OBJECTIVES: To examine the role of organizational and leadership factors on cultural competency training (CCT) in home health and hospice care (HHH) agencies. METHODS: This observational study used data from the agency component of the 2007 Home and Hospice Care Survey (NHHCS). The final analytic sample had 828 agencies representing 12,107 HHH agencies when weighted. A summary CCT composite score was created based on three items supported by factor analyses (range= 0-3; alpha= 0.6): whether the agency provided mandatory training to understand cultural differences/beliefs that may affect delivery of services (referred to as CCT) to all administrative, clerical, and management staff; all direct service providers; and all volunteers. Institutional and resource dependency theories were used to predict associations between 12 organizational/leadership factors and CCT. Descriptive, correlational, and ordinal logit regression analyses were conducted, accounting for the complex sampling design/using finite population correction. Weighted estimates were obtained for the overall sample and subpopulations: home health (HH), hospice, and mixed agencies. RESULTS: HH, hospice, and mixed agencies comprised 75%, 15% and 10% of the sample, respectively. The overall mean CCT score was 1.7 (95%CI= 1.6-1.9). Regression results showed that JCAHO accreditation increased CCT odds in HH (OR= 2.1, 95%CI= 1.0-4.2) and hospice (OR= 4.4, 95%CI= 2.1-9.4) settings. Medical/social services increased CCT odds in HH (OR= 1.4, 95%CI=1.0-2.0) and hospice (OR=1.5, 95%CI=1.0-2.1) settings. Additionally, in HH, teaching status increased CCT odds (OR=2.7, 95%CI=1.2-6.2). In the hospice setting, formal contracts with outside organizations increased CCT odds (OR=4.0, 95%CI= 1.8-9.0), and non-for-profit status decreased CCT odds (OR=0.2; 95%CI=0.1-0.5). Administrator’s tenure increased CCT odds in the mixed setting only (OR=1.1; 95%CI= 1.0-1.1). CONCLUSIONS: This study demonstrated the influence of organizational and leadership factors on CCT. HHH agencies need to increase their cultural competency practices to more effectively mitigate health disparities in this important community-based setting.