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Purpose: This study identifies factors related to job tenure among certified nursing assistants (CNAs) working in nursing homes. Design and Methods: The study uses 2004 data from the National Nursing Home Survey, the National Nursing Assistant Survey, and the Area Resource File. Ordinary least squares regression analyses were conducted with length of job tenure as the dependent variable. Tenure of CNAs was hypothesized to be motivated by the extrinsic rewards of their job, initial training and mentoring, reasons for being a CNA, organizational culture, and personal, facility, and market characteristics. Separate analyses were conducted for the overall sample and for CNAs who worked for the facility for more than 1 year. Results: Among policy-relevant domains, extrinsic rewards had the largest number of significant variables (4). Only 1 training and 1 organizational culture variable significantly affected CNA job tenure. Significant variables in domains not readily influenced by policy (e.g., personal characteristics and characteristics of the facility and surrounding market area) were often significant in both regressions. Implications: This study underscores the importance of the basic economics of job choice by low-income workers. Wages, fringe benefits, job security, and alternative choices of employment are important determinants of job tenure that should be addressed, in addition to training and organizational culture.

Purpose: This study analyzed the effect of consumer-directed versus agency-directed home care on satisfaction with paid personal assistance services among Medicaid beneficiaries in Washington State. Design and Methods: The study analyzed a survey of 513 Medicaid beneficiaries receiving home- and community-based services. As part of a larger study, we developed an 8-item Satisfaction With Paid Personal Assistance Scale as the measure of satisfaction. In predicting satisfaction with personal assistance services, we estimated an ordinary least squares regression model that was right-censored to account for the large percentage of respondents who were highly satisfied with their care. Results: Among the older population, but not younger people with disabilities, beneficiaries receiving consumer-directed services were more satisfied than individuals receiving agency-directed care. There was no evidence that quality of care was less with consumer-directed services. In addition, overall satisfaction levels with paid home care were very high. Implications: This study supports the premise that consumer satisfaction, an important measure of quality, in consumer-directed home care is not inferior to that in agency-directed care. The positive effect of consumer direction for older people underlines the fact that this service option is relevant for this population. In addition, this research provides evidence that home- and community-based services are of high quality, at least on one dimension. (Contains 1 figure and 4 tables.)

This study analyzes the 2004 National Nursing Assistant Survey and other survey data to examine the characteristics and experiences of immigrant and non-immigrant certified nursing assistants (CNAs) in nursing facilities. Descriptive results focus on differences in personal characteristics, working conditions, extrinsic rewards, work experiences, job satisfaction, and workplace discrimination. The findings indicate that immigrant CNAs are older, better educated, and somewhat more highly paid than their non-immigrant counterparts but also experience substantial levels of discrimination and language-related communication barriers at work. The paper discusses major policy issues that arise from the increase in immigrant labor in long-term care. KEYWORDS long-term care workforce, certified nursing assistants, nursing homes, immigrants DOI: 10.1080/08959420.2010.485526

Purpose: To estimate the impact of nursing home work practices, specifically compensation and working conditions, on job satisfaction of nursing assistants employed in nursing homes. Design and Methods: Data are from the 2004 National Nursing Assistant Survey, responses by the nursing assistants' employers to the 2004 National Nursing Home Survey, and county-level data from the Area Resource File. Multinomial logistic regression was used to estimate effects of compensation and working conditions on nursing assistants' overall job satisfaction, controlling for personal characteristics and local labor market characteristics. Results: Wages, benefits, and job demands, measured by the ratio of nursing assistant hours per resident day, were associated with job satisfaction. Consistent with previous studies, job satisfaction was greater when nursing assistants felt respected and valued by their employers and had good relationships with supervisors. Nursing assistants were more satisfied when they had enough time to complete their work, when their work was challenging, when they were not subject to mandatory overtime, and where food was not delivered to residents on trays. Implications: This is the first investigation of nursing assistant job satisfaction using a nationally representative sample of nursing assistants matched to information about their employing nursing homes. The findings corroborate results of previous studies in showing that compensation and working conditions that provide respect, good relationships with supervisors, and better staffing levels are important to nursing assistant job satisfaction. Key Words: Long-term care workforce, Supervision, Staffing, Respect, Wages

Individuals dually eligible for Medicare and Medicaid often receive fragmented and inefficient care. Using Minnesota fee-for-service claims, managed care encounters, and enrollment data for 2010–2012, we estimated the likely impact of Minnesota Senior Health Option (MSHO)—seen as the first statewide fully integrated Medicare-Medicaid model—on health care and long-term services and supports use, relative to Minnesota Senior Care Plus (MSC+), a Medicaid-only managed care plan with Medicare fee for service. Estimates suggest that MSHO enrollees had significantly higher use of primary care and, potentially, of community-based services, combined with lower use of hospital-based care than similar MSC+ enrollees. Adopting fully integrated care models like MSHO may have merit in other states. [ABSTRACT FROM AUTHOR]

The article discusses non-compete agreements for employees and mentions several elements of the agreement including time-frame during which the employee is restricted; geographical area in which the employee is restricted; and employment with respect to which the employee is restricted.

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The article discusses aspects of cellphone privacy in the U.S. It explains the definition of privacy and the challenges faced by law enforcement agencies in addressing privacy issues in the digital age wherein exchange of information, particularly personal information, is easy through the Internet and smartphones. It cites the privacy polices of smartphone companies like Apple Inc. in the emergence of mobile applications that collect and transmit data without the user's consent and knowledge. It also emphasizes the need for the legal system in the country to caught up with digital communication and information-related issues.

The article explores the view of world media to the legal problem of American basketball player Kobe Bryant. It describes a trial made by mass media wherein the world jumped on the said case. It discusses the categories of the media trial including merely reporting, the Rodman link, analysis and the question of admissible evidence. It notes that the media have always held the first trial and will continue at the task as the courtroom activities proceed. The authors claim that sometimes the media do a better job than the justice system in the U.S.

The article explains and demonstrates some unaddressed privacy concerns with Meaningful Use and how achieving it will cause more conflicts with the U.S. Health Insurance Protection and Accountability Act (HIPAA) goals. It provides an overview of HIPAA privacy and security rules. It evaluates the Health Information Technology for Economic and Clinical Health (HITECH) Act and its effects on HIPAA.

The article discusses various aspects of electronics discovery (e-Discovery), including its different phases, maturity model, and records management in the U.S. The e-Discovery litigation process requires parties in dispute to provide relevant information, records, and evidences related to the case. It notes the amendments to the U.S. Federal Rules of Civil Procedures in 2006 which allows eDiscovery to encompass all electronically stored information (ESI), such as word documents, spreadsheets, e-mail, and video. The author further highlights the information management, and preservation phase of the e-Discovery litigation process.

The article presents an overview on the legal actions undertaken to address spam and abusive electronic mail (emails) in the U.S. It highlights the CAN-SPAM Act of 2003, the primary effort of anti-spam law, which has been criticized as doing more to regulate and protect legitimate mass-mailers than to effectively prevent abusive email. Collaborative actions between non-government entities with user groups and security specialists tend to provide an effective tool. The website www.blacklistmonitoring.com that provides blacklisting services of identified suspects is also mentioned.

The article focuses on the Health Insurance Portability and Accountability Act (HIPAA), a privacy law within the online business realm intended to protect customer's private information. It states that HIPAA aims to prevent disclosure of personal health information and governed organizations to keep the protected health information (PHI). It adds that HIPAA is governed by two rules such as Privacy Rule imposed by the Office for Civil Rights (OCR) and the Security Rule.