The association between organizational characteristics and benefits offered to nursing assistants: Results from the National Nursing Home Survey

Background: Previous research has demonstrated that employment-based benefits are important for the recruitment and retention of nursing assistants (NAs). Purpose: The objectives of this study were to describe the availability of benefits offered to NAs and to explore the association between nursing home organizational characteristics and NA benefits using the political economy of aging framework. Methodology: Cross-sectional data on 944 nationally representative nursing homes were derived from the 2004 National Nursing Home Survey. Benefits were measured as a composite variable of five NA benefits weighted by cost. A linear regression model was used to examine the relationship between nursing home organizational characteristics and NA benefits. Findings: For-profit/nonchain ownership and Medicaid occupancy were negatively associated with NA benefits. Facility size, not-for-profit ownership (chain or nonchain), occupancy level, nurse staffing level, union involvement, and education of the nursing home administrator were positively associated with NA benefits. Practice Implications: Nursing home organizational characteristics may explain some of the variations in the availability of benefits and may be informative for policy and practice to improve benefits as a potential strategy to recruit and retain NAs. In particular, for-profit, freestanding facilities and facilities with high proportions of Medicaid residents should consider cost-effective initiatives to enhance the benefit package offered to NAs.