| Purpose | Location,
Sample &
Measurements | Findings | Authors |
| Determine the relationship between perceived importance and actions. |
- Southeastern state
- 49 nursing home administrators
- Survey with 4 point rating scales
- 48 items within major categories
|
- Positive & significant relationships found between
importance and participation ratings in most major role categories.
- These are:
- - complying with policies, standards, regulations,
- - fostering positive working relationships in the organization
- High importance, low participation
- - developing long range plans,
- - budget development,
- - reaching out into the community
- Low importance and low participation
- - nursing research activities,
- - devoting attention to public policy and its effect on the institution
|
Abedzaden & Heine, 1992 |
| Determine if higher educational standards correspond to a higher preparedness for NH administrators |
- Oklahoma and Connecticut
- 263 nursing home administrators
- Mail survey
Administrators rated functioning, 4 pt. scale
- Connecticut required a bachelors degree, to be a NH administrator, while Oklahoma did not
|
Education did not seem to have a significant effect on job performance and preparedness for nursing
home administrators. The years of experience had a direct effect on performance and preparedness of
administrators. |
Al-Assaf, Taylor, & Langston, 1992 |
| Determine expertise priorities by size of HC agency and administrator tenure. |
- USA - all members of home care associations
- 226 home care agency administrators
- Mail survey
|
| | Expertise Priorities |
| Size of Agency | 1st | 2nd |
3rd | 4th |
| Small | Oper. | Fiscal | Clin. | P&D |
| Medium | Oper. | Fiscal | P&D | Clin. |
| Large | P&D | Fiscal | Oper. | Clin. |
| |
| Tenure of Respondent | 1st |
2nd | 3rd | 4th |
| 1-2 years | Oper. | Fiscal | P&D | Clin. |
| 2-8 years | Fiscal | Oper. | P&D | Clin. |
| 8 + years | Oper. | Fiscal | Clin. | P&D |
|
Anderson, 1989 |
| Identify characteristics of effective NH executives |
- North Carolina
- 35 nurse executives &
- 37 nursing home administrators
- Mail survey with 5 point Likert response set
|
| Nursing Executive Importance Ratings |
| Support from NHA | 4.81 |
| HRM skills | 4.74 |
| Flexible & able to negotiate | 4.43 |
| Fiscal management skills (lowest) | 3.68 |
| |
| NH Administrator Importance Ratings |
| HRM skills | 4.8 |
| Knowledge re: gvm't & accrediting agencies | 4.54 |
| General nursing skills | 4.51 |
|
Ballard, 1995 |
| Determine opinions regarding important measures of nursing home quality. |
- National survey
- Randomly selected NH administrators & DONs
- Mail survey following outline of federal certification forms, 17 categories
& 161 specific items
|
- Top three areas:
- 1 Quality of care
- 2 Quality of life
- 3 Resident Rights
|
Harrington et al., 1999 |
| Hear perspectives on causes of staff shortages in home care agencies. |
- National survey
- 841 home care administrators
|
| Causes of homemaker / aide shortage: |
| Low wages | 60% |
| Poor benefits | 35% |
| No advancement | 34% |
| Top Causes for RN shortage: |
| Non-competitive salaries | 36% |
| Increased paperwork | 20% |
| Decreased RN pool | 17% |
| Contributing factors |
| Increased paperwork | 72% |
| Non competitive salaries | 69% |
| Decreased RN pool | 41% |
| Weekend work | 35% |
| No advancement | 34% |
| Poor role image | 29% |
| Poor benefits | 28% |
| Increased shift work | 19% |
|
Jones, 1988 |
Top of Page |
| Identify how home care agency administrators identify common quality problems. |
- National survey
- 128 adminis-
trators or DONs of exemplary
home care agencies
- 1-3 hour telephone surveys with semi-structured interviews
- Open-ended questions, then coding done for problem scenarios
|
- Top Methods How Administrators will Identify Problems:
- -Employee notifies
- -Other staff notifies
- -Supervisor notifies
- -Client/family notify
- -Supervisory visit
- -Documentation
- -Other
- Problem & expected method to identify problem:
- Client-worker clash
- client feedback,
- Unreliable worker-,
-
- client feedback, supervision, documentation, other staff
- Patient deteriorates
- audits, staff feedback, supervisory visit
|
Kane, Frytk, & Eustis, 1997 |
| To determine why nursing staff turnover so high. |
- Massachusetts
- Nursing home administrators and DONs
- Data from state records, then open ended questions in interviews
|
- Found all nursing homes had turnover problem, regardless if for-profit,
not-for-profit, small or large home
- None of the variables studied appear to lower turnover rates,
question: Why is situation so nearly universal?
- Found both management and nursing personnel dissatisfied
- Each group focused on their own needs
- No mention of patient directly
|
Kraus, 1974 |
| Determine state requirement for resident satisfaction surveys in nursing homes and
assisted- living facilities. |
- USA -50 states
- 50 directors of health services
- Mail survey, TC follow-up
|
- Of 50 states:
- 12 use satisfaction measure
- 7 have on-going measurements required, usually annually
- 4 use face to face interviews;
- 3 mail surveys
- Response rates varied from 51 to 87%
|
Lowe, et al., 2003 |
| Examine the effect of Medicaid prospective reimbursement system on the management behavior of
nursing home administrators. |
- Maine
- Survey in 1984 & 1986 (n=106 and 92
nursing home adminis-
trators)
- Survey solicited information on cost control strategies and mechanisms / responses
to re-
imbursement incentives
|
- -In 1984 high proportions of administrators used cost control
methods, higher proportions in 1986 used cost control methods.
- -All cost centers were being more effectively monitored.
- -Substantial increases in number of heavy care Medicaid patients.
- -Managed facilities in ways that allowed them to benefit from special
incentive features of prospective system.
- - Most popular responses were to maintain a high occupancy, retain
a stable proportion of heavy care Medicaid patients.
|
Reid and Coburn, 1996 |
Top of Page |
| Explore reasons for nursing home administrator turnover. |
- Texas
- 72 graduates of an AIT course
(45 long stayers and 27 left field)
- Telephone survey with
- - personal factors
- - NH position factors
- - expectations
- (5 pt scale)
|
- High turnover administrators had:
- - more job dissatisfaction
- - expectations not met re; staff turnover, time demands of work,
pressure from regulatory agencies
- Organizational emphasis on efficiency & autonomy over work.
- Insufficient resources to meet licensure pressures
- Reasons attracted to job:
- -wanted to help people or
- -wanted to reform or improve nursing home care
- Low turnover administrators:
- -had close, caring relationships with elders
- -had worked in another capacity in nursing home
- -reason attracted to job was one of relatives worked in homes,
enjoyed working with elderly or acquaintance recruited them.
|
Rubin & Shuttles-
worth, 1986 |
| Identify relative amount of time spent and importance attributed to specific job activities of
home care nurse execs. |
- Penn & New Jersey
- LTC Executives
- 57 home care
- 25 nursing home
- Mail Survey of 51 activities rated on 4 point scale regarding time spent and importance
|
| HC & NH Executives' Top Ranked Activities |
| Imp | Time | |
| 1 | 1 | Laws/regulations |
| 2 | 2 | Maximizing reimbursement |
| 3 | 4 | Financial Performance |
| 4 | 5 | Quality Assurance |
| 5 | 3 | Interpreting impact of changes |
| 6 | /// | Defining goals of organization |
| 7 | 9 | Identify standards of nursing care |
| 8 | 6 | Regulatory surveys |
| 9 | 7 | Communicating to staff |
| 10 | /// | Dealing with client complaints |
| /// | 10 | Develop policies & procedures |
|
Scalzi & Wilson, 1993 |
| Determine which factors, attitudes, and personal factors can predict tenure of NH administrators |
- Michigan and Indiana
- 552 nursing home administrators who stayed in LTC
from previous job
- Mail survey, 42 questions, rated on 4 point scale
|
| Top Ratings of Administrators (4 point scale) |
| Skill Compatibility | 3.22 |
| Performance Outcomes | 3.31 |
| Community attachment | 3.10 |
- Predictors for > 3 years employment:
- - past job stability
- - community attachment
- - nature of job separation
- Found relationship between facility operational outcomes & administrator's
organizational commitment
|
Singh & Schwab, 2000 |
| Investigate which job dimensions influence nursing home administrators tenure |
- Michigan & Indiana
- 552 nursing home administrators
- Mail survey
|
- Dimensions significant to longer tenure
- 1. Realized expectations (re: supervisor, ethical/moral
values, philosophies)
- 2. Organizational demands & skill compatibility (by staff,
residents, families & satisfaction with current staff)
- 3. Commitment to the organization (trust, enthusiasm, loyalty, concern
for org success, motivation to perform)
|
Singh & Schwab, 1998 |
| Determine what nursing home administrators use for their management control reports |
- Southern California
- 43 nursing home administrators from proprietary
institutions
- Survey questionnaires & interviews regarding management control practices
& Examine data reports to state health department.
|
| Reports with Highest Monthly Use |
| Dept. Expense Reports |
92% - 97% |
| Process Control reports |
70% - 97% |
| |
| Computerized accounting, admissions/discharges, department work hours |
| Revenue Source Reports |
92% - 97% |
| Inventory Control Reports |
70% - 82% |
| Income Control Reports |
79% - 94% |
- Cash flow, income statement, balance sheet
- Reports used least frequently
- 51% volunteer hours
- 42% laundry processed
- 42% report on FTE staff
|
Smith & Chatfield, 1985 |
