Turnover is a staffing problem you have more control over than you think
Certified nursing assistants leave their jobs faster than anyone else in a nursing home, and no amount of sign-on bonuses or wage bumps has changed that ranking. The 2025-2026 Nursing Home Salary and Benefits Report, published by Hospital and Healthcare Compensation Service with LeadingAge and supported by AHCA, put CNA turnover at 42.34 percent. That is down from 44.16 percent the year before, but it is still the highest of any position in the building, which means more than four in ten of your aides walk within a year. For a Director of Nursing, which is less a staffing problem than a cycle you never get out ahead of.
The reasons are not a mystery, and most leaders can name them without opening a report. Ask any CNA who left, and you hear the same handful of answers.
The work is physically and emotionally heavy
CNAs handle the closest and most demanding hands-on care in the facility, often at a ratio the workload was never designed to support. Burnout in that setting is not a personal failing, it is the predictable result of asking too few people to carry too much for too long, until even the ones who love the work run out of room to give.
The schedule is unpredictable
Aides get mandated to stay late, called in on days off, and shuffled between units with little warning, and that unpredictability wears on people in a way pay cannot offset. When someone cannot plan their own week, count on picking up their kid or keeping an appointment, the job slowly stops being worth it no matter how much they care about their residents.
The pay does not match the demand
Wages have climbed, but not fast enough to close the gap. CNA hourly pay averaged roughly 20 dollars in the most recent report, and beyond the base rate, disputes over overtime, differentials, and hours that were promised but never materialized push people out faster than a paycheck figure alone would suggest.
None of this is new, and none of it gets solved with a poster in the break room. What has changed is how much of the problem a facility can actually control.
Slowing CNA turnover comes back to two things every Director of Nursing already knows they need: reliable, qualified people, and a way to fill the gaps quickly enough that the aides who stay are not left carrying the ones who left. The trouble is that most facilities pursue both with tools that are actually working against them. Manual scheduling eats hours leadership does not have, and when a single agency says “no” to three aides for the weekend, you bring on a second, then a third, until you are managing a stack of vendors with no shared standard for who is dependable.
When you pull from several agencies to cover the same holes, you have no consistent way to know which aides reliably attend, which cancel at the last minute, and which disappear after a shift or two. You end up staffing blind, and unreliable coverage becomes its own driver of turnover, because every no-show lands squarely on the people who did report for the shift, and those are exactly the ones you cannot afford to burn out or lose.
This is where reliability scoring changes the equation. A workforce platform sits across every agency you already use and tracks each worker on the behavior that predicts dependability: whether they attend the shifts they confirm, how they perform once they are on the floor, and whether that holds over time.
For the person running the building, the result is a staffing floor that finally holds. Gaps close in hours instead of days, the aides who anchor your units stop absorbing everyone else’s absences, and the quiet churn that unreliable coverage feeds start to slow. Software will not fix wages or lighten the physical weight of the work, and it would be dishonest to pretend otherwise. What it can do is keep unreliable coverage from making a hard job harder, and that is often the difference between a CNA who stays another year and one who becomes next year’s turnover statistic.
Turnover will never fall to zero, and it never has. But the facilities that steady it are the ones that stop treating every open shift as an emergency and start filling from talent they can genuinely count on, quickly and consistently, before an unfilled gap becomes the reason another good aide walks.