OBJECTIVE To investigate the mediating effect of work-to-family conflict on the relationship between job satisfaction and turnover intention among licensed nurses in long-term care settings. BACKGROUND The considerable research on turnover in long-term care has primarily focused on the impact of job satisfaction on turnover intention. Given the well-documented high turnover rate in nursing home staffing, dissatisfaction is expected to continue. Alternatives (e.g. reduction in work-to-family conflict) for reducing turnover under the circumstance of job dissatisfaction have not been investigated extensively. METHODS A cross-sectional mailed survey. METHODS A convenience sample comprising 200 nurses from 25 private nursing homes in Central Taiwan was created. Data were collected from nurses about their level of turnover intention, job satisfaction and work-to-family conflict in 2012. A composite indicator structural equation model was used to examine the mediation model of this study. RESULTS Overall, 186 nurses (93%) returned the completed questionnaires. Consistent with published research from other countries, turnover intention in our study was significantly and negatively associated with job satisfaction and significantly and positively associated with work-to-family conflict. In addition, job dissatisfaction indirectly influenced turnover intention through high work-to-family conflict. CONCLUSIONS Findings from this study indicate the importance of work-to-family conflict to nurse turnover. While work setting has a strong, well-documented influence on job satisfaction, limiting job satisfaction efforts to work setting improvements may not yield the hoped-for results unless work-to-family conflict is also considered and addressed.