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The impact of ownership type on the cost and quality of nursing home care in the United StatesRosetti, Maureen C. O'Keeffe 06 December 1995 (has links)
The overall objective of this research was to analyze the effect
of ownership status on 1) quality of care delivered, 2) the cost of
nursing homes in the United States and 3) wages to Registered Nurses.
The model developed here uses a two stage least squares technique to
correct for observed endogeneity problems. Results show that a model
which includes ownership classification interactively with all
independent variables, performs better than a model which simply uses
dummies to proxy for ownership status.
Nonprofit homes were found to have higher direct patient care
expenditures than profit homes. Non-profits were also found to have a
more specialized nursing force. Both of these results suggest that
non-profits may actually provide a higher quality of care than for profit
enterprises. No support was found for the hypothesis that nonprofits
have more philanthropic wage policies. / Graduation date: 1996
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Facility design & planning to improve nurses' effectiveness in administering care to fulltime residents of nursing homes / Facility design and planning to improve nurses' effectiveness in administering care to fulltime residents of nursing homesPeltz, Claudia. January 2009 (has links)
The assumption underlying this study is that a spatially well planned and
appropriately furnished nursing home facility will help the nurses to perform their
work more effectively and accordingly lead to more satisfaction for the residents.
Research in the forms of a literature review, a movie analysis, and a field study of
nursing homes in Germany and the USA, including plan annotations and
observational mapping, trace study analyses and survey techniques, was conducted
and revealed an unexpected urgent need for nursing home design improvement,
especially in the U.S.
The research results led to the development of a catalogue of patterns which
are useful in the design and planning of a nursing home to improve nurses’
effectiveness in administering care to fulltime residents of nursing homes.
With the help of the developed patterns, suggestions for building renovations
of two of the researched nursing homes, one American and one German, were given. / Department of Architecture
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Nursing Homes' Compliance With State Nurse Staffing Standards And Its Relation To Quality-of-care DeficienciesPaek, Seung Chun 01 January 2011 (has links)
The purpose of this dissertation is to examine nursing homes‟ compliance with state minimum nurse staffing standards and its relation to quality-of-care deficiencies. Specifically, this study, reviewing staffing standards from 50 states and the District of Columbia for the year 2007, proposes a unique algorithm to calculate the states‟ expected nurse staffing levels for individual nursing homes in order to investigate their compliance with the state nurse staffing standards. By using hierarchical linear modeling method, this study attempts to capture the impact of the staffing standards on actual nurse staffing levels under resource dependence perspectives. Path analysis using structural equation modeling was conducted to investigate both direct and indirect effects of the staffing standards on nurse staffing levels and quality-of-care deficiencies. The major findings were as follows: (1) nursing homes in states with higher state staffing standards for the categories of RN, LN, and total nurse were found to have higher RN, LN, and total staffing levels, respectively; (2) higher nurse staffing levels resulting from higher state staffing standards were significantly associated with better quality of care (less quality-of-care deficiencies cited) in nursing homes; and (3) state staffing standards were found to have much stronger contribution to nurse staffing levels than any other organizational or contextual factors while nurse staffing levels, particularly licensed staff, were found to have stronger contribution to quality-of-care deficiencies than any other organizational factors. The study findings suggest that if the goal is to increase nurse staffing levels for better quality, increasing the stringency of both federal and state nurse staffing standards would be the iv most effective way. However, the staffing standards first need technical changes to reduce their ambiguity and ensure their fairness. If the goal is to achieve better quality, merely increasing nurse staffing levels may not be effective since the variation of the quality-of-care deficiencies explained by exogenous variables was smaller than random variation 5%. If state Medicaid reimbursements can be utilized for financial incentives for better performing nursing homes, nursing homes may improve their productivity by efficiently managing organizational personnel or increasing job satisfaction among nursing practitioners. Lastly, longitudinal analysis, considering variation in length of state staffing policy implementations, is encouraged to investigate the long-term effects of state staffing standards on nurse staffing levels and quality of care.
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