An Empirical Typology of Nursing Home Culture Change Implementation

J Appl Gerontol. 2021 Sep;40(9):1039-1050. doi: 10.1177/0733464820912365. Epub 2020 Mar 24.


Culture change in nursing homes (NHs) is a broad-based effort to transform NHs from impersonal institutions to genuine person-centered homes. Culture change practices have been implemented increasingly with varying levels of success. This study (a) generated an empirical typology of culture change implementation across Minnesota NHs using latent profile analysis based on the survey data from administrators in 102 NHs and (b) examined variations in NH characteristics and quality outcomes associated with the typology. Three types of culture change implementation were identified: high performers, average performers, and low performers. The distributions of culture change scores were distinct across the three types, with low performers lagging far behind others in family and community engagement, and end-of-life care. High performers were distinguished through demonstrating better resident quality of life and higher family satisfaction. The findings provide empirical support for policymakers, providers, and advocates to direct culture change expansion and resource allocation.

Keywords: empirical typology; family satisfaction; latent profile analysis; nursing home culture change; quality of care; quality of life.

MeSH terms

  • Humans
  • Nursing Homes
  • Organizational Culture
  • Quality of Health Care
  • Quality of Life*
  • Skilled Nursing Facilities
  • Terminal Care*