Doing better to do good: the impact of strategic adaptation on nursing home performance.
OBJECTIVE
To test the hypothesis that a greater commitment to strategic adaptation, as exhibited by more extensive implementation of a subacute/rehabilitation care strategy in nursing homes, will be associated with superior performance.


METHODS
Online Survey, Certification, and Reporting (OSCAR) data from 1997 to 2004, and the area resource file (ARF).


METHODS
The extent of strategic adaptation was measured by an aggregate weighted implementation score. Nursing home performance was measured by occupancy rate and two measures of payer mix. We conducted multivariate regression analyses using a cross-sectional time series generalized estimating equation (GEE) model to examine the effect of nursing home strategic implementation on each of the three performance measures, controlling for market and organizational characteristics that could influence nursing home performance. DATA COLLECTION/ABSTRACTION METHODS: OSCAR data was merged with relevant ARF data.


RESULTS
The results of our analysis provide strong support for the hypothesis.


CONCLUSIONS
From a theoretical perspective, our findings confirm that organizations that adjust strategies and structures to better fit environmental demands achieve superior performance. From a managerial perspective, these results support the importance of proactive strategic leadership in the nursing home industry.
Zinn
Jacqueline S
JS
Fox School of Business and Management, Temple University, 413 Ritter Annex, Philadelphia, PA 19122, USA.
Mor
Vincent
V
Feng
Zhanlian
Z
Intrator
Orna
O
D001509:Bed Occupancy / Q000706:statistics & numerical data; D014487:Centers for Medicare and Medicaid Services, U.S.; D002568:Certification; D004465:Economic Competition; D017598:Efficiency, Organizational / Q000706:statistics & numerical data; D005376:Financial Management; D006801:Humans; D007857:Leadership; D008484:Medicaid; D017146:Models, Organizational; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D015279:Organizational Culture; D009936:Organizational Innovation; D012044:Regression Analysis; D012046:Rehabilitation / Q000592:standards; D019467:Subacute Care / Q000592:standards; D017749:Total Quality Management; D014481:United States