Perceptions of safety culture within nursing homes vary greatly among staff and provider types, with nonprofit providers linked to worse staff training, a new study shows.

Researchers from the University of Michigan aimed to identify facility- and individual-level predictors of skilled nursing facility safety culture in the study, which was published Monday in the Journal of the American Geriatrics Society.

Their investigation used data from the Agency for Healthcare Research and Quality’s Safety Program for Long-Term Care, including feedback from more than 14,000 nursing home staff from 170 facilities. The staff were surveyed on five domains of safety culture: teamwork, training and skills, communication openness, supervisor expectations and organizational learning.

The study’s results showed that a facility owned by a nonprofit organization was linked to worse training and skills for its staff, as well as worse supervisor expectations. Nonprofit and chain ownership was also an indicator of worse supervisor expectations and organizational learning.

Facility ownership in general was found to have the strongest effect on the perception of safety culture within the facility.

On a staff level, nursing home administrators were found to rate all of the domains higher than nursing assistants and other frontline staff. The most staggering differences in opinion were noted for communication openness, teamwork and supervisor expectations, researchers found.

“Reporting safety culture scores according to occupation may be more important than facility-level scores alone to describe and assess barriers, facilitators, and changes in safety culture,” the team wrote.