AppId is over the quota
Reading between the lines of a study published in The Gerontologist recently, I noticed another vote for nonprofit nursing homes.
This isn’t a surprising finding, really. For years, researchers have reported that ownership status is one of the factors related to quality care. “Most studies show that nonprofits do a better job of caring for patients,” said JiSun Choi, a postdoctoral fellow in nursing and long-term care at the University of Kansas Medical Center School of Nursing. “But we’re not sure why that happens.”
We could speculate about the role that money plays, of course. A nonprofit nursing home doesn’t have to worry about paying shareholders dividends or keeping stock prices high. It can also rely on philanthropy to help bridge the gap between what it takes in from residents and government reimbursement and what it needs to spend.
But we also know that staff members’ feelings about their jobs appear to play a significant mediating role. Past studies have shown that in commercially operated homes, for instance, the certified nursing assistants who provide the bulk of the hands-on care are less satisfied with their jobs than those in nonprofits. Directors of nursing in commercial homes are less satisfied as well, and more likely to be planning to leave. In general, such homes are associated with higher — in some cases, shockingly high — staff turnover.
Dr. Choi and her colleagues, surveying nearly 900 registered nurses working in almost 300 skilled nursing facilities in New Jersey, found several characteristics that contributed to the nurses’ job satisfaction: their ability to help set the facility’s policies, their sense of having supportive managers, their feeling that they had adequate resources (translation: enough staff to get the job done well). “A more supportive practice environment,” the researchers called it.
At any rate, R.N.’s working in nonprofit nursing homes were significantly more satisfied with their jobs, the study showed.
Though turnover lay outside the scope of her study, Dr. Choi thought that greater satisfaction might keep them in their jobs longer and affect the work environment for the nursing aides and licensed practical nurses whom R.N.’s supervise. Those staff people would then also be less likely to leave, leading to better outcomes for the residents they come to know. Her next research project will look at the relationship between work force satisfaction and patient outcomes.
Trying to find the right nursing home is such a stressful and sometimes bewildering task that an industry has sprung up to try to guide, or steer, the adult children who often make the decisions.
Ownership isn’t a fail-safe way to choose, sadly. Good commercial homes do exist, and so do lousy nonprofits. In any case, there aren’t enough nonprofits for all the older people who will need long-term care.
But the evidence is mounting that as a group, they still do a better job. That’s where I would start, if I were beginning the search.
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”
No comments:
Post a Comment