Globally, in 1980, approximately 5.8 per cent of the world population was 65 years old and older. By 2050, this number will more than triple to 16 per cent. From a leadership…
Abstract
Purpose
Globally, in 1980, approximately 5.8 per cent of the world population was 65 years old and older. By 2050, this number will more than triple to 16 per cent. From a leadership perspective, there is at least one challenge (among many others challenges) to consider. This paper (viewpoint) aims to provide support for the growing need for academically prepared managers.
Design/methodology/approach
This paper is a viewpoint which presents several characteristics of the long-term care (LTC) field that support the need for academically trained leaders.
Findings
LTC leaders in all countries must be sufficiently versed in numerous management areas to provide leadership when called on by those assigned to their care. Given local area variations in population needs present across all countries, it may be unwise to advocate for national, countrywide standardization of requirements. Yet, older adults accessing LTC services should expect a minimum level of knowledge from all of their providers – not just those who provide direct, hands-on care. However, similar to those who provide direct care, leaders should receive competency-based education with specific attention to effective communication skills, team-based approaches to care delivery, information technologies and population health.
Originality/value
Although much of the extant literature focuses on the delivery of care to older persons, there is a dearth of literature addressing the role of LTC leaders in light of global aging. Establishing a minimum level of academic training and increasing transparency focused on the positive experiences of elders residing in LTC facilities should help dispel the notion that placement in an LTC facility reflects filial failure.
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Jullet A. Davis, Louis D. Marino and Mariangela Vecchiarini
This paper explores the relationship between entrepreneurial orientation (EO) (i.e., their innovativeness, proactiveness and risk-taking) and financial performance in nursing…
Abstract
Purpose
This paper explores the relationship between entrepreneurial orientation (EO) (i.e., their innovativeness, proactiveness and risk-taking) and financial performance in nursing homes. We hypothesize that nursing homes that are more proactive will report better short-term financial performance, while when firms with higher propensities for innovativeness and risk-taking will experience poorer financial performance in the short period due to the high costs associated with the initial adoption of innovation and with pursuing high-risks ventures.
Design/methodology/approach
In 2004, a survey was developed and mailed to a population of 670 nursing homes in the state of Florida who were listed in the Florida Nursing Home Guide of the Agency for Health Care Administration. The final sample for this study included 104 respondents. The data from these surveys were merged with additional variables gathered from the 2004 Online Survey Certification and Reporting (OSCAR) system and the 2004/2005 Medicare Cost Reports (MCR). EO was operationalized using a nine-item scale adapted from Covin and Slevin (1989), and financial performance was assessed using total profit margin.
Findings
The overall findings suggest partial support for the hypotheses. Support was found for the negative relationship between innovativeness and short-term financial performance, but only partial support was found for the relationship between performance and risk-taking. Our results demonstrated that the various aspects of entrepreneurial behaviors have a differential effect on firm performance.
Practical implications
From a managerial perspective, nursing home administrators may continue to seek ways to be entrepreneurial while understanding that some activities may only lead to short-term profitability. These findings should not dissuade administrators from innovative behaviors. They do suggest, however, that innovative administrators should prepare for some initial decrease in profitability following new service implementation.
Social implications
Findings suggest that to varying degrees, nursing home administrators may view themselves as being entrepreneurial despite the intense pressures from governments, poor public perceptions, decreasing reimbursement, more impaired residents, and increasing competition from substitute providers. Further administrators may need to manage the expectations of key stakeholders when they undertake innovative programs that will support social outcomes but which may not enhance short term financial performance.
Value/originality
This paper demonstrates the complex relationship between entrepreneurial activities and firm performance in nursing homes and has implications for the broader health care setting.
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Jullet A. Davis, Louis D. Marino and Lenita Davis
This study aims to examine the extent to which certain organizational characteristics of a nursing home impact its decision to target the community‐based seniors' (CBS) market by…
Abstract
Purpose
This study aims to examine the extent to which certain organizational characteristics of a nursing home impact its decision to target the community‐based seniors' (CBS) market by offering nursing home services to non‐residents. The study aims to hypothesize that service provision would be greater in not‐for‐profit, innovative nursing homes, those with organizational slack, and those that are chain‐affiliated.
Design/methodology/approach
Data came from the 1999 National Nursing Home Survey. There are 1,075 nursing homes in the sample population. The data were analyzed using logistic regression.
Findings
The results show that for‐profit nursing homes were predisposed to offer these services. However, innovative nursing homes were less likely to offer these services. Finally, homes with slack in the form of physical therapists offered these services, but homes with nurse's aide slack were less likely to offer these services.
Research limitations/implications
The findings support the theoretical propositions that CBS service provision is guided by both customer lifetime value principles and the tenets of relationship marketing. The purpose of establishing a long‐term relationship with a consumer is to achieve long‐term profits. Some nursing homes may be achieving this goal.
Practical implications
The health care system is steadily undergoing changing consumer behavior. Consumers will be more actively engaged in their own service delivery; therefore, providers will have to create innovative methods to meet consumer needs. The provision of services to non‐residents is an important and necessary response to market demands for services. The key for health care providers is to offer greater service diversity.
Originality/value
The paper provides evidence that for‐profit nursing home providers offer more services to non‐residents than not‐for‐profit providers.
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Jullet A. Davis, Louis Marino and Joshua Aaron
Real options theory has been used to examine how manufacturing firms make incremental investments under conditions of uncertainty. However, it has not been extensively applied to…
Abstract
Purpose
Real options theory has been used to examine how manufacturing firms make incremental investments under conditions of uncertainty. However, it has not been extensively applied to service firms. Using real options theory, the purpose of this article is to explore how service firms make platform investments.
Design/methodology/approach
Data come from a survey of Florida nursing homes. Several hypotheses examine the extent to which organizational characteristics, environmental scanning, internal and external slack, and entrepreneurial orientation impact the degree of investment in a portfolio of services to community based clients. Data were analyzed via ordinary least squares regression.
Findings
Results indicate a positive relationship between platform investments and customer preferences and nursing home innovativeness. Risk‐taking behavior and internal slack received mixed support.
Research limitations/implications
The study did not include measures of economic performance; therefore, it is unclear if differences in market strategies yield better financial outcomes for the nursing homes. The study was set in the nursing home industry that is a highly regulated service industry. It is possible that specific attributes of this industry impacted our results.
Practical implications
In deciding whether an options approach to managing customer value is appropriate for any individual service firms, managers should consider that a firm's strategic posture and the availability of slack resources.
Originality/value
There has been relatively little research in the management literature that examines how firms in a service context employ strategies and tactics consistent with options theory to reduce uncertainty. This lack of research is problematic given that service firms compromise an increasing percentage of the GDP of many developed countries.
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Jullet A. Davis, Diane Brannon, Jacqueline Zinn and Vincent Mor
This study tests the contingency theory proposition that a nursing facility's strategy moderated by its management structure improves performance. Strategy is modeled in terms of…
Abstract
This study tests the contingency theory proposition that a nursing facility's strategy moderated by its management structure improves performance. Strategy is modeled in terms of degree of innovation; while structure is modeled as organic versus mechanistic. Payor mix, measured as the proportion of Medicaid residents, is used as an indicator of financial performance. Facilities in eight states comprise the sample (N = 308). The data are analyzed via hierarchical moderated regression analysis. The primary finding is that facilities that are both innovative and have an organic structure are more likely to have a lower proportion of Medicaid residents, an indicator of stronger financial performance.