The Effect of Administrative Resources on Care in Nursing Homes

Abstract

This article evaluates whether the hours spent on the job by nursing home administration have an effect on the quality of care. Administration with more hours on the job were expected to be actively involved in developing market strategies, implementing continuous, quality improvement, and in developing stricter facility guidelines for care-all of which contribute to improved care processes. The proportion of residents who were restrained, catheterized, had pressure ulcers, or were given psychoactive drugs and the number of health-related deficiencies and nonhealth-related deficiencies were used as measures of quality in 15,834 nursing facilities. We examined effects separately for facilities that belong to a chain and those that are freestanding. Overall, the results indicate that the quality indicators are associated with the number of fulltime equivalent hours of administration in both chain and freestanding facilities. This study provides preliminary evidence that the intensity of facility administration can have an important effect on the quality of care residents receive.

Relationship of the Job Tenure of Nursing Home Top Management to the Prevalence of Pressure Ulcers, Pain, and Physical Restraint Use

“…Turnover among nursing staff, for example, is associated with the leadership and communication styles of top management (Anderson, Corazzini, & McDaniel, 2004;Donoghue & Castle, 2009). Researchers also found a greater ratio of administrative positions to residents related to resident outcomes, including lower restraint use and pressure ulcers (Castle & Banaszak-Holl, 2003). Administrator turnover has also been shown to be associated with staff turnover (Castle, 2005), deficiency citations (Christensen & Beaver, 1996), and resident outcomes (e.g., Castle, 2001).…”

An instrument to measure job satisfaction of nursing home administrators

“…NHAs may be professionally isolated (i.e., coworkers may be an important influence on NHAs' job satisfaction). Moreover, empirical analyses [ 16 ] have shown the flat administrative structure to increase the work load of NHAs. In many instances, to accomplish objectives, NHAs must undertake initiatives themselves (i.e., work demands may be an important influence on NHAs' job satisfaction).…”

Work Life Stress and Career Resilience of Licensed Nursing Facility Administrators

“…In addition, the profession is facing rising costs and declining revenue streams for long-term care, challenging requirements for more person- and relationship-centered care, and increasing emphasis on coordination of care with other health care providers. Furthermore, the quality of their leadership and decision making has a direct and substantial impact on our most vulnerable citizens (Castle & Banaszak-Holl, 2003).…”