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Journal of Applied Gerontology
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The Effect of Administrative Resources on Care in Nursing Homes

Nicholas G. Castle

RAND

Jane Banaszak-Holl

University of Michigan

This article evaluates whether the hours spent on the job by nursing home administration have an effect on the quality of care. Administration with more hours on the job were expected to be actively involved in developing market strategies, implementing continuous, quality improvement, and in developing stricter facility guidelines for care—all of which contribute to improved care processes. The proportion of residents who were restrained, catheterized, had pressure ulcers, or were given psychoactive drugs and the number of health-related deficiencies and nonhealth-related deficiencies were used as measures of quality in 15,834 nursing facilities. We examined effects separately for facilities that belong to a chain and those that are freestanding. Overall, the results indicate that the quality indicators are associated with the number of full-time equivalent hours of administration in both chain and freestanding facilities. This study provides preliminary evidence that the intensity of facility administration can have an important effect on the quality of care residents receive.

Key Words: quality • restraint use • psychotropic drugs • catheterization rates • code violations • pressure ulcers

Journal of Applied Gerontology, Vol. 22, No. 3, 405-424 (2003)
DOI: 10.1177/0733464803253590
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