The relationship between long-term care providers' involvement, licensed nursing home administrators' behavioral preferences, and the managerial system of the long-term care facility

Long-term care research reviewed by the Health Care Financing Administration identified the lack of research on provider behavior. This study proceeded to empirically describe behaviors of long-term care providers and administrators and the managerial systems which result from their inter-relationship. An assumption of this study was provider involvement in interaction with administrator behavioral preferences are connected to managerial systems.;The theoretical framework defined the relationship as a duality of command integrating three theories: (1) the natural-system or humanistic approach which involves the inter-relationship of people in an internal structure, (2) the headship theory treated as a concept of two persons in tandem, rather than a dichotomy of one person, describing the construct of the provider/administrator relationship, and (3) the theory of agency, which identifies the authority and autonomy between the provider and administrator.;The hypotheses were: (1) Is there a significant relationship between provider involvement and type of managerial system? (2) Is there a significant relationship between behavioral preferences of administrators and type of managerial system? (3) Is there a significant relationship between, on one hand, the interaction of provider involvement and administrator behavior preferences and, on the other hand, type of managerial system?;Data were collected from New York State licensed administrators on three instruments, the Likert Profile of Organizational Characteristics to score the managerial system, the Myers-Briggs Type Indicator to determine administrator behavioral preferences, and a questionnaire on provider involvement. Hypothesis 3 was accepted. Based on ANOVA, 2-way interaction, with p =.01, provider involvement in functional areas of facility operation, in interaction with the behavioral preferences of the administrator was statistically significant.;The data suggest that administrator behavioral preferences and provider involvement interact to increase the participative rating of the managerial system in long-term care facilities. However, provider involvement beyond two operational areas interfered with the managerial system, changing the relationship between the provider, administrator and organization. This fluctuation indicates that 'duality of command' is a potential organizational theory for long-term care organizations.