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It's Not So Simple: Understanding Participant Involvement In The Design, Implementation, And Improvement Of Cash & Counseling Programs, Erin E. Mcgaffigan

Graduate Doctoral Dissertations

For more than three decades, the United States federal government and the states have worked to restructure the long-term care system to be more community based and responsive to personal preferences. Some argue that those who seek such services should be actively engaged in their design (Morris, 2008; Priester, Hewitt, & Kane, 2006). While many who design and implement home and community-based services may believe that participant engagement could be beneficial, most plans move forward with little to no provision for such engagement. The existing literature provides very little insight into the implications of such decisions.

The Cash & Counseling …

Stakeholder, Organizational And Environmental Influences On Nursing Home Regulatory Enforcement : A New Perspective, Tamika R. Black

Legacy Theses & Dissertations (2009 - 2024)

This dissertation proposes a conceptual framework that integrates stakeholder and compliance theory and employs a multi-method approach to examine the influence of stakeholders, bureaucratic discretion and external environment on nursing home inspections and enforcement. Negative binomial regression analysis was conducted on a population of 655 nursing homes in New York to identify determinants of variation in compliance and enforcement (as measured by deficiency citations). As hypothesized, organizational characteristics (i.e., nursing home bed capacity, sponsorship, occupancy rates and Medicaid revenue) were significant predictors of regulatory compliance and quality of care. Nursing home complaints, the presence of family councils, political party of …