Staffing-Related Deficiency Citations in Nursing Homes

There is evidence that staffing characteristics influence quality of care in nursing homes. Federal and state surveyors conduct inspections of homes to assess their compliance with regulatory standards, including requirements related to staffing. Deficiency citations are issued when these standards are not met. This article examines the relationship between operational, facility, and market characteristics and organizational performance measured as staffing-related deficiency citations. Online Survey Certification of Automated Records (OSCAR) data from 2000 through 2007 were used with multinomial logistic regression analyses to identify factors associated with deficiency citations for staffing. Chain members and facilities with poor quality of care were more likely to receive deficiency citations for staffing. Greater bed count and competition between nursing homes were associated with a decreased likelihood of deficiency citations for staffing. Staffing-related deficiencies within nursing homes vary according to various operational, facility, and market characteristics.     

The Nursing Home Compare Report Card: Consumers' Use and Understanding

The Nursing Home Compare report card provides information on the World Wide Web about quality measures for almost every nursing home in the United States. In this research, we first examined whether consumers were using Nursing Home Compare. Second, we examined whether consumers could accurately interpret the quality information given in Nursing Home Compare. Data were collected from 4754 family members of nursing home residents. A comprehension index was used to examine whether the information contained in Nursing Home Compare for each quality measure was understood by family members. We found that 31% of these consumers used the Internet in choosing a nursing home, and 12% recalled using Nursing Home Compare. We also found that, in general, the comprehension index scores were high, indicating good understanding. Simply having the Nursing Home Compare report card available does not mean that it will be used, nor does it mean that it can influence consumers in any meaningful way. The findings show that consumers understand Nursing Home Compare information, and approximately 12% currently access the Web site.     

WHAT IS THE MULTITUDE?

Nicholas Brown and Imre Szeman continue their conversation with Michael Hardt and Antonio Negri. (See ‘The Global Coliseum: On Empire’ in Cultural Studies, 16.2, (March 2002), p. 177–192). In this new interview they press the authors of Empire and Multitude on questions that have arisen both out of their own involvement with the theoretical issues generated by Empire and from new areas opened up by Multitude. Why is the multitude not a class? How can the unity of a political project be maintained in the multiplicity of the multitude? Is democracy still a project for the future? Can a political subject constitute itself outside the structure of sovereignty? In other words, what is the multitude?     

Exploring the Experiences of Lesbian,Gay, Bisexual,and Questioning Adolescents in Foster Care

This article is based on the findings from a subset of gender identity and sexual orientation questions from The Casey Field Office Mental Health Study (CFOMH). It aims to contribute the experiences of youth in the care of Casey Family Programs to the increasing body of research on lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth in foster care, as well as inform future studies in this area. The CFOMH study interviewed 188 adolescents ages 14 to 17 who were receiving foster care services from Casey Family Programs in 2006. The experiences in care of youth who identified as LGBQ (n = 10) are presented in narrative form, along with data from all youth in care (N = 188) regarding their perceptions of the foster care environment for LGBTQ youth. These findings are intended to underscore the need to conduct a larger, more in-depth study of the experiences of LGBTQ youth in foster care and the environment that foster care provides for them.     

Sorcery,Theft and Affinity: The Estrangement of Intimacy in Eastern Java

Research has called attention to the importance placed on incorporating the ‘Other’— turning outsiders into insiders—particularly in local and rural contexts of Southeast Asia. This can be seen in a variety of cultural phenomena such as origin myths, marriage patterns and even home design. Rather than focusing on the way strangers are included, in this article I analyse the converse phenomenon: estrangement among family, neighbours and friends. In Tegalgaring in far east Java, house design and a relaxed trespass etiquette welcome passers-by; nevertheless, while front doors are left open, bedrooms and cupboards remain locked. When something is presumed stolen, it is either said to be ‘missing’ or attributed to ‘outsiders’. Suspicion, however, falls on those who are nearest. Sorcery is thought, in theory, to work over long distances. Yet in ‘actual’ cases, the ‘victim’ is often the alleged sorcerer's neighbour, family member or friend. I contextualise these phenomena in terms of other research from the region and argue that, while the inclusion of the ‘Other’ is crucial, the in-group estrangement is also significant.     

Thinking generations

Often, and increasingly, social and political life is narrated using the concept of generation. This article looks at contemporary expressions of ‘generationalism’ in British public life. It identifies the salient themes which emerge, links these to the social and political contexts in which these ideas are produced, and examines the points where they are vulnerable to critique. Bridging science and normativity, the generational view offers a convenient master‐narrative for a variety of political orientations – yet one whose democratic credentials are doubtful. ¹      

Underserved parents,underserved youth: Considering foster parent willingness to foster substance-using adolescents

Adolescents involved with foster care are five times more likely to receive a drug dependence diagnosis when compared to adolescents in the general population. Prior research has shown that substance use is often hidden from providers, negating any chance for treatment and almost guaranteeing poor post-foster care outcomes. There are virtually no studies that examine the willingness (and its determinants) to foster youth with substance abuse problems. The current study conducted a nationally-distributed survey of 752 currently licensed foster care parents that assessed willingness to foster youth overall and by type of drug used, and possible correlates of this decision (e.g., home factors, system factors, and individual foster parent factors such as ratings of perceived difficulty in fostering this population). Overall, willingness to foster a youth involved with alcohol and other drugs (AOD) was contingent upon the types of drugs used. The odds that a parent would foster an AOD-involved youth were significantly increased by being licensed as a treatment foster home, having fostered an AOD-involved youth in the past, having AOD-specific training and past agency-support when needed, and self-efficacy with respect to positive impact. Surprisingly, when religion played a large part in the decision to foster any child, the odds of willingness to foster an AOD-involved youth dropped significantly. These results suggest that a large proportion of AOD-involved youth who find themselves in the foster care system will not have foster families willing to parent them, thereby forcing placement into a variety of congregate care facilities (e.g., residential treatment facilities, group homes). Specific ways in which the system can address these issues to improve placement and permanency efforts are provided.