Nursing Home Administrators’ Attribution of Antifacility Bias to Ombudsman Programs

Abstract

The federally mandated ombudsman program is a part of a deterrence approach to improving nursing home care. The author investigated whether nursing home administrators’(NHAs) views of volunteer resident advocates’ work would predict attributions of antifacility bias to ombudsman programs. Both quantitative and qualitative data were analyzed from questionnaires completed by 199 NHAs. Perceptions of volunteers as aggressive and as hindrances, the belief that issues would be resolved without the program, and little contact with volunteers predicted an antifacility bias. There were four types of administrators who articulated needed improvements in ombudsman programs: positive activists, adversarials, collaborators, and educators. Strained relationships between NHAs and those who monitor them may increase facility and agency turnover and diminish the efforts of both. Research on person-environment fit for facility and ombudsman positions should be useful for those who train, license, certify, or hire these personnel.

Keywords

nursing home administrators resident advocates ombudsman program antifacility bias adversarial relationships volunteers

Get full access to this article

View all access options for this article.

References

Angelelli, J. , Mor, V. , Intrator, O. , Feng, Z. , & Zinn, J. (2003). Oversight of nursing homes: Pruning the tree or just spotting bad apples? The Gerontologist, 43, 67-75.

Castle, N. G. (2000). Deficiency citations for physical restraint use in nursing homes. Journal of Gerontology: Social Sciences, 55B, S33-S40.

Castle, N. G. (2001). Administrator turnover and quality of care in nursing homes. The Gerontologist, 41, 757-767.

Castle, N. , & Banaszak-Holl, J. (2003). The effect of administrative resources on care in nursing homes. The Journal of Applied Gerontology, 22, 405-424.

Daft, R. , & Weick, K. (1984). Toward a model of organizations as interpretation systems. The Academy of Management Review, 9, 284-295.

Driskill, G. , & Brenton, A. (2005). Organizational culture in action. Thousand Oaks, CA: Sage.

Harrington, C. , Zimmerman, D. , Karon, S. , Robinson, J. , & Beutel, P. (2000). Nursing home staffing and its relationship to deficiencies. Journal of Gerontology: Social Sciences, 55B, S278-S287.

Harris-Wehling, J. , Feasley, J. , & Estes, C. (1995). Real people real problems: An evaluation of the long-term care ombudsman programs of the older Americans act. Washington, DC: Institute of Medicine, Division of Health Care Services.

Kane, R. A. (2003). Definition, measurement, and correlates of quality of life in nursing homes: Toward a reasonable practice, research, and policy agenda. The Gerontologist, 43, 28-36.

10.

Keith, P. (2003). Doing good for the aged. Westport, CT: Praeger.

11.

Lusky, R. , Friedsam, H. , & Ingman, S. (1994). Provider attitudes towards the nursing home ombudsman program. Denton: University of North Texas, Center for Studies on Aging.

12.

Mullen, W. (1985). Identification and ranking of stressors in nursing home administration. The Gerontologist, 25, 370-375.

13.

Nelson, H. (1995). Long-term care volunteer roles on trial: Ombudsman effectiveness revisited. Journal of Gerontological Social Work, 23, 25-46.

14.

Nelson, H. , Hooker, K. , DeHart, K. , Edwards, J. , & Lanning, K. (2004). Factors important to success in the volunteer long-term care ombudsman role. The Gerontologist, 44, 116-120.

15.

Netting, F. , & Hinds, H. (1984). Volunteer advocates in long-term care: Local implementation of a mandate. The Gerontologist, 24, 13-15.

16.

Persson, D. (2004). Volunteer ombudsmen in the nursing home: Obstacles to retention. Journal of Aging Studies, 18(2), 205-214.

17.

Reynolds, W. (2003). Policy values and culture change in long-term care—The role of state government in catalyzing change. Journal of Social Work in Long-Term Care, 2, 297-410.

18.

Ringgenberg, W. (2000). A study of demographics, self-perception, and response to change as it relates to job choice in Iowa-licensed nursing home administrators. Master’s thesis, Iowa State University, Ames.

19.

Schneider, S. (1997). Interpretation in organizations: Sense making and strategy. European Journal of Work and Organizational Psychology, 6, 93-102.

20.

Sellnow, T. , & Ulmer, R. (2004). Ambiguity as an inherent factor in organizational crisis communication. In D. Millar & R. Heath (Eds.), Responding to crisis (pp. 251-262). Mahwah, NJ: Lawrence Erlbaum.

21.

Singh, D. , & Schwab, R. (2000). Predicting turnover and retention in nursing home administrators: Management and policy implications. The Gerontologist, 40, 310-319.

22.

Tabachnick, B. , & Fidell, L. (2001). Using multivariate statistics (4th ed.). New York: Harper-Collins.

23.

Wiener, J. (2003). An assessment of strategies for improving quality of care in nursing homes. The Gerontologist, 43, 19-27.