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Who Hires Social Workers? Structural and Contextual Determinants of Social Service Staffing in Nursing Homes

机译：谁雇用社会工作者？ 护理家庭社会服务人员的结构和背景决定因素

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Although nurse staffing has been extensively studied within nursing homes (NHs), social services has received less attention. The study describes how social service departments are organized in NHs and examines the structural characteristics of NHs and other macrofocused contextual factors that explain differences in social service staffing patterns using longitudinal national data (Certification and Survey Provider Enhanced Reports, 2009-2012). NHs have three patterns of staffing for social services, using qualified social workers (QSWs); paraprofessional social service staff; and interprofessional teams, consisting of both QSWs and paraprofessionals. Although most NHs employ a QSW (89 percent), nearly half provide social services through interprofessional teams, and 11 percent rely exclusively on paraprofessionals. Along with state and federal regulations that depend on facility size, other contextual and structural factors within NHs also influence staffing. NHs most likely to hire QSWs are large facilities in urban areas within a health care complex, owned by nonprofit organizations, with more payer mixes associated with more profitable reimbursement. QSWs are least likely to be hired in small facilities in rural areas. The influence of policy in supporting the professionalization of social service staff and the need for QSWs with expertise in gerontology, especially in rural NHs, are discussed.
机译：虽然护士人员配备人员在护理家庭（NHS）中被广泛研究，但社会服务受到不太关注。该研究描述了如何在NHS中组织社会服务部门，并审查NHS和其他宏观语境因素的结构特征，以说明使用纵向国家数据（认证和调查提供商加强报告，2009-2012）的社会服务人员配置模式的差异。 NHS使用合格的社会工作者（QSWS）有三种用于社会服务的人员配置;霸权社会服务人员;和贸易组成的团队，包括QSWS和Parafrofestals。虽然大多数NHS雇用了QSW（89％），但近一半通过贸易专业团队提供社会服务，11％独自依赖Parafrofestals。随着依赖于设施规模的国家和联邦法规，NHS内的其他语境和结构因素也会影响人员。 NHS最有可能雇用QSWS在非营利组织拥有的医疗中心内的城市地区的大型设施，其中包含更多的付款人混合与更有利可图的报销相关联。 QSWS最不可能聘用农村地区的小型设施。讨论了政策对支持社会服务人员专业化的影响以及具有QSWS的QSW，特别是在农村NHS中的QSWS。

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