In France, more than 75% of the establishments specialized in the care for dependant elderly peopleare EHPADs (Establishments with housing for dependant and elderly people). These structures were created with the aim to rationalize the offer in this sector, but remain economically inefficient. Besides the fact that private and for-profit EHPADs would be more efficient, the studies devoted to the efficiency of these nursing homes do not allow to comprehend the actual causes explaining thissituation. Throughout this article, we attempt to open the EHPAD’s black box in order to identify thedifferences in the production’s organization from which the inefficiencies could originate. Wehypothesize that EHPAD managers have different preferences, correlated with their professionalcharacteristics, which would explain their managingstrategies, especially concerning human resources. The results of an original survey among a sample of EHPAD managers focused onmanagement practice matched to the EHPA2011 survey were mobilized in the testing of this relation.It first appears that the directors adopt differentstrategies to optimize the management of their human resources. Three decisive points concerning the policy for optimizing personnel management were studied: organizing the nurses’ timetables in ten-hour days versus maintaining a traditional organization in 7-hour days, introducing a regular attendance bonus versus not integrating this bonus in the form of remuneration, proposing diploma courses versus only offering short training courses.Probit models were used to explain the existence ofdifferent behaviors. In all three cases, the choices are determined by the managers’ professional characteristics, notably their training. These results open up new perspectives for public authorities to improve the efficiency of EHPADs and the quality of the service they have to offer.
