Document Type


Publication Date



nursing homes, disparities, culture change, artifacts of culture change, Medicaid, cross-sectional

Digital Object Identifier (DOI)


Quality of care has been a long-standing issue in US nursing homes. The culture change movement attempts to transition nursing homes from health care institutions to person-centered homes. While the adoption of culture change has been spreading across nursing homes, barriers to adoption persist. Nursing homes that disproportionately serve minority residents may have additional challenges implementing culture change compared with other facilities due to limited financial and staffing resources. The objective of this study was to examine how nursing home characteristics are associated with culture change adoption in Central Florida nursing homes. This cross-sectional study included 81 directors of nursing (DONs) who completed the Artifacts of Culture Change survey. In addition, nursing home organizational data were obtained from the Certification and Survey Provider Enhanced Reports (CASPER). A logistic regression was conducted to examine the relationship between high culture change adoption and nursing home characteristics. The overall adoption of culture change scores in Central Florida nursing homes was low. Nevertheless, there was variability across nursing homes in the adoption of culture change. High culture change adoption was associated with nursing homes having lower proportions of Medicaid residents.

Rights Information

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Was this content written or created while at USF?


Citation / Publisher Attribution

INQUIRY: The Journal of Health Care Organization, Provision, and Financing, v. 55