To begin with, we conducted a series of open-ended telephone interviews with either an administrator or director of nursing from four skilled nursing facilities, one assisted living facility, two home care agencies, and one adult day service provider to gain a better understanding of supervisory structures in each type of organization. These organizations represented all five states participating in the BJBC demonstration. We also spoke with home health care trade associations. The phone calls allowed us to explore the concept of supervisory function with the respondents.
From the information collected during both the telephone interviews discussed above and subsequent cognitive testing of procedures with clinical managers from local long-term care organizations, we developed a Supervisor Identification Instrument. This identification instrument included nine tasks, or supervisory responsibilities, which were divided into primary and secondary responsibilities. A person qualified as a supervisor if he or she performed one or more of the following primary responsibilities:
- Ensure that DCWs are giving proper care to clients/residents;
- Initiate disciplinary action;
- Document DCW performance problems;
- Provide feedback to DCWs on job performance;
- Directly respond to job concerns raised by DCWs.
or if they performed at least two of the following secondary responsibilities:
- Act as a mentor to DCWs;
- Schedule DCWs;
- Recommend training for DCWs;
- Conduct on-the-job training.
The Supervisor Identification Instrument (task list) is included as Appendix A.