This study suggests that certain management practices used to empower nurse aides can influence resident outcomes. Further, effects of nurse aide staff stability vary with respect to the physical versus psychosocial nature of the outcome.

Future studies of facility turnover should avoid modeling turnover as a linear function of a single set of predictors in order to provide clearer recommendations for practice.

Purpose: The study's goals were to understand what changes in management practices would most improve the jobs of frontline workers from the perspective of workers themselves and to analyze differences across settings. Design and Methods: The baseline survey of direct care workers (N ¼ 3,468) conducted as part of the National Study of the Better Jobs Better Care demonstration asked the following: ''What is the single most important thing your employer could do to improve your job as a direct care worker?' ' We coded the openended responses and grouped them into categories. We then compared the percentages of workers recommending changes in these categories across settings and interpreted them in the context of previous conceptual frameworks. Results: Across settings, workers called for more pay and better work relationships including communication; supervision; and being appreciated, listened to, and treated with respect. The fraction of workers calling for these changes and additional specific changes differed substantially across nursing facilities, assisted living facilities, and home care agencies. Implications: To increase retention of frontline workers, policy makers should design public policies and management practices to increase pay and to improve work relationships. However, specific strategies should differ across settings.

Using data from the Medicare Current Beneficiary Survey, we identify differences in hospital days, home health visits and physician office visits across five geographical categories. After controlling for individual characteristics and availability of health care providers, we find significant differences in service use. Results show greater use of home health care and less use of physician office visits and hospital care in rural areas. Because service use exhibits patterns of substitution and complementarity, future research on the use of health services needs to move beyond modeling the use of single services to modeling the range of services used.

The current study suggests that workplace training has an important role in helping reduce direct care worker injuries, thereby decreasing organizational expenses related to injury, such as workers' compensation, sick time, and turnover. The NIOSH Organization of Work and Occupational Safety and Health framework offers a mechanism by which occupational health and safety interventions may be derived to reduce incidents of injury.