Quality improvement and cost containment initiatives in health care increasingly involve interdisciplinary teams of providers.
To understand organizational functioning, information is often needed from multiple members of a leadership team since no
one person may have sufficient knowledge of all aspects of the organization. To minimize survey burden, it is ideal to ask
unique questions of each member of the leadership team in areas of their expertise. However, this risks substantial missing
data if all eligible members of the organization do not respond to the survey. Nursing home administrators (NHA) and directors
of nursing (DoN) play important roles in the leadership of long-term care facilities. Surveys were administered to NHAs and
DoNs from a random, nationally representative sample of U.S. nursing homes about the impact of state policies, market forces,
and organizational factors that impact provider performance and residents’ outcomes. Responses were obtained from a total
of 2,686 facilities (response rate [RR] = 66.6%) in which at least one individual completed the questionnaire and 1,693 facilities
(RR = 42.0%) in which both providers participated. No evidence of nonresponse bias was detected. A high-quality representative
sample of two providers in a long-term care facility can be obtained. It is possible to optimize data collection by obtaining
unique information about the organization from each provider while minimizing the number of items asked of each individual.
However, sufficient resources must be available for follow-up to nonresponders with particular attention paid to lower resourced,
lower quality facilities caring for higher acuity residents in highly competitive nursing home markets.