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Innovative Managers Improve Performance in Nursing Homes, Says New Study

Medical team with the hospital administrator

Innovative management in nursing homes can change the way Americans live their senior years. According to a new study in the Journal of Public Administration Research and Theory, researchers found that innovative, forward-looking management strategies significantly improve the quality of nursing home care.

School of Public Affairs Associate Professor Anna Amirkhanyan, SPA Distinguished Visiting Scholar Ken Meier, and their co-authors studied the effect of management and other factors on different dimensions and measures of performance in public, nonprofit, and for-profit U.S. nursing homes. They combined archived government data on nursing home performance with a recent nursing home administrators’ survey.

The researchers found significant differences in performance across public, private, and for-profit organizations. One key finding is that across all sectors, nursing home managers who employed more innovative management practices achieved higher star ratings for their facilities and had far fewer health violations.

“This paper gave us the first glimpse of what management strategies make a nursing home truly successful,” said Amirkhanyan. “Innovation in nursing home management refers to a manager’s ability to adopt new ideas, care practices, technologies, and service opportunities.”

“Our hope is that these findings will help policy makers find ways to encourage innovation,” said Meier. “That way, facilities that aren’t as innovative can follow the lead of others who found success in new practices.”

In addition to fewer health violations and improved care, the researchers found indirect evidence that these practices are also associated with higher revenue: lower income patients – those on Medicaid – are less likely to reside in such innovative facilities. Cutting-edge nursing homes attract healthier and more affluent clients. Higher revenue also leads to higher quality of care, and a better reputation as well. In addition, smaller public and nonprofit nursing homes have fewer violations and higher quality ratings than larger, for-profit homes. Nonprofit homes also tend to serve fewer Medicaid clients and are more effective at personalized care.

Amirkhanyan and Meier worked with the three other researchers—Laurence O’Toole, Mueen Dakhwe, and Shawn Janzen—on the study.