All ETDs from UAB

Advisory Committee Chair

Larry R Hearld

Advisory Committee Members

Nir Menachemi

George H Pink

Robert Weech-Maldonado

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


The focus of this research is the relationship between environmental and organizational characteristics and critical access hospitals (CAHs) being contract managed or acquired. The resource dependence theory guided the methodology. Based on this theory, organizations prefer to remain autonomous until key resources become scarce. The scarcity of resources combined with a dynamic external environment causes environmental uncertainty that requires organizations to consider a variety of strategic responses in order to survive. Given the results of this study, contract managed CAHs were associated with markets that were less munificent and more dynamic with older facilities, relative to independent hospitals. Due to the small sample size of acquired CAHs, results should be considered exploratory. These hospitals were found to be associated with more munificent markets. The organizational characteristics associated with acquired critical access hospitals included less net income, and not-for-profit and government entities.