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This study assesses the relationship between the presence of Oregon volunteer long-term care ombudsmen and externally handled abuse complaints, survey reports, and regulatory sanctions. In 1987, new amendments to the Older Americans Act mandated long-term care ombudsmen access to nursing homes. No studies have systematically examined the relationship between these empowered ombudsmen programs and regulatory abuse investigations, survey findings, or sanction activities. Contrary to pre-1987 studies, this research found that the presence of ombudsmen was related to increased abuse reporting and abuse complaint substantiations, more survey deficiencies, and higher sanction activity.

This study examines how job satisfaction in six subscales and select stressors and demographic covariates influence nursing home administrator’s (NHA) intentions to quit. Quantitative and qualitative data were collected from 311 NHAs in five states. Adjusted odds ratios and 95% confidence intervals for the ordered logistic regression models indicated that NHAs with satisfying work demands, rewards, and coworkers, and who experienced less role conflict and had fewer prior nursing home jobs had lower turnover intentions. Although generally satisfied, roughly 24% reported intending to quit. Surprisingly, NHAs reporting higher job skills were more likely to consider leaving, suggesting that talented NHAs may choose career advancement eased by stigma-free job-hopping in an industry with high mobility norms. Qualitative data suggested that job satisfaction/dissatisfaction was influenced by a more nuanced interpretation of satisfying and more taxing job facets and quitting triggers, including themes such as helping residents and struggling with regulations.