The Association Between Residential Care Facility Manager's Educational Attainment and the Presence of Structural and Service Innovations.

For many service-oriented firms, knowledge is a key commodity, and the process by which knowledge is codified is critical for firm survival. The administrator or top manager acts as the repository and disseminator of organizational knowledge. The purpose of this project is to examine the association between the administrator's educational attainment and innovation in residential care facilities.

The need for leadership training in long-term care settings.

Purpose Globally, in 1980, approximately 5.8 per cent of the world population was 65 years old and older. By 2050, this number will more than triple to 16 per cent.

Person-Centered Care Practices in Long-Term Care in the Deep South: Consideration of Structural, Market, and Administrator Characteristics.

The purpose of this study was to identify structural, market, and administrator factors of nursing homes that are related to the implementation of person-centered care. Administrators of Medicare/Medicaid-certified nursing homes in the Deep South were invited to complete a standardized survey about their facility and their perceptions and attitudes regarding person-centered care practices (PCCPs). Nursing home structural and market factors were obtained from public websites, and these data were matched with administrator data.

Electronic Information Systems Use in Residential Care Facilities: The Differential Effect of Ownership Status and Chain Affiliation.

The use of electronic information systems (EISs) including electronic health records continues to increase in all sectors of the health care industry. Research shows that EISs may be useful for improving care delivery and decreasing medical errors. The purpose of this project is twofold: First, we describe the prevalence of EIS use among residential care facilities (RCFs), and second, we explore utilization differences by ownership status and chain affiliation.

Contextual determinants of US nursing home racial/ethnic diversity.

We hypothesized that for-profit/chain affiliated nursing homes, those in states with higher Medicaid reimbursement, and those in more competitive markets would have greater resident racial/ethnic diversity than nursing homes not meeting these criteria. Using 2004 Online Survey, Certification and Reporting data, Minimum Data Set, Lewis Mumford Center for Comparative Urban and Regional Research data, and the Area Resource File, we included U.S.

The use of innovative advance directives programs in nursing homes.

End-of-life service providers continue to seek improved instruments for individuals to convey their last wishes. Two such instruments are Five Wishes and Physician Order for Life-Sustaining Treatment. This project explores the relationship of nursing home profit status and innovativeness to the use of these advance directive programs (ADPs).

In a niche of time: do specialty hospitals outperform general services hospitals?

Niche hospitals represent a growing segment in the health care industry. Niche facilities are primarily engaged in the treatment of cardiac or orthopedic conditions. The effectiveness of this strategy is of interest because niche hospitals focus on only the most profitable services.

Exploring the relationship between nursing home financial performance and management entrepreneurial attributes.

Purpose: This paper explores the relationship between entrepreneurial orientation (EO) (i.e., their innovativeness, proactiveness and risk-taking) and financial performance in nursing homes.

Perceptions of school nurses on the challenges of service provision to ESL students.

The number of English-as-as second-language (ESL) students in public schools across the country is rising creating unique challenges for school health services with the introduction of new cultures and languages. This study describes the perceptions of school nurses in Alabama schools regarding the challenges they face when communicating with ESL students and their parents. The population consists of school nurses in Alabama public schools.

Organizational factors associated with the use of information systems in nursing homes.

Purpose: The use of information systems (ISs) in nursing homes is gradually increasing, yet little is known about the factors that promote the use of these systems. Using resource dependency theory as the conceptual framework, this study examines how chain membership, ownership status, and innovativeness are associated with ISs use in nursing homes.

Design And Methods: We analyzed the results of the 2004 National Nursing Home Survey.

Registered nurses' perceptions of cultural and linguistic hospital resources.

As the patient population continues to diversify, the need to provide care that is culturally and linguistically appropriate is intensifying. This study describes the perceptions of registered nurses (RNs) in Alabama hospitals regarding the training and resources available for providing culturally and linguistically appropriate care. The population consists of all RNs working in Alabama hospitals.

Organizational characteristics associated with cultural and linguistic service provision within Alabama hospitals.

Like several states in the Southeast, Alabama is in the nascent stages of an increase in the population of foreign-born individuals for whom English is a second language. These individuals are also culturally different from the traditional southern population. Given the impact of culture and language on a person's service utilization, the introduction of new cultures may pose significant challenges for Alabama's health care providers if they are not prepared.

Implementing cultural and linguistic competence in healthcare management curriculum.

As our nation's population continues to diversify, the need to provide culturally and linguistically appropriate services will intensify. In the healthcare industry, specifically, it is imperative that the services provided are congruent with patients' beliefs and practices in order to avoid fatal and costly errors. Much attention has been given to the role of clinicians in providing appropriate services to racially and ethnically diverse groups to eliminate disparities and lessen barriers to access.

Cultural and linguistic competence in healthcare: the case of Alabama general hospitals.

As the nation's foreign-born population continues to increase, the importance of understanding cultural, ethnic, and religious differences to combat racial/ethnic disparities in access to and utilization of healthcare services intensifies. In Alabama, specifically, the shifting migration patterns and the growth of the foreign-born population have altered the state's demographics, introducing new cultures and languages to this traditionally biracial state. Because Alabama general hospitals are not immune to the widespread cost, access, and quality paradox that plagues every healthcare organization, they too must consider the value of cultural and linguistic competence in providing high-quality, cost-effective care.

Differences in the health care needs and service utilization of women in nursing homes: comparison by race/ethnicity.

The purpose of this study is to describe health care needs and service utilization among institutionalized women of color. The sample was dichotomized by length of stay to determine how African American, Native American, Asian/Pacific Islander, and Hispanic/Latino women differed at two points in time. Data for this study came from the Current Resident Survey of the 1999 National Nursing Home Survey.

Do characteristics associated with nursing home residents vary by race/ethnicity?

This study identifies differences in the predisposing, enabling, and need characteristics of racial/ethnic minorities and non-Hispanic white men and women upon nursing home admission. The data come from the 1999 National Nursing Home Survey of Current Residents and contain 3,798 women of color, 3,787 men of color, 18,719 non-Hispanic white men, and 36,900 non-Hispanic white women. We estimated prevalence differences and 95% confidence intervals for the absolute differences in prevalence.

The impact of the prospective payment system for skilled nursing facilities on therapy service provision: a transaction cost approach.

Objective: To examine skilled nursing facilities (SNFs) "make-or-buy" decisions with respect to rehabilitation therapy service provision in the 1990s, both before and after implementation of Medicare's Prospective Payment System (PPS) for SNFs.

Data Sources: Longitudinal On-line Survey Certification and Reporting (OSCAR) data (1992-2001) on a sample of 10,241 freestanding urban SNFs.

Study Design: We estimated a longitudinal multinomial logistic regression model derived from transaction cost economic theory to predict the probability of the outcome in each of four service provision categories (all employed staff, all contract, mixed, and no services provided).

Organizational downsizing: a review of literature for planning and research.

The use of downsizing as management's strategic response to environmental and institutional changes is prevalent in all U.S. industries, including healthcare.

An exploration of job, organizational, and environmental factors associated with high and low nursing assistant turnover.

Purpose: This article examines factors that distinguish nursing facilities with very high and very low nursing assistant turnover rates from a middle referent group, exploring the possibility that high and low turnover are discrete phenomena with different antecedents.

Design And Methods: Data from a stratified sample of facilities in eight states, with directors of nursing as respondents (N = 288), were merged with facility-level indicators from the On-Line Survey Certification of Automated Records and county-level data from the Area Resource File. Multinominal logistic regression was used to identify factors associated with low (less than 6.