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The Centers for Medicare & Medicaid Services  and publicize nursing director turnover in its five-star rating system, say researchers who discovered turnover among nursing directors significantly affects quality outcomes. The researchers, who published their findings in the Journal of the American Medical Directors Association, believe nursing home operators can boost care quality and quality scores by retaining their nursing directors through leadership training, workload support and improvements to organizational culture. The researchers conducted data analysis on CMS five-star ratings, consumer satisfaction scores and nursing home characteristics across nursing homes in Ohio. Higher turnover of nursing directors and nursing home administrators was associated with worse scores, with nursing director turnover affecting care quality more, even when nursing homes retained certified nursing assistants. (McKnights Long-term Care News , 9/4/25)