An Examination of Assisted Living Facility Administrator Qualifications Across States.

Resident acuity, Medicaid's increased role in funding assisted living, and the COVID-19 pandemic have brought increased attention to the regulatory environment of assisted living facilities (ALFs) and the responsibilities of ALF administrators (ALFAs) are growing increasingly complex. This study explores, describes, and compares the education (degree and assisted living-specific training), experience, exam (competency), and continuing education requirements for ALFAs across all states, and how states' requirements compare to national assisted living associations' suggested standards for entry-level and ongoing practice. Wide variation in ALFA qualifications are identified, with some states found to have extremely low qualification requirements.

Leadership and Staff Perceptions on Long-term Care Staffing Challenges Related to Certified Nursing Assistant Retention.

OBJECTIVE: This study investigates practices that may help retain certified nursing assistants (CNAs) and address the staffing challenges faced in long-term care. BACKGROUND: CNAs are critical to quality care and retention has never been more challenging. To solve this staffing crisis, understanding the unique perspective of CNAs is imperative. METHODS: In semistructured interviews, 5 nursing assistants, the director of nursing, and the nursing home administrator at 59 long-term care facilities answered 4 questions, providing multiple perspectives about causes and solutions to CNA staffing challenges. RESULTS: Key responses for each stakeholder group were identified. CNAs highlighted the nature of the job as a bigger challenge than leadership recognized. Although pay is a top concern, emotional support, training, relationship-building, communication, and the work culture can be equally important in reducing turnover. CONCLUSION: When organizational leaders understand how to meet the needs and interests of CNAs, they can reduce turnover.

Leadership Perceptions and Practices of Hospitality in Senior Care.

Senior care providers are increasingly focused on hospitality to distinguish themselves from competitors. A mixed-methods approach was used to examine perceptions of hospitality from leadership (i.e., administrators of nursing homes and assisted living facilities) and use of hospitality practices across settings and lines of service. Results indicated that hospitality practices readily exist in senior care settings (i.e., nursing homes, assisted living facilities), but may be referred to by names other than hospitality. There also appear to be more similarities than differences in practices across long-term care service lines (i.e., short- and long-stay nursing home residents, assisted living), suggesting that, regardless of provider type, hospitality in senior care is becoming part of the expected culture and cadre of services for residents. Overall, findings suggest hospitality practices are related to providers' census, payer mix, and organizational performance.

Qualitative analyses of nursing home residents' quality of life from multiple stakeholders' perspectives.

PURPOSE: Quality of life has been defined in various ways by nursing home stakeholders over the years. As such, analyzing the levels of agreement or disagreement among these stakeholders to ascertain if staff and leadership align with resident-identified factors for "good" quality of life has become important to include in the literature. This study sought to identify contributory factors to resident quality of life, as well as analyze areas of commonality in qualitative responses. METHODS: Semi-structured interviews were conducted at 46 Midwestern nursing homes, with residents (n = 138), nursing assistants (n = 138), social workers (n = 46), activities directors (n = 46), and administrators (n = 46), on whether each stakeholder felt residents had a good quality of life and the factors contributing to resident quality of life. RESULTS: Overall, the majority of residents perceived their quality of life as "good," though differences were noted in their main contributing factors when compared to staff members' and management's perspectives. Findings also demonstrated that nursing assistants most closely aligned with resident perspectives. CONCLUSIONS: Given the implications of resident satisfaction with quality of life on multiple facets of a nursing home (e.g., survey process, financial reimbursement), it remains ever critical for management to engage residents and to truly listen to resident perspectives to enhance and ensure an optimal quality of life.

Consequences of uninsurance in Wisconsin.

BACKGROUND: More than 9% of Wisconsin residents are without health insurance. Several states have passed legislation to increase access to health care and move toward universal coverage. Wisconsin legislators are also considering health care reform proposals that present alternatives to the current system. OBJECTIVE: To describe experiences and concerns of individuals who are uninsured as compared to individuals with health insurance. The purpose is to contribute to the current policy debate on health care reform in Wisconsin. METHODS: Participants in this qualitative study were selected from a set of individuals in west-central Wisconsin who completed a health care survey (n = 222) and gave consent to be contacted for an interview. The interviews were conducted in the spring of 2008; the sample (n = 18) includes equal numbers of individuals with and without health insurance. RESULTS: Regardless of insurance status, participants in this study reported worries about affordability, access to health care, and the influence that health insurance coverage has on their choices in life. Participants agreed that all citizens have a right to health care and favor health care reform to make that right a reality. CONCLUSION: Wisconsin residents, both insured and uninsured, experience worries and uncertainties about health care access and affordability. These qualitative findings provide evidence of public support for health care reform.

A descriptive analysis of health care coverage and concerns in West Central Wisconsin.

This study examines the level of health care coverage and health care concerns among a sample of 222 West Central Wisconsin residents. More than 68% of respondents felt that Wisconsin health care has at least major problems, and only 2.7% felt that there were no problems. Approximately 60% were extremely or very worried about not being able to afford health care services, whereas more than 70% were extremely or very worried that insurance companies care more about profits than patient care. These concerns translate into a desire for reform, with more than 90% of respondents saying it is extremely or very important for Wisconsin to make health care more affordable and accessible for all residents. Despite some differences between the insured and uninsured, the call for action to expand access and control costs was significant among both groups. These results can help guide the current policy debate on health care reform.