A Quantitative Analysis of Retention Intention: A Repeated Cross-Sectional Study, 2023-2025

Objective: Long-term care (LTC) providers face a persistent employee turnover problem, with various sources citing turnover rates of 79-124% in 2024. This study aims to identify, measure, and manage the workplace and psychological drivers of employee retention, using the Three-Component Model (TCM) of commitment and the Transtheoretical Model of Change (TTM) to give healthcare employers evidence-based tools for strengthening employee commitment, supporting behavior-change strategies, and improving retention among LTC employees. Methods: This repeated cross-sectional study surveyed LTC and older-adult healthcare employees in Wisconsin in 2023 (n=327, 14 organizations) and again in 2025 (n=393, 35 organizations). Pearson correlations examined how workplace factors, including pay range, hours worked, tenure, and department consistency, related to employee commitment, and how commitment, in turn, related to employees’ retention intention (intent to stay). Results: Workplace factors and all three commitment types (affective, normative, continuance) were significantly correlated with retention intention in both waves. Affective commitment remained the strongest predictor of retention across both years (r=0.446 in 2023; r=0.462 in 2025). Normative commitment’s correlation with retention intention increased from r=0.145 in 2023 to r=0.288 in 2025, suggesting employees are increasingly staying out of a sense of obligation rather than emotional attachment alone. Conclusion: Employee commitment is a measurable, malleable mechanism linking workplace factors to retention intention, and the relative strength of its components shifted meaningfully between 2023 and 2025. These findings offer employers guidance for designing retention strategies that address both the emotional and obligation-based dimensions of commitment. Future research should examine the bidirectional effects of workplace factors and commitment to retention over time.