Management and Performance in U.S. Nursing Homes

39 Pages Posted: 20 Mar 2018

See all articles by Anna Amirkhanyan

Anna Amirkhanyan

American University - School of Public Affairs

Kenneth J. Meier

American University; Cardiff University; Leiden University - Institute of Public Administration

Laurence J. O'Toole

University of Georgia - Department of Public Administration and Policy

Mueen A. Dakhwe

Brazos County Health Department

Shawn Janzen

Independent

Date Written: March 20, 2018

Abstract

Accountability pressures have generated complex performance measurement regimes to evaluate and improve public or publicly-funded services. Performance management, however, faces many challenges including the tradeoffs posed by numerous dimensions of performance and a lack of consensus on which organizational and environmental factors can improve these results. This study seeks to understand the effect of management and other factors on different dimensions and measures of performance in U.S. public, nonprofit, and for-profit nursing homes. Using a hybrid data set that combines archival government data on performance in nursing homes with a recent nursing home administrators’ survey, we find that innovative management significantly improves the quality of care. In addition, more innovation and less power sharing in management are associated with serving fewer Medicaid-funded clients. Significant differences in performance exist across public, nonprofit, and for-profit organizations. These differences are notable across both the archival and perceptual models of performance.

Suggested Citation

Amirkhanyan, Anna and Meier, Kenneth J. and O'Toole, Laurence J. and Dakhwe, Mueen A. and Janzen, Shawn, Management and Performance in U.S. Nursing Homes (March 20, 2018). American University School of Public Affairs Research Paper No. 3144761. Available at SSRN: https://ssrn.com/abstract=3144761 or http://dx.doi.org/10.2139/ssrn.3144761

Anna Amirkhanyan (Contact Author)

American University - School of Public Affairs ( email )

Washington, DC 20016
United States

Kenneth J. Meier

American University ( email )

4400 Massachusetts Ave, NW
Washington, DC 20016
United States

Cardiff University ( email )

Aberconway Building
Colum Drive
Cardiff, Wales CF10 3EU
United Kingdom

Leiden University - Institute of Public Administration ( email )

P.O. Box 13228
Den Haag, 2501 EE
Netherlands

Laurence J. O'Toole

University of Georgia - Department of Public Administration and Policy ( email )

Athens, GA 30602
United States

Mueen A. Dakhwe

Brazos County Health Department ( email )

201 N Texas Ave
Bryan, TX 77803
United States

Shawn Janzen

Independent ( email )

No Address Available

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