An Empirical Typology of Nursing Home Culture Change Implementation

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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.

Original languageEnglish (US)
Pages (from-to)1039-1050
Number of pages12
JournalJournal of Applied Gerontology
Issue number9
Early online dateMar 24 2020
StatePublished - Mar 24 2020

Bibliographical note

Funding Information:
The authors would like to thank all nursing home administrators for participating in the survey, Teresa M. Lewis from the Minnesota Department of Human Services for her assistance in data collection, and Margot Schwartz and Dr. Susan C. Miller from Brown University for their instructions on the use of the culture change assessment tool. The author(s) received no financial support for the research, authorship, and/or publication of this article.

Publisher Copyright:
© The Author(s) 2020.


  • empirical typology
  • family satisfaction
  • latent profile analysis
  • nursing home culture change
  • quality of care
  • quality of life

PubMed: MeSH publication types

  • Journal Article


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