Table 3.

Qualitative Results Summarized by Levels of Influence by Facility Group

Groups	Levels of Influence per NIMHD Framework
	Individual (Theme 1)	Organizational (Theme 2)	Community (Theme 3)
High-disparity group	Resident relationships: Tensions among BIPOC and White residents; segregation based on residents’ race/ethnicity; frequent use of racial slurs; instances of aggression.	Care from staff: BIPOC residents described receiving inferior care vs White residents or residents who had racial/ethnic or cultural similarity with staff. Activities: Few options for engagement; most common activity was bingo. BIPOC residents said activities were not culturally sensitive. Food: Most BIPOC residents were highly dissatisfied with food, which they described as bland and White-centric.	Engagement with BIPOC communities and volunteers: Most facilities had no volunteers with very few exceptions. Lack of engagement with BIPOC community groups (despite being located in racially/ethnically diverse neighborhoods), led to lack of transparent culture of care and fewer options for residents’ engagement.
Low-disparity group	Resident relationships: Many BIPOC and White residents got along. Some noted issues with immigrant residents with limited English proficiency, especially related to communication.	Care from staff: Most residents describe care as “equal” across race/ethnicity. Diversity is viewed positively. Activities: Facilities invested in a variety of activities, including by providing transportation to take residents on outings and having dedicated indoor and outdoor spaces for activities and gardens. Food: Although residents had concerns about food and mistakes were made, residents said facility leadership was working to make changes.	Engagement with BIPOC communities and volunteers: Strong volunteer presence and infrastructure to support ongoing community engagement.
Mixed-results group	Resident relationships: BIPOC residents had mixed reactions if race/ethnicity was a factor in relationships. Most White residents said it was not a factor.	Care from staff: Many residents said race/ethnicity did not affect care, although some differences based on racial/ethnic concordance noted. Activities: Residents said more activities were needed, especially on weekends but many residents were satisfied with activities offered. Food: Mixed experiences with food, but efforts were made to improve offerings.	Engagement with BIPOC communities and volunteers: Limited community involvement, with a few volunteers and primarily church groups on Sunday.

Notes: BIPOC = Black, Indigenous, and people of color; NIMHD = National Institute on Minority Health and Health Disparities.

*Per NIMHD framework, societal level of influence is also important but is outside the scope of our focus for this article.

**p < 0.01. ***p < 0.001.