Organizational predictors of outcomes of long-stay nursing home residents.

Analysis of physical function as a measure of nursing home resident outcomes in 10 nursing homes revealed that organizational design variables were important. Results were consistent with contingency theory, which posits that to maximize performance organizational structure should be adjusted to variations in task difficulty and variability. This study revealed that better resident outcomes sometimes are achieved in faster-paced nursing homes when employees are less closely supervised and when the basis for job assignment is clear and consistent. A more hierarchical structure may be effective when workload is heavy. However, when workload and pace are held constant, better outcomes are associated with smaller hierarchies and non-specific job assignment. Implications for management and future research are discussed.