Date of Conferral



Doctor of Business Administration (D.B.A.)


Business Administration


Lisa Cave


In 2019, hospital profitability margins were at their lowest levels since the great recession due to a declining volume of patients. Hospital executives who fail to improve profitability are at risk of sustainability. Grounded in the service-profit chain theory, the purpose of this quantitative correlational study was to examine whether nurse-to-patient ratios and patient satisfaction scores significantly predict hospital profitability. Data were collected from 74 hospitals in Southern California from the Centers for Medicare & Medicaid Services government database and publicly available financial statements. Results from multiple regression analysis were not statistically significant. A key recommendation is for hospital executives to invest in software to monitor the number of nurses on staff, the number of hospital beds filled, and the patient satisfaction scores they are receiving. The implications for positive social change include the opportunity for hospital executives to understand nurse-to-patient ratios and patient satisfaction in hospitals to improve the health of the individuals in local communities.