Research indicates that faith-based organizations (FBOs) have become more active in community economic development (CED) initiatives and many of their activities are often limited to certain types of congregations in specific areas and under certain conditions, typified by those that are theologically liberal, have supportive pastoral leadership, and are largely African American.   Little if anything is known about faith-based nursing homes in general, and African American (church-sponsored) nursing homes in particular.  Using Vidal’s (2001) typology of FBOs, which characterized four broad advantages and four broad disadvantages, two questions are explored:  (1) What distinctive advantages can faith-based nursing homes bring to CED for racial/ethnic populations? (2) What are the disadvantages faced by those who wish to engage in this endeavor? This case study describes the experiences of three distinctive types of faith-based nursing homes located in Ohio and New York: an urban African American facility with links to the religious community, a rural church-sponsored facility, and an urban African American church-sponsored facility.  This study is based on qualitative analysis of data and information gathered through semi-structured interviews with board members, staff and volunteers, private and public documents, and related research literature. We examined the resources leveraged by faith-based nursing homes engaged in CED activities.  We found that the quality-of-life in faith-based nursing homes is affected most by the local socio-cultural climate of the residents.  The findings also show that the advantages may outweigh the disadvantages of FBOs operating nursing homes.  That is, the advantages noted by Vidal (2001) assisted faith-based nursing homes with sustaining their missions through CED activities such as providing culturally competent care to residents and hiring of community members.

The Nursing Home Reform Act (NHRA) was adopted and implemented to improve the quality of care that residents receive in nursing homes by having state inspection agencies issue deficiencies for substandard care. Some studies have indicated that there has been a decrease in chemical and physical restraint usage after the implementation of the NHRA, as well as an overall decrease in the percentage of facilities being cited for not complying with the NHRA over the period 1991 through 1997. However, there has been an increase in the prevalence of malnutrition and pressure sores and there is a great deal of variation in the average number of deficiencies cited by state inspectors. The goals of this study are twofold: 1) to identify the impact of political factors on the variation in deficiencies and nursing home compliance, and 2) to provide the Health Care Financing Administration (HCFA) with a strategic planning model that will help to improve its ability to oversee state implementation of the NHRA. This is one of the first quantitative studies that explains some of the variance in inspection agencies citing deficiencies and nursing homes complying with the NHRA from 1995 through 1999. The research design included cross-sectional and longitudinal components. Regression analyses were performed on state-level panel data. The results indicated that political factors influenced both nursing home compliance with the NHRA and inspection agencies citing deficiencies. Political party control of the governorship and legislative houses accounted for significant amounts of variance in deficiency citations. These results are discussed in terms of how HCFA’s limited resources can be strategically allocated to identify states that may be at a higher risk for ineffectively implementing the NHRA.

Research has also shown that there is a growing increase in the percentage of Caucasians and minorities that are residing in nursing homes.  Growth in the utilization of nursing home services among minority and Caucasian populations create challenges for the industry.  One of the challenges that the nursing home industry will encounter is the provision of culturally sensitive to its growing diverse population. This study will explore how three nursing homes attempt to provide culturally sensitive care to its residents.  Semi-structured Interviews were conducted with nursing home board members, administration, and staff.  The results indicate that the resident’s quality of life is improved when they receive culturally sensitive care.

Home care is rapidly becoming a means for reducing premature nursing home placement and for reducing federal and state spending on nursing home care.  One of the primary goals of supportive homecare services is to enhance individual independence and autonomy.  As federal- and state-level policymakers adopt laws that expand the provision of home care services, scholars argue that satisfaction with these services and stabilized functional status must be recognized as an important outcome.  This is one of the first studies to examine the impact that homemaker/homehealth aide services has on clients’ functional status. The major research questions to be addressed are: 1) Are elderly clients  satisfied with the homemaker services provided by a nonprofit agency? 2) Is the health status of homemaker services clients stabilized after the provision of services? and 3) Does the provision of homemaker/homehealth aide services reduce premature nursing home placement?  This case study is based on both quantitative and qualitative analysis.  Surveys were administered to clients of a nonprofit homemaker/homehealth aide program in the city of Akron, Ohio.  Open- and closed-ended questions were posed to 103 clients. We posit that the elderly clients are satisfied with homemaker/homehealth aide services provided by the home health agency.  More importantly, we found that some clients’ functional status were stabilized after the provision of services.  The study’s findings show that the provision of homemaker/homehealth aide services stabilizes some clients’ functional status and the clients are satisfied with the services they receive. 

This study examines how the lobbying techniques that various interest groups and key stakeholders employed influenced the passage of the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA).  The major research question to be addressed is:  How did the lobbying activities of various interest groups and key stakeholders influence the passage of the TWWIIA?  This case study is based on the qualitative analysis of data and information obtained from witness prepared statements presented before the House Committee on Ways and Means, Subcommittee on Social Security between 1997 and March 1999, public documents, and relevant research literature.   We argue that interest groups achieve influence through the acquisition and strategic transmission of information needed to make public policy.  More specifically, we show that the information that interest groups and key stakeholders provided to Congress facilitated the practice of informing policy.  The study’s findings show that interest groups and key stakeholders acquisition and strategic dissemination of information can influence the enactment of policies that meet the needs of the public.  Wright, J. R. (1996). Interest groups and Congress: Lobbying, contributions, and influence.