Do Safety Culture Scores in Nursing Homes Depend on Job Role and Ownership? Results from a National Survey

Abstract

Objectives: To identify facility- and individual-level predictors of nursing home safety culture. Design: Cross-sectional survey of individuals within facilities. Setting: Nursing homes participating in the national Agency for Healthcare Research and Quality Safety Program for Long-Term Care: Healthcare-Associated Infections/Catheter-Associated Urinary Tract Infections Project. Participants: Responding nursing home staff (N = 14,177) from 170 (81%) of 210 participating facilities. Measurements: Staff responses to the Nursing Home Survey on Patient Safety Culture (NHSOPS), focused on five domains (teamwork, training and skills, communication openness, supervisor expectations, organizational learning) and individual respondent characteristics (occupation, tenure, hours worked), were merged with data on facility characteristics (from the Certification and Survey Provider Enhanced Reporting): ownership, chain membership, percentage residents on Medicare, bed size. Data were analyzed using multivariate hierarchical models. Results: Nursing assistants rated all domains worse than administrators did (P