Abstract
This paper focused on low wages and staff shortages as causes for high turnover of care staff and examined the corresponding countermeasures. While focusing on special nursing homes, the supply behavior of nursing providers was analyzed through a detailed consideration of factors including the system, legislation, cost of establishment and operation of facilities as well as the sources of income. It was found that low wages and staff shortages are caused by: 1) a possibility that excessive facilities construction costs, largely dependent on borrowings, are leading to a squeeze in personnel costs due to the high carrying cost of loans; 2) a possibility that the nursing provider is overestimating future anticipated expenditures due to insufficient understanding of accounting rules for social welfare corporations, thus squeezing personnel costs in order to realize an excessively large surplus of income over expenditure; 3) a possibility that the owners of the nursing facility are squeezing personnel costs for private gain; and 4) a possibility that cuts in personnel costs are being implemented through an increased use of non-permanent staff and by requiring staff to take on multiple roles. In order to improve retention of care staff, proactive measures by the government and financial institutions against excessively costly facility plans, government advice in terms of appropriate levels of income over expenditure ratios, and measures to make hiring permanent care staff and improving staff retention more financially attractive for providers are necessary.
