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Serving Workers in the Human Services: The Roles of Organizational

Ownership, Chain Affiliation, and Professional Leadership in Frontline
Job Benefits
Anna Haley-Lock and Jean Kruzich
Nonprofit and Voluntary Sector Quarterly 2008; 37; 443 originally published online
Dec 12, 2007;
DOI: 10.1177/0899764007310421
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Serving Workers in the Human Services: The Roles
of Organizational Ownership, Chain Affiliation, and
Professional Leadership in Frontline Job Benefits
Anna Haley-Lock
Jean Kruzich
University of Washington
A growing body of research has sought to understand forces shaping firms’ approaches
to employee compensation and the impacts of job benefits on both organizational per-
formance and worker well-being. One such line of work has documented advantages
from employers adopting generous compensation practices, as evidenced by more suc-
cessful worker recruitment and retention. Little of this work, however, has attended to
benefits provided within nonprofit and public human service settings or to low-level
workers. Drawing on a sample of Wisconsin nursing homes, this study addresses this
gap by examining the roles of ownership, chain affiliation, and professional leadership
in compensation provided to nursing assistants. Results indicate that public and non-
profit ownership and chain membership are positively related to benefit levels. Workers
fare unexpectedly less well with professional directors in for-profit and public settings
but better within professionally led nonprofits.
Keywords: employment compensation; frontline workers; organizational ownership;

nursing homes
A growing body of research has examined the relationships between organi-

zations’ employment practices and both organizational performance and
workers’ well-being (Arthur, 1994; Batt, 1999, 2002; Haley-Lock, 2003, 2007;
Heneman & Milanowksi, 2004; Huselid, 1995; Ichiniowski, Shaw, &
Prennushi, 1997; Lambert & Haley-Lock, 2004). More generous and flexible
approaches to the provision of employment benefits, for example, have been
Note: The research for this study was supported in part by National Institute on Aging Grant 5
R01-AG06103. The authors would like to thank Steven Rathgeb Smith and the anonymous
reviewers for their valuable comments. An earlier version of this article was presented during
a poster session at the 2006 annual program meeting of the Council on Social Work Education,
Chicago, February 19, 2006.
Nonprofit and Voluntary Sector Quarterly, vol. 37, no. 3, September 2008 443-467
DOI: 10.1177/0899764007310421
© 2008 Association for Research on Nonprofit Organizations and Voluntary Action
443
444 Haley-Lock, Kruzich
associated with enhanced worker retention, job performance and satisfaction,

and organizational citizenship behaviors (Almer & Kaplan, 2002; Aryee, Luk
& Stone, 1998; K. E. Christensen & Staines, 1990; Grover & Crooker, 1995;
Kossek & Nichol, 1992; Lambert, 2000). By contrast, low pay, restricted
access to supports such as health insurance and retirement pensions, and
irregular work hours have been linked to dissatisfaction, burnout, and turnover
(Drake & Yadama, 1996; Ellis & Westbrook, 2004; Lambert & Haley-Lock,
2004; Mor Barak, Nissly, & Levin, 2001).
Yet across this research, the determinants of the level of support employment
provides remain far from clear, and knowledge of employment conditions faced
by frontline human service workers is particularly limited. Several recent
studies have found, however, that firms operating in the same field and local
labor market can offer strikingly contrasting levels of benefits, differences
that are consequential for individuals’ abilities to stay and prosper in employ-
ment (Haley-Lock, 2003, 2007; Hunter, 2000; Lambert & Haley-Lock, 2004).
Lambert and Haley-Lock (2004) and Lambert, Waxman, and Haley-Lock
(2002), for example, found that cashiers at one major retailer were given
higher starting wages, quicker access to benefits, and more—and more pre-
dictable—hours than did cashiers at a retailer just a few miles away. Haley-
Lock (2003, 2007) obtained similar results in a study of staff in nonprofit
domestic violence programs, which revealed variation in the benefits
extended to frontline workers within the same employing agency and for the
same frontline job title across different agencies. As many social service orga-
nizations continue to struggle over staff recruitment and retention, under-
standing the predictors of such variation is important for identifying
potential managerial and public policy remedies (Alwon & Reitz, 2000;
Drake & Yadama, 1996; Ellis & Westbrook, 2004; Ewalt, 1991; Graef & Hill,
2000; Koeske & Kirk, 1995; Mor Barak et al., 2001).
In this article, we investigate the potential role of several organizational
structural factors in the employment benefits received by nursing assistants.
We specifically address a gap we perceive in the literature in understanding
the potentially distinct contributions of public, nonprofit, and for-profit
ownership, chain versus independent ownership status, and presence of
professional leadership to frontline job quality. With respect to sectoral affil-
iation, prior research points to likely differences in lower-level job rewards.
Comparing for-profits and nonprofits, for example, Roomkin and Weisbrod
(1999) and Ballou and Weisbrod (2003) found that although total CEO
salaries were larger in for-profit agencies, nonprofits provided larger base
wages and for-profits larger bonuses, establishing divergent incentives across
the two sectors for budget maximizing and cost minimization, respectively.
Studies of sectoral differences in staff turnover (Banaszak-Holl & Hines, 1996;
Serow, Cowart, Chen, & Speaker, 1993) have revealed that for-profit firms
exhibit lower staffing levels, including hours of frontline staff allocated per
service recipient, than their public or nonprofit counterparts (Harrington,

Serving Workers in Human Services 445
Woolhandler, Mullan, Carrillo, & Himmelstein, 2001). In the analyses presented

here, we advance this research by comparing all three sectors within the
same model.
Turning to chain affiliation and professionalized leadership, scholarship
that attends to the roles of these organizational features in shaping the quality
of lower-level jobs has been relatively scarce. O’Brien, Saxbery, and Smith
(1983) were the first to introduce the importance of chain affiliation to the
discussion of ownership and quality of care within the nursing home industry,
asserting that distinguishing among nationwide, multisite corporations, and
sole proprietor, neighborhood-based facilities is critical to isolating the effect
of sectoral affiliation on care quality. Only in the past few years, however,
have organizational researchers begun to take chain affiliation into account as
a critical measure of organizational complexity and a unique organizational
form (Kruzich, 2005; Luksetich, Edwards, & Carroll, 2000). Nursing home
membership in a multifacility organization, or chain, versus independent
operation is likely to correspond to differences in organizational mission,
board ideology, ability to secure capital and pursue growth, structural capacity,
and motivation to handle consumer problems (Banaszak-Holl, Berta, Baum,
& Mitchell, 2002).
Employee professionalization, finally, is a relative buzzword within the
human services, where advanced education and other training have been
identified as strategies for enhancing practitioner performance in the fields
of child care, child welfare, and youth work (Astroth, Garza, & Taylor, 2004;
DeVita, Twombly, & Montilla, 2002; A. J. Ellett, 2004; C. D. Ellett, Ellett, Ellis,
Westbrook, & Dews, 2004). To date, however, this research has rarely been
extended to investigating the potential impact of professionalized leadership
on the working conditions for lower-level workers. In one exception, Hunter
(2000) found that Massachusetts nursing homes with professionally trained
administrators featured superior frontline jobs.
This article, then, is intended to advance our knowledge of the relation-
ships between entry-level job quality and the organizational structural
factors of ownership, chain affiliation, and professionalized leadership. We
take nursing homes as our organizational focus because they represent a
category of human service provision that has shown striking institutional
variation in both sectoral and chain statuses. We also find nursing homes
compelling given that in few other organizational settings is the potential
consequence of poor job quality of greater social concern; those receiving
care within these facilities are some of society’s most vulnerable members. In
light of recent scholarship documenting the decline of low-level, low-wage
jobs (Kalleberg, Reskin, & Hudson, 2000; Tilly, 1996a, 1996b), we have chosen
to further concentrate our examination of employment conditions on the
frontline providers of this care, nursing assistants.

LITERATURE REVIEW
FRONTLINE JOB QUALITY
The topic of job quality has captured sustained researcher and practitioner
interest given the documented relationship between “high performance” or
“high-commitment” human resource practices and better employee perfor-
mance, retention, and commitment (e.g., Batt, 1999; Huselid, 1995; Tsui,
Pearce, Porter, & Tripoli, 1997). With these terms, scholars refer to the array of
practices firms establish for rewarding and designing jobs as a strategy for
employee recruitment and retention. In contrast, organizations with little
investment in retaining all or part of their workforce may embed those jobs
in what has been termed a “spot” labor market, an approach to offering few
or no benefits, which typically corresponds to high worker turnover (Jacobs,
1994). In the service sector, where the worker–client interface is the primary
“product,” organizations may realize even greater gains from their human
resource investments. They also face greater risks from minimally supported,
low-quality jobs that may generate dissatisfied, poorly performing, and
fairly transient workers.
More recently, the topic of job quality has received attention for its apparent
decline in the United States, at the lower ends of the skill and wage spec-
trums in particular. Tilly (1996a, 1996b), Kalleberg et al. (2000), and Kalleberg
(2003) have documented a trend among U.S employers during the past
several decades of reducing the number and generosity of job benefits in
response to increasing global competition, rising health care costs, and resul-
tant pressures to control labor expenses. Technological advances have mag-
nified these impacts in certain capital-intensive sectors such as manufacturing,
which has seen the reduction or elimination of entire blocks of jobs. In the
labor-intensive service sector, where most nonprofit organizations operate,
cost-minimization strategies have struck even more bare the limited oppor-
tunities that have historically existed for workers occupying the lower ends
of the skill and wage spectrums (Kalleberg et al., 2000; Tilly, 1996a, 1996b).
Low-level workers remain particularly vulnerable to these vagaries of the
employment experience.
The disciplines of labor economics and organizational and occupational
sociology have provided leading accounts for why employers structure their
workplace benefits as they do, with some offering notably “higher commit-
ment” compensation than others. Several scholars have asserted that firms
are primarily motivated to invest in their human resources out of anticipated
gains to economic efficiency and market competitiveness (Pfeffer, 1995).
Others have shown that “legitimacy imperatives”—that is, firms’ tendency
to imitate their successful competitors as a way to succeed themselves—may
propel employers to adopt generous employment practices (DiMaggio &
Powell, 1991; Hunter, 2000; Scott, 1995).
Though this prior research has illuminated some of the forces behind and
impacts of job quality, the present article extends this work on job quality in
several important theoretical and methodological respects. First, we concep-

tualize and measure employment benefits in a multidimensional “bundle,”
in contrast to previous research that has tended to separately focus on single
compensation items (Althauser & Kalleberg, 1981; Bridges & Villemez, 1991;
Doeringer & Piore, 1985; Pfeffer & Cohen, 1984; Wholey, 1985). As illuminated
by the work of MacDuffie (1995) and Huselid (1995), we assert that research
to understand the causes and consequences of job quality requires attending to
the supports that work provides as a constellation rather than as stand-alone
benefits that may have variable relevance across employees. A below-average
salary, for example, may have less onerous implications for workers when
employers provide both employee and dependents health insurance. Yet,
low salary paired with few or no health benefits may prevent workers from
entering or staying in a given job.
From a methodological perspective, variation in the availability of employ-
ment benefits across firms is more likely to be captured when those benefits
are considered as a cluster. Along these lines, the compensation bundle we
devised for this study contains three items, each of which was measured to
maximize the amount of underlying variation captured. With respect to nursing
assistants’ access to health insurance, for example, we move beyond the more
standard, binary yes–no approach to incorporating the amount of employer
contribution to individual and dependent plan premiums. Because the majority
of U.S. firms (and all the organizations in our study) still provide at least full-
time employees with access to health insurance, differences in workers’ health
insurance are more likely to emerge at this point of benefit implementation
(Hoffman, Carbaugh, Moore, & Cook, 2005).
Our study, finally, represents a novel extension of scholarship on job quality
to the human services domain. Prior research in this area has investigated
employment conditions in firms across the service industries, including call
centers, banking, transportation, and housekeeping (Batt, 1999, 2002; Lambert
& Haley-Lock, 2004). The business of providing “caring labor” within nursing
homes, however, has numerous characteristics that are distinct from these
others (England, Budig, & Folbre, 2002). Consumers of service are often not
the sole payers, and they often experience limited options for and information
about those services. Human service providers, in turn, face chronic resource
scarcities, excess demand from clients whose needs for service are complex
and rapidly changing, and dependence on comparatively “soft” technology,
all of which make quantifying organizational outcomes difficult (Hasenfeld,
1983; Lipsky, 1980). These unique traits of social service agencies and the
work conducted within them may limit the generalizability of past job quality
research to these settings.
OWNERSHIP
Scholars have observed an increasing role of proprietary organizations in

diverse human services functions. As of 1998, government-owned facilities

represented 7% of all nursing homes in the United States, varying by state

from less than 1% to 38% (American Health Care Association, 1998). However,
Harrington and Carrillo (2000) found that for-profit ownership of nursing
homes in the United States had increased from 38% in 1990 to 65% in 1999
(as cited in Kitchener & Harrington, 2004). Surveying the entire range of
health care providers, Gray and Schlesinger (2002) also noted an expanding
dominance of for-profit firms, in both market share and absolute numbers,
in the period from 1982 to 1997. For-profits have begun to predominate in
several domains in which nonprofits prevailed as recently as 15 to 20 years
ago, including health maintenance organizations, home health care, dialysis
centers, and rehabilitation hospitals. Beyond the health care sector, proprietary
agencies are also the primary providers of residential treatment, group homes,
day care, recreation, and legal services (Salamon, 1999). Recent empirical
research has established that systematic differences exist between for-profit
and nonprofit nursing homes, with investor-owned homes appearing to supply
lower-quality care across multiple client outcomes (Chou, 2002; Hillmer,
Wodchis, Gill, Anderson, & Rochon, 2005; Kruzich, Clinton, & Kelber, 1992).
Ownership is an important structural factor to consider as an influence on
human services job quality because of its presumed relationship to organi-
zational goals and behavior. For-profit firms are primarily oriented to economic
efficiency, to maximizing profit for shareholders by minimizing expenses.
They have accordingly been shown to expend fewer resources on patient
care than public or nonprofit facilities (Hawes & Phillips, 1986; Nyman, 1988;
Nyman & Bricker, 1989). By contrast, public and nonprofit sector agencies
face a profit nondistribution constraint; some have found that this creates a
converse incentive for “budget maximizing” (Hansmann, 1980; Niskanen, 1971).
It is theoretically possible that nonprofit agencies attempt to capitalize on
the presumed altruism of their employees—in the form of the their willing-
ness to accept a salary penalty in exchange for contributing to a good cause or
for access to family-friendly working conditions. Labor economists refer to
this effect as the “compensating differential” for this type of work (England
et al., 2002). In either case, frontline wages and benefits should be no different, or
even worse, than those in for-profit settings. On the other hand, rent theories
suggest that nonprofits may apply savings from their unique tax-exempt
status toward more generous wages (DiMaggio & Anheier, 1990).
Nonprofit organizational operations are also shaped by ideological
missions that dictate, officially if not always operatively, what services will
be provided and how (Hasenfeld, 1983, 1992; Hyde, 1992). If such altruistic
operating philosophies are extended to the treatment of staff and residents,
then nonprofit workers’ employment benefits stand to be better than average.
This proposition appears to parallel results obtained by Roomkin and
Weisbrod (1999) and Ballou and Weisbrod (2003), who found that nonprofits
give executives more generous base compensation and minimal merit pay
than do for-profits, which make a greater share of wages contingent on firm
performance. Within nonprofits, in other words, employment supports are

ample and stable, offered without respect to subsequent performance; within

for-profit settings, by contrast, employees face greater uncertainty in wages
pending their attainment of organizational goals.
Without much illuminating the impetus behind their generous approaches
to compensation, empirical research has repeatedly documented that across
diverse job titles, public agencies provide compensation superior to that in
for-profit firms. The U.S. Congressional Budget Office (1998) found that the
federal employment system offers more benefits (e.g., paid vacation days
and disability insurance, retiree health insurance, and retirement plans), and
at a higher proportion of employee salary, than does the private sector
(including for-profit and nonprofit firms). Moore and Newman (1991) found
that Houston Metropolitan Transit Authority workers, including cleaners, bus
drivers, and mechanics, received total compensation (wages plus benefits)
that was 31% to 83% higher in value than did comparable private sector
workers. Miller’s (1996) investigation of state and local governments revealed
that jobs at the low end of the pay scale offered pay superior to their equiv-
alents in the private sector. Similarly, in nonprofits, Pitt-Catsouphes, Swanberg,
Bond, and Galinsky (2004) found that large nonprofit employers were more
likely to offer extended family leave and to contribute to part-time workers’
health insurance.
Within nursing homes, Serow et al. (1993) found in a study of 464 Florida
facilities that although mean starting salaries and annual raises for all levels of
nurse preparation (registered nurse, licensed practicing nurse, and nurse aide)
did not significantly differ across sectors, nonprofit and public employers
provided more generous benefits as a percentage of salary than their for-profit
equivalents (20%, 31%, and 16%, respectively). Taking these theoretical and
empirical accounts into consideration, we hypothesized,
Hypothesis 1: Public and nonprofit statuses will be positively associated

with the level of nursing assistant job benefits.
CHAIN AFFILIATION
A second increasingly prominent structural feature of human services

organizations, one common but not exclusive to the health care field, is
agency membership in a chain. Reflecting an organization’s scope (Luksetich
et al., 2000), chain facilities constitute a collection of similar organizations linked
together by an overseeing corporate organization; often the sole differentia-
tion among a chain’s components is geographical location (Baum, 1999). The
national trend from independent to chain-owned businesses has been
documented for the industries of hospitality, banking, food service, and
auto service (Greve & Baum, 2001). There is further evidence to suggest that
chain representation among health care organizations is also growing:
Between 1991 and 1999, the proportion of nursing homes belonging to a
multiunit chain organization increased from 41% to 60% (Hing, Sekscenski,

& Strahan, 1989; Jones, 2002). With respect to chain ownership, 76% of chain
facilities were proprietary as of 1999; unfortunately, public use data combine
nonprofit and governmental into one category, together accounting for the
other 24% (National Center for Health Statistics, 2007).
Like ownership, chain affiliation has theoretically ambiguous implications
for nursing assistant job quality. Agencies that are part of large-scale, multi-
institutional systems may offer superior nursing assistant jobs for at least two
reasons. They have access to more financial resources, a product of corporate
size and economies of scale, and more and possibly better information regarding
best practices for workforce management. Chains may also enjoy enhanced
processes of intrasystem knowledge transfer (Banaszak-Holl, Berta, Bowman,
Baum, & Mitchell, 2002; Baum & Ingram, 1998; Darr, Argote, & Epple, 1995;
Epple, Argote, & Murphy, 1996). Yet chain-affiliated firms’ orientations toward
standardization and efficiency may also conspire toward a minimalist approach
to employee compensation. Luksetich et al. (2000) found chain membership to
be associated with reduced spending on nursing care–related costs, including
nursing assistant compensation. They observed this effect even among
nonprofits, which the authors noted “behave more like for-profits”—by curtailing
employee benefits—when they belonged to chains (p. 276).
The suggestion has also been made that the lack of community context
further enhances profit motives among corporate chain owners while mini-
mizing collegiality and trust among staff (Banaszak-Holl, Berta, Baum, et al.,
2002; Light, 1986). Several scholars have, finally, found that administrators of
chain-affiliated institutions experience considerably less decision-making
autonomy as compared to their independent counterparts (Kruzich, 2005;
Singh & Schwab, 1998). Considered together, then, the relatively more entre-
preneurial, bureaucratic, and impersonal contexts in which chains operate
may diminish their use of strategies for maximizing organizational perfor-
mance through human capital investments.
Prior research on the relationships between chain status and a range of
other organizational performance indicators, as may be anticipated by the
previous discussion, has been equivocal. Chain nursing care facilities have
been reported to exhibit higher rates of resident hospitalization (Zimmerman,
Gruber-Baldini, Hebel, Sloane, & Magaziner, 2002), lower resident satisfaction
(Harrington et al., 2001; Kruzich et al., 1992), and higher deficiency rates
according to state regulatory standards (Anderson, Weeks, Hobbs, & Webb,
2003; Banaszak-Holl, Berta, Baum, et al., 2002). Chain-owned nursing homes
also serve a smaller proportion of high-need residents, as defined by those who
are incontinent or taking antipsychotic medications. For-profit chain facilities
also show higher levels of pressure ulcers among residents compared to inde-
pendent for-profits and nonprofits (Banaszak-Holl, Berta, Baum, et al., 2002).
One employee-related focus of research on the effects of chain status has been
staff turnover. Consistent with the predominantly negative correspondence
between chain status and client care, chains have been shown to have higher
turnover rates than independent facilities among both nursing home aides

(Castle, 2005) and administrators (Angelelli, Gifford, Shah, & Mor, 2001; Castle,
2001; C. Christensen & Beaver, 1996). They also exhibit lower staffing levels
(Banaszak-Holl, Berta, Baum, et al., 2002). Given the preponderance of negative
impacts of chain affiliation on clients and workers, we hypothesized,
Hypothesis 2: Chain affiliation will be negatively related to the level of

nursing assistant job benefits.
MANAGEMENT PROFESSIONALIZATION
Administrative and other staff professionalization has long been a subject of

academic and practical interest. Within the human services field particularly,
those trying to account for a “workforce crisis” among public child welfare
workers have proposed that insufficient professional training hampers both
employee effectiveness and satisfaction and reduces tenure (A. J. Ellett, 2004;
C. D. Ellett et al., 2004). Primarily concentrating on frontline workers, these
studies have generated prescriptions for increased professionalization in the
form of advanced degree completion in such fields as social work, human
services, public affairs, and management to better equip the workforce to
manage the demands of human services employment. Scholarship on how
professional leadership shapes nonprofessional human service job conditions
appears more limited, however.
The literature on professionalization has tended to define the concept along
two central dimensions: acquisition of technical knowledge, or “rationality,”
and obedience to a set of norms held by one’s profession that are distinct
from the mission or objectives of a given organizational employer (Schon,
1983; Wilensky, 1964). With his notion of the “reflective practitioner,” Schon
(1983, p. 21) also notes that professionals distinguish themselves by bringing
to their positions a set of distinct “instrumental problem solving” skills. Hiring
a professional, then, establishes a social contract in which the employer
trades the candidate’s expertise and values for task autonomy and decision-
making control in the hope of promoting competence, innovation, and altruism
(Cruess, Cruess, & Johnston, 2000; Kultgen, 1988; Wilensky, 1964). Though
organizations may attempt to influence or else ignore them, professional norms
have been recognized as a central force for organizational transformation
(DiMaggio & Powell, 1983).
Neoinstitutional theory (DiMaggio & Powell, 1991; Scott, 1995) suggests
that professionalization should influence leader behavior, and by translation
organizational practice, in several respects. The professions deliver values of
practice to their members through the course of advanced training, then
monitor compliance to these values through postgraduation requirements
for licensing or other credentialing and group affiliation. Professionals in
violation of field norms risk their own, and their agencies’, reputation among
funders, agency peers, and even clients, in addition to fellow professionals.
Along these lines, Wilensky (1964) observed years ago that a well-developed

norm across professionalized fields is that of “‘[doing] what you can to maintain
professional standards of work’” (p. 141). In his study of nursing assistants,
Hunter (2000) found that professional administrators who retained active
ties to their fields provided higher-quality entry-level jobs.
In addition to imposing a set of social expectations for organizational
practice, professional leadership is likely to have access to a wider range of
information about management practices through an extended network and
expertise in applying it. Following this work, we predicted,
Hypothesis 3: Professionalized leadership will be positively related to the

level of nursing assistant job benefits.
THE INTERACTION OF ORGANIZATIONAL

PROFESSIONALIZATION AND OWNERSHIP
Our review of the literature also suggested that a nonlinear relationship

may exist between professional leadership and job quality, conditioned by
firm ownership (DiMaggio & Anheier, 1990; Majone, 1984; Weisbrod, 1988).
This prior work suggests a level of convergence between the nonprofit
sector and the professions in both values and goals. That is, professionally
trained administrators may disproportionately gravitate toward these
settings as a way of implementing their commitment to advancing their
adopted service ethic; the profit nondistribution constraint serves as a key
institutional support for enacting this preference for work that may not be
profit generating. Nonprofit settings have also been found to grant profes-
sionals greater autonomy and influence than their counterparts in other sectors
(e.g., Kruzich, 2005). This organizational characteristic represents a potential,
though to date unstudied, mechanism by which professional nonprofit
administrators who are so inclined may be better able to create high-quality
entry-level jobs.
We therefore elected to investigate the potential interactive effect on job
quality of an organization’s ownership (nonprofit) status and professional
leadership. We anticipated that the coincidence of both structural features
within a facility would have a direct and positive effect on job quality.
Hypothesis 4: Professionalized leadership in nonprofit facilities specifically

will be positively related to the level of nursing assistant job benefits.
METHOD
SAMPLE
The sampling strategy devised for the study for which these data were orig-
inally collected was intended to capture the diversity of organizational forms
that exist in nursing homes. Consequently, geographic location, ownership,
chain affiliation, and bed size were taken into account. A stratified quota
sampling strategy was applied to the sampling frame of 231 facilities licensed
for skilled care, with 50 or more beds, located within a 100-mile radius of a
major Wisconsin metropolitan area at the time the data were gathered in
1988-1989. (The criteria of skilled nursing care license status and minimum
number of beds were used to establish the frame in light of the definitional
ambiguities around use of the term nursing home.) The Wisconsin State
Bureau of Quality Compliance was used to identify the sampling frame
through their provision of information on the names, addresses, numbers of
licensed beds, percentages of resident care funded by three reimbursement
sources (Medicaid, Medicare, and privately paying), proportions of residents
receiving skilled and intermediate levels of care, and ownerships and chain
affiliation statuses for all facilities located in counties within this geographic
area.
Administrators and their staff were recruited for participation at nursing
home trade association meetings and announcements about the study
inserted in agency newsletters. To supplement administrators who agreed to
participate through these strategies, additional nursing homes were personally
contacted until the desired goal was reached of 24 nonprofit (46% of which
were church affiliated), 24 for-profit, and 6 government facilities of varying sizes
and chain statuses. Of the administrators approached, 54 agreed to participate,
representing a 69% response rate. Two facilities were subsequently removed
from analyses because of the incompleteness of survey information provided
by their administrators.
Statistical comparisons of respondents and nonrespondents found no
significant differences in ownership or chain affiliation between participating
and nonparticipating facilities and the remaining facilities in the sample frame.
Because only 14% of Wisconsin’s nursing homes in 1988-1989 were govern-
mentally owned, our decision to sample facilities within a 100-mile radius
further resulted in a relatively small sample of six governmental facilities.
The lack of significant variation by ownership or chain affiliation among
participating and nonparticipating facilities was heartening; however, it is
possible that organizational and administrator attributes we did not account
for in this comparison would have revealed differences among the groups.
INSTRUMENTS AND MEASURES
In each home in the sample, the head administrator completed a confi-

dential survey containing questions about his or her personal demographic
characteristics and job history; the facility’s human resources and other
administrative policies and practices generally and with respect to several
specific job titles; and a range of workforce statistics, including turnover and
unionization rates.

Table 1. Nursing Assistant Job Quality “Bundle”
Item M SD Min Max
Hourly salary (Mdn $) 5.40 0.56 4.30 6.57

Facility contribution to individual health plan (%) 70.12 21.61 21.00 100.00
Facility contribution to family health plan (%) 53.73 27.15 0.00 100.00
Bundle of 3 items (additive, nonstandardized) 129.25 42.72 33.83 206.57
Dependent variable. We measured job quality with an index of three items: the
median hourly salary for nursing assistants and the percentage that facilities paid
toward nursing assistants’ personal and family health insurance premiums.1
Descriptive data on the bundle measure appear in Table 1. We employed
principal components analysis to transform the items into a factor score
appropriate for linear regression. This index reflects a measurement model
theorizing that “formative,” or causal, item components determine the latent
variable of job quality (Bollen & Lennox, 1991). In this conceptualization, an
increase in one indicator should result in an increase in the latent variable,
but we would not assume that an increase in the latent variable of job quality
would necessarily lead to concurrent elevations in all of the indicators. For
example, an increase in an employer’s rate of coverage of worker health
insurance plan costs would not necessarily be accompanied by a raise in
wages.2 Given this causal order, we had no expectations of unidimensionality
or high interitem correlation.
Independent variables. We measured facility ownership with two dichotomous

variables, one for public sector facilities and another for nonprofits. Chain
affiliation was coded as 1 for facilities that were part of multi-institutional
systems.
Management professionalization was measured with a dichotomous
variable indicating an administrator’s completion of a master’s degree. This
operationalization of a complex concept is admittedly limited, given that it
does not tease out potentially distinct effects by field type nor capture an
effect from continuing professional affiliation beyond the administrator’s
initial period of professional training. We did not have access to continuing
affiliation information, and the small organizational sample size constrained
our statistical ability to segregate out relationships to job quality by graduate
program type (four administrators also did not provide their program focus).
With this variable, then, we capture the potential impacts of advanced
analytical skills and presumptive identification with a field external to the leader’s
employing organization. As noted earlier, we also introduced an interaction
term for a firm’s nonprofit status and administrator’s advanced degree receipt.
Control variables. We controlled for several additional organizational charac-

teristics that we anticipated would be related both to our structural independent
variables and the quality of nursing assistant jobs. Facility size has been
linked to the level of development of a firm’s human resource functions and

internal labor markets (e.g., Barsky, 2004; Burke & Morton, 1990). It was
operationalized as the number of beds for which the facility is licensed, then
transformed by taking its natural log to normalize its distribution (Kennedy,
1998). We also expected—per Barsky (2004) and Hunter (2000)—that nursing
assistant jobs represented by a union would offer better benefits access as a
product of collective bargaining agreements, and we measured this effect
with a dichotomous variable. The proportion of skilled nursing beds,
defined as those whose occupants receive around-the-clock services provided
by a registered nurse or licensed practicing nurse, was controlled for given
the possibility that demands for more, and more professionalized, care may
reduce a facility’s prioritization of the entry-level nursing assistant role;
alternately, the provision of high levels of skilled care may correspond with
superior frontline jobs as a product of what Hunter (2000) found to be a facility’s
“customer differentiation” strategy. Percentage of residents covered by
Medicaid was controlled for given our expectation that having high propor-
tions of residents whose care is reimbursed at below-market rates would
depress spending on employee compensation. Such facilities may also be
less likely to pursue “high-commitment” human resource strategies as a
product of serving indigent clients facing constricted consumer choice. And
facility occupancy rate and size of wait list, both calculated as a proportion of
licensed beds, were controlled for as measures of competitive market position,
following Phillips’s (2001) finding that organizations’ market success has a
negative relationship to their employees’ structural advancement because
such success enhances firms’ labor bargaining position. These two measures
have been commonly used by the nursing home industry to capture facility
performance (Kostelni, 2003).
The bivariate correlations for all of the independent variables are reported in
Table 2. Based on our examination of these correlations and variance inflation
factor and tolerance scores used for diagnosing multicollinearity, we ran
additional versions of these analyses in which we omitted the interaction of
nonprofit status and professional leadership. Because the size, direction, and
standard errors of the coefficients remained relatively stable across the two
versions, and because the base variables and interaction term all achieved
significance within the fuller model, we felt that this model was more reflective
of underlying relationships among the variables.
RESULTS
Table 3 summarizes descriptive data for the independent variables for the
organizational sample generally and by ownership status in more detail. A
notable distinction among the homes by ownership is the variation in resi-
dent composition by economic and medical need status. A significantly
lower percentage of residents in nonprofit homes than in their public and

Table 2. Pearson Correlation Coefficients for Independent Variables
1 2 3 4 5 6 7 8 9 10 11
Control variables
1. Facility size 1
2. Skilled nursing beds –.094 1
3. Medicaid residents .121 .159 1
4. Unionized nursing .122 –.163 .270 1
assistants
5. Occupancy rate .144 .198 –.113 .019 1
6. Waiting list –.205 –.106 –.460** –.215 .047 1
Explanatory variables
7. Nonprofit facility .189 –.074 –.464** –.214 .315* .350* 1
8. Public facility –.088 –.296* .205 .188 –.407** –.139 –.334* 1
9. Chain affiliation .100 .220 .171 .031 .019 –.306* –.290* –.297* 1
10. Professional leadership .196 –.131 –.150 .007 .128 –.061 .456** –.066 –.150 1
11. Interaction, Nonprofit × .212 –.020 –.364** –.123 .276* .050 .720** –.241 –.209 .778** 1
Professional Leadership
*Correlation significant at the .05 level (two-tailed). **Correlation is significant at the .01 level (two-tailed).
for-profit counterparts were Medicaid funded (48% vs. 70% and 66%, respec-
tively). Not surprisingly, then, nonprofits also had a significantly higher pro-
portion of privately paying residents. This finding echoes results of
Banaszak-Holl, Berta, Baum, et al. (2002) and Hirth (1999), which revealed a
preference by higher-income residents for obtaining care in nonprofit set-
tings. The significantly lower occupancy rates and smaller waiting lists in
public settings in this sample further suggest that clients with choice facili-
tated by economic means pursue care in other, disproportionately nonprofit,
facilities. The proportion of residents requiring skilled nursing care also dif-
fered across sectors and was highest in for-profits and nonprofits (72% and
67%, respectively, vs. 58% in public institutions; Table 3).
Chain affiliation appears to be a strongly for-profit characteristic in this
sample, encompassing 68% of such facilities versus just one fourth of nonprofits
and no public homes. Professional leadership is concentrated in nonprofits,
with 67% of administrators in these settings bearing advanced degrees but
only 33% and 18% in public and for-profit homes, respectively (Table 3).
As summarized in Table 4, our examination of the types of master’s
degrees administrators reported having did not reveal any notable patterns
in educational focus, though our modest sample size likely limited our abil-
ity to detect such patterns. Directors reported having graduate degrees in
such fields as social work, psychology and counseling, and health adminis-
tration, most relevantly, and theology and journalism (Table 4). As noted, 4
of the 22 graduate degree holders did not report a field.
Table 5 presents results for a two-stage ordinary least squares regression
analysis. The first model contains the control variables, achieving an adjusted
R2 of .108 and an F score of 1.993. After adding the explanatory variables, the
R2 for the second model jumped to .687. We report statistical significance

Table 3. Descriptive Data for Nursing Facility Sample
Publica Nonprofitb For Profitb
Item M SD Min Max M SD M SD M SD
Control variables
Facility size (beds) 159.25 83.82 44 415 138.00 74.19 177.63 92.98 145.00 74.52
Skilled nursing beds∗∗ 67.97% 12.92 38.89 89.66 57.60 13.97 66.97 13.70 72.09 10.07
Medicaid residents∗∗ 58.23% 20.68 1 99 69.83 9.83 47.96 17.39 66.27 21.40
Occupancy rate∗∗ 96.66% 5.06 71.00 100.00 91.01 10.67 98.36 2.51 96.34 3.96
Waiting list∗∗ 16.79% 32.57 0.00 170.45 4.47 6.93 28.77 43.65 6.62 11.07
Unionized nursing 26.92% — 0 1 50.00 — 16.67 — 31.82 —
assistants
Explanatory variables
Chain affiliation† † 40.38% — 0 1 0.00 — 25.00 — 68.20 —
Professional leadership† † 42.31% — 0 1 33.30 — 66.70 — 18.20 —
Note: N = 52.
a. n = 6.
b. n = 24.
∗∗Difference in means is significant at the .05 level (one-way ANOVA test).
††
Difference in means is significant at the .05 level (Chi-square test).
Table 4. Distribution of Professional Training
Program of Graduate Study Cases
Health administration 6
Not listed 4
Master’s of social work 2
Theology 3
Master’s of business administration 1
Management 1
Psychology 1
Law (juris doctor) 1
Education 1
Counseling 1
Journalism 1
Note: N = 22.
here to the p ≤ .10 level, marginal by traditional statistical standards, to inform

future research in this area. Subsequent studies seeking to replicate these
results with larger institutional samples may obtain more decisive significance.
OWNERSHIP
Consistent with our first hypothesis, both nonprofit and public sector long-
term care facilities provide nursing assistant jobs with more generous benefits
than do those found in for-profit institutions (Table 5). The public sector
coefficient is larger by a notable magnitude (2.740 vs. 0.547 for nonprofits) and
achieves significance with a narrower confidence interval (p = .000).
Table 5. Summary of Ordinary Least Squares Regression Results for

Nursing Assistant Job Quality
Job Quality, Job Quality,

Basic Model Predictors Added
Independent Variable Coeff. SE Coeff. SE
Controls
Facility size 0.381 0.261 0.278* 0.166
Skilled nursing beds –0.031*** 0.011 –0.021*** 0.007
Medicaid residents 0.007 0.008 0.012** 0.005
Unionized nursing assistants –0.210 0.326 –0.213 0.198
Occupancy rate 0.013 0.028 0.050** 0.018
Waiting list 0.004 0.005 0.006* 0.003
Predictors
Nonprofit facility 0.547* 0.282
Public facility 2.740*** 0.325
Chain affiliation 0.377* 0.198
Professionalized leadership –1.074*** 0.304
Interaction, Nonprofit × 1.294*** 0.411
Professional Leadership
F 1.993 10.791
Adjusted R2 0.108 0.687
Note: N = 52. Coefficients are not standardized.

*p ≤ .10. **p ≤ .05. ***p ≤ .01.
CHAIN AFFILIATION
Contrary to our second hypothesis, predicting a negative association

between chain affiliation and job quality, multi-institutional facilities exhib-
ited nursing assistant jobs superior to those offered in independent homes
(though only marginally significant at p < .10; Table 5).
PROFESSIONAL LEADERSHIP
Our third hypothesis, anticipating a positive association between profes-

sionalized leadership and nursing assistant job quality, yielded unexpected
results. Across for-profit, nonprofit, and public facilities, those headed by
administrators with master’s degrees had significantly lower-quality frontline
jobs than did their counterparts with less credentialed leadership. The
interaction of professionalization with nonprofit status, however, indicated
that this effect notably reverses within nonprofit settings, where some of the
highest-quality jobs in this sample were found (Table 5). Nursing assistant
employment benefits appear to be best in professionally led, nonprofit facilities.
Among the control variables, several findings are worthy of note. As we
anticipated, and as prior studies across diverse industries have found, the size
of a facility was positively associated with the level of employment benefits it

provides (Table 5). The proportion of skilled nursing beds was negatively
related to job quality, as anticipated. Considering nonprofits’ dominance
within this sample as the provider of care to medically needy residents and
their status as providers of disproportionately high-quality nursing assistant
jobs, facilities in this sector are apparently successful in compensating for the
negative impacts of skilled care on entry-level job benefits. Proportion of
Medicaid residents, however, was positively, albeit modestly, associated
with level of nursing assistant job benefits, as were occupancy rate and wait list
size. The latter is contrary to Phillips’s (2001) finding of a “promotion paradox,”
or an inverse relationship between an employer’s performance and provision
of employee advancement opportunities. Finally, unionization of nursing assis-
tants was not found to be correlated with job quality in this sample.
DISCUSSION
Previous research has documented the links between for-profit status and
chain affiliation and lower quality of care to clients. The contribution of the
present study to that prior body of scholarship, and to the public and non-
profit management literatures, is its novel attention to relationships between
organizational form and a different type of quality: the benefits provided to
entry-level workers in these care settings. Several of our results are consistent
with theoretically and empirically driven expectations that the cost-minimizing
and profit-maximizing orientations of for-profits should align with lower-quality
frontline nursing assistant jobs. We extended this insight by considering
potential distinctions between the public and nonprofit sectors, identifying a
substantially larger, positive relationship between public ownership and
nursing assistant employment benefits.
Several of our findings were not anticipated, however. The positive, if
marginally significant, coefficient we obtained for chain affiliation—suggesting
that nursing assistant jobs in multi-institutional settings are better compensated
than are those in independent facilities—runs counter to Hunter’s (2000)
results. This finding would also seem to diverge from the set of scholarship
that has documented disproportionately negative quality of resident care
and outcomes in chain-affiliated facilities. As noted earlier, the greater
resources and economies of scale available to chain homes may enable more
generous benefits provision, for example their ability as larger institutional
entities to negotiate more competitive employee health plans with insurance
companies. Whether the greater expenditure on human resources by chains
in this sample should be interpreted as institutional inefficiency or instead as
intentional commitment to low-wage employment requires further empirical
examination.
We also uncovered an interesting set of relationships between profes-
sional leadership and the level of benefits provided to nursing assistants in
this sample. Net of other structural factors, facilities whose administrators

reported having a graduate degree exhibited entry-level jobs with inferior

levels of employment benefits. This surprised us, as it contradicts considerable
neoinstitutional literature asserting the role of the professions in creating
imperatives for organizational “best practices.” Were we to conduct equivalent
analyses on job benefits offered to registered nurses—or other professional
staff—we might obtain findings that uphold the neoinstitutional argument.
(We unfortunately do not have data on benefits for those position titles.) Within
this organizational sample, then, taken-for-granted codes of professional
conduct appear to not extend to low-level, low-wage jobs.
The combination of professionalized leadership and nonprofit status,
however, did yield the positive relationship to job quality that theory would
predict. The professional credential appears to make little difference to nursing
assistant benefits as long as the facility is nonprofit; the quality of jobs over-
seen by graduate-degreed and nondegreed administrators within nonprofit
organizations was comparable. It was administrators with master’s degrees
working in public and for-profit facilities, on the other hand, who were linked
to notably inferior entry-level benefits.
Nonprofit ownership, then, appears to be associated with generous nursing
assistant benefits irrespective of leadership credentials, whereas professional
leadership outside of the nonprofit context functions in the reverse.
Administrators of nonprofit facilities may represent a unique group that sorts
into positions permitted the freedom and resources to implement “higher-
commitment” approaches toward personnel management. As we noted earlier,
our data limited the manner with which we could construct this measure,
resulting in a professional leadership variable that prioritizes the effect of
advanced education, namely its theorized provision of technical knowledge
and service values, without incorporating field-specific distinctions.
Our findings do partially parallel those Hunter (2000) obtained by using
a field-specific professional affiliation variable (the coefficient for our inter-
action term aligns with his direct effect for professional leadership). Together,
these suggest that multiple facets of administrator professionalization are
likely to correspond with frontline job quality: for example, the presence of
technical or strategic knowledge for creating such positions, professional
values and identification, autonomy to operationalize knowledge or values,
or some combination thereof. In separate analyses of these data, Kruzich
(2005) found that leaders of nonprofit nursing homes, where many profes-
sional administrators work, did experience greater autonomy over employee
management than did their public and for-profit counterparts. However, we
found no significant differences in administrators’ autonomy by education
level. It would be helpful to understand more about the nature of the mech-
anism driving the relationship between nonprofit professionalization and
better frontline jobs.
The relevance and generalizability of the findings reported here are more
broadly limited in several respects. Our sample size of 52 total and just 6
public facilities within a single state may restrict how generally our results

can be applied to other nursing homes. On the other hand, ensuring that all
facilities in the sample fell within a 100-mile radius provided a control for the
influence of variations in local market conditions on our findings. The age of
the data also place into potential question how reflective our results are of the
current roles of ownership, chain affiliation, and leadership professionaliza-
tion on the outcome of employment benefits in the rapidly changing domain
of health care. Because there have been no other published studies or national
or state data sets that have included the individual- and organizational-level
variables found in the present analyses, there is no way to know. There has
been no national policy in the past two decades that directly influences nurs-
ing assistants’ compensation levels. Federal government efforts have
included several demonstration projects to make health insurance coverage
available to direct care workers, and state efforts have included offering
higher Medicaid reimbursements designated for wages or benefits (wage or
benefit “pass-throughs”; Wright, 2005). However, Yamada’s (2002) study
comparing nursing aide salaries from 1987 to 1989 and 1997 to 1999 found
that, in real dollars, nursing home aides’ median hourly wage had decreased
from $7.29 to $7.00 per hour. She further found no increase in the proportion
of aides with access to employer-provided health insurance and in fact a lower
rate of employer contribution toward insurance premiums in the late 1990s
compared to the decade before. These trends suggest that frontline job quality
in the nursing industry has not significantly changed in the aggregate.
If our results are suggestive, then documentation by scholars of the growing
trends toward privatization of nursing homes and other human services, and
what has alternately been identified as increasing commercialization, marketi-
zation, and entrepreneurialism of nonprofit and public agencies (Eikenberry &
Kluver, 2004; Singh, 2002; Weisbrod, 1998), may be ominous for the quality of
some entry-level service jobs. Yet expansion in the forms of facility size and
scope (chain affiliation) may bode well for the access of frontline workers to
employment benefits.
CONCLUSION
These findings raise additional theoretical and policy questions about the
relationships between how services are delivered (staff compensation or job
quality) and to whom they are delivered (resident composition, arguably one
dimension of care quality for human services institutions). In this sample,
for-profit facilities offered the least generous entry-level compensation, but
they also appeared to serve financially and physically vulnerable residents
in the highest proportions. Public and nonprofit homes, by contrast, seemed
to balance their provision of service and job quality more evenly, though
differently. The public settings in the study offered the most generous entry-level
compensation while serving predominantly poor residents, but the lowest
proportion of those with high medical need. Nonprofits offered good jobs

and disproportionate amounts of skilled care, but to a far lower proportion

of indigent clients.
Previous empirical work linking service and job quality is scant, however.
As England and Folbre (2001) observed, public and nonprofit firms have
been most frequently studied for their role in remedying inequalities in
access to and quality of services caused by self-interest–based market processes.
Rarely have scholars considered the roles of nonprofits in equalizing access
to quality employment. Another area deserving further attention is potential
variation between nonprofit facilities that are church affiliated and those that
are secular. Our sample size did not allow such comparisons in our final
analyses, and we observed no significant differences of means between non-
profit secular and religiously affiliated homes on the three variables that
composed our compensation bundle. Knox, Blankmeyer, and Stutzman
(2006), however, uncovered significant efficiency differences among these
two types; future research on larger institutional samples may also reveal
divergent practices.
Fewer studies still have examined the extent to which job and service
quality are treated as trade-offs (clients lose when employees win, or vice
versa) or complementarities (win–win). In an environment that appears to be
increasingly pushing for adoption of market-oriented values and practices
(Eikenberry & Kluver, 2004; Singh, 2002), balancing the provision of good
care to clients and “caring” work to employees would seem an unavoidable
challenge confronting public and nonprofit sector employers and employment
policy makers. Future scholarship might then fruitfully probe the nature of
this interplay toward identifying more deliberative and effective approaches
to its management at both organizational and policy-making levels.
Job quality encompasses more than wages and health care coverage, of
course (just as service quality includes far more than merely what clients an
organization serves). Its potential value as a management tool also extends
beyond stabilizing workforce tenure and performance, though the implications
of such gains for service quality and continuity are significant. Organizational
strategies for designing and rewarding jobs also shape individuals’ capacities
to balance the demands of work, family, and community. Inadequate employee
compensation benefits can impose very tangible costs on communities, as
increasing numbers of workers uninsured by employers for their health care
costs apply for public programs such as Medicaid. Health Care for Health
Care Workers (2006) reported, for example, that just 48% of nursing home
aides versus 66% of all Americans younger than 65 have access to health
insurance through their employers. For-profit corporations in other indus-
tries have weathered considerable recent scrutiny for such entrepreneurial
behaviors that, although asserted as fulfilling the business imperatives of
serving shareholders and customers, maximize profits at dire costs to workers
(Abelson, 2004; Regopoulos & Trude, 2004). Further research investigating
how human services job quality interacts with the domains of family and
community would also go far to illuminate the difficulties facing many
human service organizations with recruiting and retaining dedicated staff.
Notes
1. These data do not reflect actual employee take-up of the insurance benefits, information that
would reveal job quality “in use” as opposed to “on paper.” Yet we feel, as do many scholars, that
employer provision of high-cost benefits such as health insurance has notable symbolic, and often
quite literal, value as a job quality indicator.
2. We did, nonetheless, conduct a principal components analysis, which yielded a single factor
accounting for 61.02% of the variance with factor loadings from 0.715 to 0.861. A reliability analysis
produced a Cronbach’s alpha of .51.
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Anna Haley-Lock is an assistant professor at the University of Washington School of Social Work. Her research
is in human resource management, focusing on the relationship of job compensation and design to workforce
stability, diversity, and performance, and employee work–life balance, in nonprofit and for-profit settings.
Jean Kruzich is an associate professor at the University of Washington School of Social Work. Her
research focuses on the influence of organizational structures and processes on service providers and
client outcomes. Some of her projects utilize consumer and provider perspectives to inform the develop-
ment of human service practice interventions.

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Nonprofit and Voluntary Sector

Serving Workers in the Human Services: The Roles of Organizational

The online version of this article can be found at:

Association for Research on Nonprofit Organizations and Voluntary Action

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Citations (this article cites 78 articles hosted on the

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Keywords: employment compensation; frontline workers; organizational ownership;

A growing body of research has examined the relationships between organi-

associated with enhanced worker retention, job performance and satisfaction,

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Woolhandler, Mullan, Carrillo, & Himmelstein, 2001). In the analyses presented

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FRONTLINE JOB QUALITY

several important theoretical and methodological respects. First, we concep-

Scholars have observed an increasing role of proprietary organizations in

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represented 7% of all nursing homes in the United States, varying by state

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ample and stable, offered without respect to subsequent performance; within

Hypothesis 1: Public and nonprofit statuses will be positively associated

A second increasingly prominent structural feature of human services

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Hypothesis 2: Chain affiliation will be negatively related to the level of

Administrative and other staff professionalization has long been a subject of

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Hypothesis 3: Professionalized leadership will be positively related to the

THE INTERACTION OF ORGANIZATIONAL

Our review of the literature also suggested that a nonlinear relationship

Hypothesis 4: Professionalized leadership in nonprofit facilities specifically

INSTRUMENTS AND MEASURES

In each home in the sample, the head administrator completed a confi-

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Table 1. Nursing Assistant Job Quality “Bundle”

Item M SD Min Max

Hourly salary (Mdn $) 5.40 0.56 4.30 6.57

Independent variables. We measured facility ownership with two dichotomous

Control variables. We controlled for several additional organizational charac-

linked to the level of development of a firm’s human resource functions and

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Table 2. Pearson Correlation Coefficients for Independent Variables

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Table 3. Descriptive Data for Nursing Facility Sample

Publica Nonprofitb For Profitb

Item M SD Min Max M SD M SD M SD

Table 4. Distribution of Professional Training

Program of Graduate Study Cases

here to the p ≤ .10 level, marginal by traditional statistical standards, to inform

Table 5. Summary of Ordinary Least Squares Regression Results for

Job Quality, Job Quality,

Independent Variable Coeff. SE Coeff. SE

Note: N = 52. Coefficients are not standardized.

Contrary to our second hypothesis, predicting a negative association

Our third hypothesis, anticipating a positive association between profes-

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reported having a graduate degree exhibited entry-level jobs with inferior

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and disproportionate amounts of skilled care, but to a far lower proportion

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