Degree Name

EdD (Doctor of Education)

Program

Educational Leadership

Date of Award

12-2002

Committee Chair or Co-Chairs

Russell F. West

Committee Members

W. Hal Knight, Terrence A. Tollefson, Richard Wissell

Abstract

The purpose of this study was to determine the extent to which nursing home organizational structure and cultural variables were related to the outcomes reported by the Health Care Finance Administration public use data set (HCFA-NHCD). A second purpose was to examine the effects of a new style of nursing home management called the Eden Alternative™ concept. A related purpose was to test the usefulness of the HCFA-NHCD in predicting the quality of care for residents in federally approved nursing homes. Secondary data analysis was conducted on the HCFA-NHCD, as published in December 2001. Descriptive statistics and measures of association were used to assess the degree of relationship between the organizational structure and culture variables and the eight clinical health indicators of the HCFA-NHCD. Multiple regression analyses were conducted to measure the impact of the organizational structure and culture variables on the quality of care for residents in federally approved nursing homes.

When compared with previously collected statistics, these findings suggest that there is a nationwide trend towards smaller nursing homes; smaller Eden homes were associated with a higher level of individualized attention. Smaller Eden homes with council representation had better scores on a majority of the eight clinical health indicators when compared to their counterparts with no council representation. Council representation was inversely related to a nursing homes' reliance on RN and LPLVN services. However, a regression model assessing the impact of organizational structure and cultural variables on the quality of care for residents in federally approved nursing homes had very limited predictive power (R2=2.2%). The findings of this study suggest that quality improvements in the HCFA-NHCD are needed in order to better serve families.

Document Type

Dissertation - Open Access

Copyright

Copyright by the authors.

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