Interorganizational linkages and service and personnel shortages in rural nursing homes

Increased demands on nursing homes for more diversified and technically complex services pose particular challenges for rural facilities. Because coordinating mechanisms have been proposed as a management strategy to deal with these issues, we studied the relationship between interorganizational linkages and shortages of personnel and services in a sample of 152 rural Pennsylvania nursing homes. Significant shortages of health cam personnel that are central to long-term care were reported, as were shortages of services, especially for ventilator-dependent and demented residents. Although no evidence exists that coordination efforts were effective remedies to these problems in early 1992, it is apparent that managing patient/resident flows between hospitals and nursing homes through contractual agreements and other forms of ''coordination'' war identified as a strategy. Further research is required to assess the effectiveness of these types of agreements in terms of ensuring the continuity and quality of long-term care services in rural areas.