Determinants of turnover among low wage earners in long term care: The role of manager-employee relationships

Michael Matthews, Melissa K. Carsten, Douglas J. Ayers, Nir Menachemi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


The demand for Long-Term Care (LTC) is steadily increasing as Baby Boomers age and enter retirement. High turnover rates among employees in LTC creates challenges for supervisors and administrators, and can negatively impact quality of care. This study examines manager-subordinate relationship quality using Leader-Member Exchange Theory (LMX) as an antecedent to turnover among low-wage earners in the LTC environment. Survey data measuring LMX, job satisfaction, and demographic information was collected at time 1, and turnover data was collected 18 months later at time 2. The results reveal that all four LMX dimensions were rated significantly different among subordinates who left versus those who stayed, however, only the LMX dimension of supervisor loyalty was a significant predictor of turnover among low wage earners. Our study adds a more nuanced view of the reasons low-wage employees turnover, and presents implications for clinical managers and LTC organizations more broadly.

Original languageEnglish (US)
JournalGeriatric Nursing
StateAccepted/In press - Jan 1 2018


  • CNA turnover
  • Leader-member exchange
  • Leadership
  • Long term care
  • Nurse assistant turnover

ASJC Scopus subject areas

  • Gerontology

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