Administrative turnover is more important than facility size or location when it comes to quality of care in nursing homes, according to a study published in the Annals of Long-Term Care. A high rate of administrator turnover and a high number of reported deficiencies were linked in the nursing homes studied.
The researchers say they focused on facility leadership because they believe other studies neglected them in their analyses of staffing levels’ effects on care quality.
“Based on our findings, it appears that prior studies that focused exclusively on direct care staffing characteristics have been missing an important piece of the puzzle: administrators,” the authors write. “These individuals clearly have a tremendous impact on the quality of care at [long-term care] facilities.”
Administrators play in important role in care quality because they oversee facility operations, control budgets, plan staff training, start quality assurance initiatives, determine care practices and help manage the direct care staff members implementing those practices, the investigators write.
The authors base their conclusions on analysis of data from 151 institutions in Iowa. Future quality-related research conducted on a national level should consider facilities’ indirect as well as direct care staffing characteristics, they add.