories?",{"text":68,"@type":64},"Facilities with 12-hour or mixed shifts showed significantly higher overwork prevalence and higher turnover rates, including a larger increase in turnover for 12-hour shifts compared with 8-hour facilities.",{"name":70,"@type":61,"acceptedAnswer":71},"How did shift type relate to quality of care measures?",{"text":72,"@type":64},"Quality of care was worse in 12-hour shift facilities across 16 of 22 measures, with higher rates of pressure ulcers, falls, and depressive symptoms.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},427766,1790930245,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,111,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":108,"show_sort_weight":109,"slug":110},7,"Healthcare",40,"healthcare",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":112,"slug":113},30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":55,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":97},962084925636,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","710 Innovation in Aging, 2025, Vol. 9, No. S2  \nAbstract citation ID: igaf122.2420  \nASSOCIATION OF SHIFT PATTERNS WITH  \nOVERWORK, TURNOVER, AND CARE QUALITY IN  \nU.S. SKILLED NURSING FACILITIES  \nFangli Geng1, Yuqian Lin2, Pedro Gozalo1, and  \nElizabeth White3, 1. Brown University, Providence, Rhode Island, United States, 2. Massachusetts General Hospital, Boston, Massachusetts, United States, 3. Brown University School of Public Health, Providence, Rhode Island, United States  \nWorkforce challenges, including high turnover and staffing shortages, persist in skilled nursing facilities (SNFs) . Understanding how shift structures influence workforce stability and care quality is critical for policy and operational decisions. This study identified the dominant shift for SNFs, defined as the most frequent daily work hours for the majority of nurses (Registered Nurses, Licensed Practical Nurses, and Certified Nurse Assistants), and classified SNFs into three shift categories: predominantly 8-hour shifts, 12-hour shifts, or a mix of both. Using facility-level data from 2021, integrating Payroll-Based Journal data, Nursing Home Care Compare quality measures, and Long-Term Care Focus facility characteristics, we fit linear regression models with state fixed effects to assess the association between dominant shift type and key workforce and care quality outcomes, adjusting for facility characteristics such as ownership, size, and case mix. Of the total 13,071 facilities studied, 10,821 (83%) had a dominant 8-hour shift, 1,918 (15%) had a dominant 12-hour shift, and 332 (2%) used mixed shifts. Facilities with 12-hour or mixed-shifts had significantly higher overwork  \nInnovation in Aging, 2025, Vol. 9, No. S2 711  \nprevalence (2.1 and 1.3 percentage points higher than 8-hour facilities, respectively) and turnover rates (7.6 percentage points higher for 12-hour shifts) . Quality of care was also worse in 12-hour shift facilities across 16 of 22 measures, including higher rates of pressure ulcers, falls, and depressive symptoms. Policies should address the implications of different types of shifts, and future research should explore interventions to balance staffing efficiency with staff well-being and patient care.","cbCaioJIxPOwOYSu","https://ap.wps.com/l/cbCaioJIxPOwOYSu","pdf",1266079,"English","# Abstract\n## Study design and shift classification\n## Data sources and regression approach\n## Workforce outcomes and care quality findings\n## Policy implications and future research","[{\"question\":\"How did the study define the dominant shift in skilled nursing facilities?\",\"answer\":\"Dominant shift was defined as the most frequent daily work hours for the majority of nurses (registered nurses, licensed practical nurses, and certified nurse assistants). Facilities were categorized as predominantly 8-hour, predominantly 12-hour, or mixed shifts.\"},{\"question\":\"What were the main workforce outcome differences across shift categories?\",\"answer\":\"Facilities with 12-hour or mixed shifts showed significantly higher overwork prevalence and higher turnover rates, including a larger increase in turnover for 12-hour shifts compared with 8-hour facilities.\"},{\"question\":\"How did shift type relate to quality of care measures?\",\"answer\":\"Quality of care was worse in 12-hour shift facilities across 16 of 22 measures, with higher rates of pressure ulcers, falls, and depressive symptoms.\"}]","Association of Shift Patterns with Overwork, Turnover, and Care Quality in U.S. Skilled Nursing Facilities | PDF",1790644762]