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The purpose of this paper is to explore the attitudes of nursing home administrators and key managerial staff toward health information technology (health IT).

This research is exploratory in nature, and applies qualitative case-study methodology to further understand health IT adoption by nursing homes through multiple in-depth semi-structured interviews of management, and direct observations of employee behavior at each participating facility. A modified Technology Acceptance Model is used to examine the attitudes and perceptions of administrators.

This study finds that there are differences in the level of health IT adoption by nursing homes. While some administrators are aware of health IT and are implementing or updating their IT systems in a gradual but haphazard manner, others exhibited a lack of interest in implementing change. Overall, there is a lack of systematic planning and decision-making toward health IT adoption. Adoption is not evidence-based, instead driven primarily by real and perceived regulatory requirements combined with a lack of information about, or consideration of, the real costs and benefits of implementing health IT.

Including six in-depth case studies, the sample for this study is small for generalizing the findings. Yet, it contributes to the literature on the slow process of health IT adoption by nursing homes. Moreover, the findings provide guidelines for future research.

This study demonstrates that nursing home administrators must systematically plan the adoption of health IT, and such decision making should be evidenced-based and participatory so that employees can voice their opinions that could prevent future resistance.

This study is original and advances knowledge on the reasons for the slow adoption of health IT in nursing homes. It finds that lack of adequate information regarding the utility and benefits of health IT in management adoption decisions can result in haphazard implementation or no adoption at all. This finding has significant value for policy makers’ practitioners for improving accessibility of information regarding the use of health IT in nursing homes that could address the health IT adoption challenge in this industry.

Extant research has shown the positive effects of value congruence on individual attitudes, behaviors and performance. However, very few studies have been conducted to examine the difference in the relationship between value congruence and attitudinal outcomes across people of different attributes. The purpose of this paper is to examine how the relationships between employee-organization value congruence and job attitudes vary across different occupational groups, with the focus on different levels of nurses. The study provides evidence to organizations to adopt better approaches to harness the benefit from employees’ spontaneous work motivation.

Nursing homes provide a unique research context because of the different nursing occupations with varying degree of identifying characteristics including educational attainment, skill level, income and decision-making power. The present study thus examines how the relationships between nurses-home value congruence and nurses’ job attitudes vary across different nursing occupations, instrumented by a survey of nursing staff of nursing homes in a Midwestern state in the USA.

Consistent with prior research, value congruence is found positively associated with nurses’ job satisfaction and organizational commitment, but negatively with turnover intention. Consistent with the “diminishing marginal effect” argument, the relationships between value congruence and job satisfaction and organizational commitment are found more pronounced among nurses of lower occupational level.

The extant literature does not explicitly compare the effect of within-occupation value congruence on various attitudinal and behavioral outcomes across different occupations. As values have individual and social foundations, in a specific workplace context, it is impractical, if not impossible, to gain a comprehensive view of employees’ value profile and work-related consequences without looking further into the differences across types of employee. Although without sufficient existing literature to compare to, the present study does provide consistent results with theoretical predictions, and display a relatively clear picture of how the relationships between value congruence and job attitudes are unwrapped along the occupational dimension.