There are many other support departments that exist in the nursing home and maintain its functionality, and that are part of the overall system. Laundry, outdoor activities, housekeeping needs, and dietary departments are all separately organized within the overall structure of the organization, with distinct expectations, roles, and procedures defined for each department. The coordination of the timing of the various operations these departments perform is coordinated by the operations management office, which is directly responsive to the business office. It is in this way that the authoritarian structure of the organization is preserved (Huber 2006).

Upper management in the organization consists solely of the officers in the business office as well as the board of directors of the company itself. All on-site managers and leaders would have to be considered middle management due to the level of decision-making they are actually empowered with (Huber 2006). Again, the limitations on authority and decision making capability amongst the middle managers in the organization -- not to mention the line staff consisting of nurses, orderlies, interns, clerical workers, and others -- make for an organization where behavior outside the norm is not well tolerated, and thus where innovation and transformational...

This has led to some conflicts between various levels of management; there is the hierarchy of middle management that exists between the operations managers and some individual department leaders, but generally the company's hiring and promotion policy seems to have put individuals in place that respond well to and work effectively in the company's culture and structure.
Authoritarian structures that attempt to exert detailed control over the various parts of an organizational system are not conducive to innovation or change, and can make many organizational members chafe under the weight of their constraints (Huber 2006; Griffin & Moorehead 2009). At the same time, such structures provide a great deal of efficiency and can be highly effective when the proper scope of information is included in decision making (Huber 2006). At the nursing home in question, this organizational structure led to an effective and efficient system of operation.

References

Garner, J., Smith, H. & Piland, N. (1990). Strategic nursing management. Washington,

DC: Aspen publishing.

Griffin, R. & Moorehead, G. (2009). Organizational behavior. Mason, OH: Cengage.

Huber, D. (2006). Leadership and…