Facility Ownership and Resident Satisfaction with Assisted Living

Abstract

Although the majority of assisted living facilities operate as for-profit organizations and serve increasingly frail elderly populations, little is known about the impact of ownership on the quality of care in assisted living. This study examines the relationship between facility ownership and the quality of care in assisted living, using resident satisfaction as a quality indicator. The assessed aspects of satisfaction include health care, housekeeping, physical environment, relationships with staff, and social life/activities. The relationship of facility ownership to resident satisfaction is examined controlling for resident psychological well-being, functional ability, facility size, and staff resources. Data were collected in personal interviews with 156 residents, including 96 residents in eight for-profit facilities and 60 residents in five nonprofit facilities in Maryland. Residents in the sampled nonprofit facilities were more satisfied with assisted living than were residents in the for-profit facilities. In particular, residents in nonprofit facilities were more satisfied with health care, physical environment, and social life/activities in the facility. Better understanding of the relationship between facility ownership and resident satisfaction can help administrators create environments that maximize resident satisfaction in both nonprofit and for-profit facilities.     

Beyond Cans and Capacity

Many essential public services are provided through networks of community‐based nonprofit organizations. Previous research has demonstrated that simply providing additional resources to these organizations is insufficient to better address demands for public services. We also know little about how and why these organizations adopt network‐level objectives related to service provision. In this analysis, we expand the focus of service provision beyond capacity to incorporate the unique roles that define the very existence of nonprofit organizations, and how these roles affect organizational behavior with respect to service network objectives. We use focus group, survey, and administrative data from one hundred community‐based nonprofit organizations in an emergency food service network to explore the relationships among capacity, roles, and specific program objectives.     

Which Leadership Constructs Are Important for Predicting Job Satisfaction,Affective Commitment,and Perceived Job Performance in Profit versus Nonprofit Organizations?

As an integrative research effort, the present study critically analyzed the relative importance of six leadership constructs—(1) transformational, (2) transactional, (3) laissez‐faire, (4) consideration, (5) initiating structure, and (6) leader‐member exchange (LMX)—as predicting indicators of leadership effectiveness in the for‐profit versus the nonprofit sector. Based on data from seven samples from the for‐profit and nonprofit sectors, the unique effects of the six leadership constructs were tested on three criteria of leadership effectiveness on the individual level: job satisfaction, affective commitment, and perceived job performance. The results for the for‐profit samples revealed that LMX was the most important aspect for explaining variance in job satisfaction, and initiating structure was most important for commitment. In the nonprofit samples, LMX was the most important aspect of job satisfaction and transformational leadership for commitment. In both for‐profit and nonprofit organizations, initiating structure had the strongest unique impact on perceived job performance. We discuss implications for current leadership research and practical implications.     

Organizational innovativeness and its determinants in South Korean nonprofit human service organizations

This study compares the level of organizational innovativeness and its determinants in different types of nonprofit human service organizations. Based on theoretical conceptualizations of organizational innovation, it was hypothesized that community service organizations (CSOs) would be more innovative than residential service organizations (RSOs), and determinants of organizational innovation (such as organizations' characteristics, internal and external properties, and executive leadership) would influence innovativeness. Data from a survey of two types of human service organizations in South Korea (127 RSOs for children and 220 CSOs) revealed that the level of innovation in both types of organizations was not significantly different. The determinants of decentralization and formalization showed significant impacts on innovativeness in CSOs. Decentralization also had a significant positive effect on innovativeness in RSOs. However, executive leadership was a significant determinant of organizational innovativeness in CSOs only. Based on these results, administrative implications are suggested for the facilitation of organizational innovation in nonprofit human service organizations.     

A social identity model of prosocial behaviors within nonprofit organizations

This study draws on social identity theory, while developing and testing the Social Identification Model of Prosocial Behavior among voluntary participants in nonprofit organizations. This model posits relationships between organization identification, commitment, satisfaction, and prosocial behavior among nonprofit volunteers. Path analysis results indicate successful identification of the model. Specifically, when volunteers identified with their nonprofit, they had higher levels of prosocial behaviors, commitment, and satisfaction. This study provides several important extensions to social identity theory and nonprofit literatures while highlighting the need for further research examining motivations behind prosocial behaviors within nonprofits.     

The effectiveness of nonprofit lead‐organization networks for social service delivery

Public agencies increasingly contract with nonprofit organizations to lead community‐based networks for social service delivery. We explore the role that partnership characteristics play in the effectiveness of these networks. Using data on children and family services in Los Angeles County, we consider the impact of both the motivations for forming partnerships and the nature of the resulting partnerships on perceived outcomes for clients, interorganizational relationships, and organizational learning. We find that client outcomes and interorganizational relationships are enhanced when partnerships are formed to meet certain programmatic and organizational goals. Organizational learning, however, is affected only when partnerships are formed to enhance organizational legitimacy. Partners selected because they share common vision increase effectiveness, while those selected because there are few alternative partners decrease effectiveness. Finally, when partnerships use an interorganizational coordination mechanism, client outcomes are improved. The managerial implications of these impacts for the nonprofit sector are developed. The results lend considerable support to the role of partnership motivation and partner selection in the effectiveness of nonprofit lead‐organization networks, and specificity about the nature of that role.     

Effects of Donor Priority Strategy on Relationship Fundraising Outcomes

Nonprofit organizations commonly implement donor priority strategies, yet little research has explored the effects of this relationship strategy. Whereas previous research highlighted the positive effects of benefit segmentation and analyzed donor motives to choose a specific donation level, this study investigates the effects of priority benefit perception on relationship factors such as donor satisfaction, donor loyalty, upgrade/downgrade intentions, and voluntary behavior. Based on data from the German cultural sector—804 donors of a friend circle that differentiates two donation levels—the results of the partial least squares path analysis show that donors' perception of priority benefits positively affects donor satisfaction and donor loyalty. The study also shows that a priority strategy negatively influences intentions to downgrade among higher‐prioritized donors and positively enhances intentions to upgrade among lower‐prioritized donors. Applying multigroup comparison the authors find that most relationship effects do not differ significantly across higher‐ and lower‐prioritized donors. This study thereby supports the implementation of donor priority strategy among cultural organizations because of its advantages for developing strong relationships with donors of all levels. Several managerial recommendations are given; for example, managers should better implement only a few instead of a large number of donor levels, should determine carefully which benefits to offer at the different levels, and analyze the donor base in order to identify donors with strong potential for upgrading.     

The belonging model of trust

Although we know that high‐quality employee–organization relationships are beneficial, these relationships are complex and not fully understood, especially among employees of nonprofit organizations. In particular, we know little about how these employees perceive trust, which may overlook an important contributor to effective management. We begin to address this issue by testing a new theoretical model that conceptualizes perceived insider status, psychological ownership, and organizational identification as foundations for the perception of justice and subsequent trust. Our results indicate that psychological ownership and perceived insider status relate to trust through procedural and interpersonal justice. These results contrast those typically found in for‐profit contexts in that organizational identification did not predict justice and that distributive and informational justice did not predict trust.     

The effects of perceived quality of organizationally provided meal service on employees’ job performance and mediating role of organizational identification

Contemporary managers are developing alternative ways to sustain their competitive advantages. Motivation-enhancing features such as high-quality meal service provided by organizations can be thought of as one of these methods. The effect of the perceived quality of meal service provided by organizations on the job performance of employees and the mediating role of organizational identification during this process is studied. Private security-sector employees working in Turkey (N?=?597) are being focused in this study. As a result of analyses (correlation and regression analyses, structural equation model), the authors find that the perceived quality of meal service provided by organizations improves employees’ job performance significantly and organizational identification has a partial mediating role on this association. The findings of this study will be of interest to key stakeholders such as public or private organizations, labor unions and the media.     

Growth and resilience of pioneering nonprofit human service organizations: a cross-case analysis of organizational histories

Knowledge of organizational history is important for recognizing patterns in effective management and understanding how organizations respond to internal and external challenges. This cross-case analysis of 12 histories of pioneering nonprofit human service organizations contributes an important longitudinal perspective on organizational history, complementing the cross-sectional case studies that dominate the existing research on nonprofit organizations. The literature on organizational growth, including lifecycle models and growth management, is reviewed, along with the literature on organizational resilience. Based on analysis of the 12 organizational histories, a conceptual model is presented that synthesizes key factors in the areas of leadership, internal operations, and external relations that influence organizational growth and resilience to enable nonprofit organizations to survive and thrive over time. Both cross-sectional and longitudinal examples from the organizational histories illustrate the conceptual map. The paper concludes with a discussion of directions for future research on nonprofit organizational history.     

Communication and donor relations: A social skills perspective

The work of donor relations in nonprofit organizations is accomplished through communication. This article suggests a relationship between social skills abilities and effective organizational communication. High-level social skills may facilitate strong relationships with potential donors and enable development personnel to address institutional goals more effectively.     

Institutional isomorphism and nonprofit managerialism: For better or worse?

Nonprofit organizations (NPOs) have increasingly adopted business‐like practices as a response to institutional pressures. Some researchers argue that this development leads to mission drift, whereas others find a positive effect on organizational performance. However, the institutional pressures responsible for shaping the nonprofit sector have remained hard to distinguish from each other. This study explores the consequences of mimetic, normative, and coercive pressures, and looks at how they affect managerialism, organizational performance, and mission drift. We link these concepts through a structural equation model based on survey data and find that one aspect of managerialism, strategic behavior, is a key construct in influencing the response to isomorphic pressures and can positively affect organizational performance while holding off‐mission drift. Normative isomorphism even has a direct positive effect on organizational performance. Mission drift can take place when organizations are under coercive pressure without having strategies or internal processes in place. These findings imply that organizations should invest in their strategy and the professional development of their staff to increase organizational performance and avoid mission drift.     

Wage Inequality and Performance in Nonprofit and For‐Profit Organizations

This article examines the effects of several forms of wage inequality on service quality and employee effort. We suggest that two popular theories, tournament and fair wage/equity, are not necessarily competing. Each theory accurately describes aspects of employee behavior, but because of sectoral differences in organizational objectives and employee attitudes, tournament theory's predictions are relatively stronger in the for‐profit sector, while fair wage/equity theory's predictions are relatively stronger in the nonprofit sector. Using an employer–employee matched data set of nursing homes linked to a federal regulatory database and a resident survey, we found that ownership moderates the relationship between wage inequality and service quality. Although wage inequality positively affects service quality in the for‐profit sector, the reverse is true among nonprofit organizations. We also found that overall wage inequality in the workplace has a more pronounced influence on employee discretionary effort than does the employee's place in the distribution of wages.     

Toward More Targeted Capacity Building: Diagnosing Capacity Needs Across Organizational Life Stages

Investments to build nonprofit organizational capacity have increased rapidly in recent years as both funders and nonprofits seek ways to improve performance. Yet, while research has elucidated the variety of capacity areas organizations generally depend on, we do not yet have a clear empirical understanding of which capacity areas are important to focus on developing or how these capacity needs vary across organizations. Using a life-cycle perspective and extensive data on 71 human service organizations, we examine the relative strength of ten capacity areas at different stages of the nonprofit life-cycle. Findings contribute greater empirical grounding for research on organizational capacity development and have implications for researchers, managers, and funders interested in nonprofit capacity building.     

Human capital inflow in nonprofits: Entry‐level employees’ sector shift

Although recruitment and retention of qualified employees are some of the biggest challenges in the nonprofit sector, nonprofit organizations must maintain human capital inflow due to its significant impacts on organizational success. Through person‐organization value fit, this paper explores the factors that influence labor shifts from the public or for‐profit sector into the nonprofit sector in the South Korean context. Specifically, the effects on the likelihood of employees switching to the nonprofit sector from the perspective of eight job satisfaction measures and three education–job match measures are investigated. Two groups of employees (those whose career started in the for‐profit sector and those starting in the public sector) are compared. Results indicate that there is substantial variation between the two groups. In particular, intrinsic job satisfaction has completely different effects on those working in the for‐profit sector than on those working in the public sector regarding their likelihood of having experienced an intersectoral shift into nonprofits. The more public employees are satisfied with intrinsic job rewards, especially job reputation, the more likely they are to move to nonprofits. These results suggest that when employees in the public sector are satisfied with intrinsic rewards they tend to pursue greater intrinsic satisfaction in the nonprofit sector. This paper also reports that education–job match is only significant for those whose first job was in the for‐profit sector.     

Using Social Network Analysis to Enhance Nonprofit Organizational Research Capacity: A Case Study

As donor agencies become more specific in funding requirements, research that can demonstrate the collaborative efforts of a nonprofit agency with its organizational neighbors and how those efforts pay off in terms of capacity and provision of services is highly useful. Recognizing these benefits, a local funding agency in Virginia commissioned a study to look at the ways in which social network analysis (SNA) can enhance the data resources available to nonprofits for funding and grant requests. In this article, we present a case study of a network of 52 nonprofit organizations to illustrate the viability of SNA in terms of funding and research needs specific to nonprofit organizations. We discuss the outcomes of the case study in terms of how the visual and metric outputs of SNA can be used by nonprofits to enhance the accomplishment of their organizational missions and strengthen their grant requests.     

Transformational leadership,organizational culture,and innovativeness in nonprofit organizations

This is an exploratory study of leadership, organizational culture, and organizational innovativeness in a sample of nonprofit human service organizations: Associations of Retarded Citizens. Although leadership has been held out as one of the most important predictors of innovation, this study found it was not correlated with organizational innovativeness. Examination of the relationships between leadership and cultural variables provided some alternative explanations for this finding. Positive relationships among transformational leadership, organizational values, and cultural consensus (degree of agreement among employees on those values) indicate that leadership practices employed in this sample created strong cultural consensus around values that may inhibit innovation. These findings suggest that examining the link between leadership and organizational culture is important for understanding how leadership and innovation are related. This article sets out practical implications, based on the results of the study, that may help nonprofit managers create workplaces supportive of innovation.     

A Review of Models for Measuring Organizational Effectiveness Among For‐Profit and Nonprofit Organizations

Induced by unprecedented growth, invasion of for‐profit organizations in the nonprofit domain, and high‐profile cases of mismanagement in the nonprofit sector, a recent surge in the literature suggests ample opportunities for research to compare the organizational effectiveness of for‐profit and nonprofit organizations. This article presents a literature review of nonprofit organizational effectiveness from which four models of organizational effectiveness are selected. These models are discussed and analyzed because they apply to both for‐profit and nonprofit organizations.     

Leader–member exchange in nonprofit sport organizations

Numerous human resource studies examining the relationship between leaders and followers have found that employees' high levels of leader–member exchange (LMX) are associated with higher job satisfaction and a greater intention to stay with their organizations. Considering the nature of voluntary work in nonprofit sport organizations, leader–member relations may be one of the most important factors influencing volunteer workers' commitment. This study examines the influences of LMX dimensions (Affect, Loyalty, Contribution, and Professional Respect) of volunteer leaders and followers on job satisfaction and assesses the influences of LMX dimensions and job satisfaction of volunteer leaders and followers on intention to stay with their organizations. The findings imply a strong value in positive reciprocal relationships between leaders and followers for enhancing job satisfaction and retention.