Abstract
A key component of culture change is staffing empowerment supported by nursing home management. On the labor side, collective bargaining is one strategy to improve labor conditions; however, it is unknown if unionized facilities implement staff empowerment practices associated with culture change. In this paper, we examine changes in nursing assistant unionization in U.S facilities, compare staff empowerment practices for unionized and non-unionized facilities, and model the relationship between empowerment practices, leadership practices, and union status. Using a 14-item composite measure to score facilities’ empowerment practices, we find that unionized and non-unionized facilities do not differ significantly. Staff are more often cross-trained in unionized facilities and less likely to work with the same residents or receive rewards for extra training/education. After adjustment, we find that empowerment practices do not differ as a factor of union status (b=.035; 95% CI: -.022, .092), but are linearly associated with higher leadership scores.
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