Decision-making influence: an empirical study of social workers in nursing homes

Health care research on social workers' organizational influence has focused almost exclusively on the hospital setting. Little is known about social workers' influence in nursing homes, in particular organizational factors that support or constrain their impact on resident care. This article presents findings from a survey of 90 social workers employed in 53 nursing homes who identified their level of influence in five spheres of organizational decision making. With the exception of personnel decisions, there were few differences between the influence levels of the directors of social services and social workers without administrative responsibilities. Number of full-time-equivalent social workers, type of ownership, and length of employment of the director of social services were significantly related to the level of perceived influence held by the director of social services. The implications of these findings for social work practice in nursing homes are discussed.