The joint relationship between organizational design factors and HR practice factors on direct care workers' job satisfaction and turnover intent

Jungyoon Kim, Nizar Wehbi, Jami L. Dellifraine, Diane Brannon

Research output: Contribution to journalArticle

6 Scopus citations


BACKGROUND:: Human resource (HR) practices, such as training and communication, have been linked to positive employee job commitment and lower turnover intent for direct care workers (DCWs). Not many studies have looked at the combined interaction of HR practices and organizational structure. PURPOSE:: The aim of this study is to examine the relationship between organizational structure (centralization, formalization, and span of control) and HR practices (training, horizontal communication, and vertical communication) on DCW's job satisfaction and turnover intent. METHODOLOGY:: Data were collected from 58 long-term care facilities in five states. We used latent class analysis to group facility characteristics into three sets of combinations: "organic," "mechanistic," and "minimalist." We used multivariate regression to test the relationship of each of these groups on DCW's job satisfaction and turnover intent. FINDINGS:: After controlling for state, organizational, and individual covariates, the organic group, which represents decentralized and less formalized structures and high levels of job training and communication, was positively related to job satisfaction and negatively related to intent to leave. On the other hand, the minimalist group, which is characterized by low levels of job-related training and communication, showed no significant differences from the mechanistic group (referent) on job satisfaction and intent to leave. PRACTICE IMPLICATIONS:: These findings imply that managers in long-term care facilities may want to consider adopting organic, decentralized structures and HR practices to retain DCWs.

Original languageEnglish (US)
Pages (from-to)174-184
Number of pages11
JournalHealth Care Management Review
Issue number2
StatePublished - Jan 1 2014



  • Human resource practices
  • latent class analysis
  • long-term care
  • multivariate regression
  • organizational structure

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Strategy and Management

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