Nursing Home Leadership Tenure and Resident Care Outcomes

Abstract

Because of the relatively short tenure of nursing home leaders in their facilities, questions have been raised about the relationship between the length of tenure and the quality of care. The objective of this data analysis was to determine whether the tenure of nursing home administrators (NHAs) and directors of nursing (DONs) in their current facility or any facility was associated with quality as measured by survey deficiencies. This cross-sectional secondary data analysis linked tenure data from the National Nursing Home Survey and quality (deficiency) data from the Online Survey, Certification, and Reporting system to explore this relationship. Following descriptive analysis of tenure, odds ratios and confidence intervals were calculated in the presence of covariates, using Generalized Estimating Equations with a logit link. Many NHAs and DONs had relatively short tenures (less than 1 year) at their current facility (NHA 23%; DON 42%), although most had experience at other facilities. When compared to peers with long tenure, short tenure of NHAs was associated with twice the odds of having a deficiency. Short tenure of DONs was associated with four times the odds the facility had severe deficiencies as long tenure. Additional covariates, including additional experience, did not influence the results. Increasing leadership tenure in nursing facilities should be a component of quality nursing home improvement. © 2014 National Council of State Boards of Nursing, Inc.