Committee Chair

Rausch, David W.

Committee Member

Bernard, Hinsdale; Crawford, Elizabeth K.; Bumphus, Vic


School of Professional Studies


College of Health, Education, and Professional Studies


University of Tennessee at Chattanooga

Place of Publication

Chattanooga (Tenn.)


This quantitative causal-comparative study was designed to examine potential relationships between independent variables (job level, dependency of patient, work environments, sex, and race) related to health care practitioner offenders and the dependent variable (types of abuse) in Tennessee from 2006 to 2015. A total of 227 practitioners who were either licensed, certified, or trained in their perspective professional practice or job level, convicted of abuse, physical/emotional abuse and financial abuse, were examined from criminal and civil dispositions. The Pearson’s Chi-square was used to evaluate the five research questions and test the null hypotheses for potential relationships. Additional testing with the Holm’s Sequential Bonferroni Method was used to control for Type I error for pairwise comparisons between variables. The chi-square results indicated strong relationships between job level, dependency of patient, and work environments with small but weak relationships for sex and race of the offenders and types of abuse. The results of this study indicated that financial abuse was prominent for all independent variables measured while physical/emotional abuse was secondary. Offenders with technical or advanced job levels committed 87.3% of financial abuse. Patients dependent on skilled care nursing were 60.7% more likely to experience physical/emotional abuse. Practitioners in private duty care committed 83.1% of financial abuse. Female offenders committed 37.1% of physical/emotional abuse compared to males who committed 75.7% of financial abuse. The findings for financial abuse was 74.0% of Caucasians offenders and 63.6% of minority offenders. The descriptive analysis examined variables relative to all offenders convicted of patient abuse, their position of professional authority and the work environments, as well as the dependency of the victims on care services.


I would like to begin with expressing my gratitude and appreciation to my doctoral committee chair Dr. David Rausch. I have always appreciated your disciplined guidance and pointed direction, “read it out loud” on many occasions. I had no idea that I was going to task my life with a “formal research paper that is the culmination of months and even years of diligent research effort on behalf of a graduate student” as stated in the University of Tennessee-Chattanooga (UTC) Graduate School Thesis and Dissertation Standards. Thank you to Dr. Hinsdale Bernard who always reminded me to follow the variables analysis guide; that would be key to all my dissertation work. Thank you to Dr. Beth Crawford who tirelessly answered, one more edit, or EndNote problem that kept me from software destruction. Thank you to Dr. Vic Bumphus who assisted my direction in my dissertation. To my family, friends, and coworkers at Tennessee Bureau of Investigation, Medicaid Fraud Control Unit in Tennessee, I truly thank you for allowing me to learn, train, and get the practitioner experience with you; it turned into a body of research. Honorable mentions include Terry Reed, Roger Turner, Dora Arnold, Darrin Shockey, Barry Carrier, JD, and Stanley Hodges, EdD. Thank you to Drs. Douglas R. Clark and Kathy O. Thacker who always encouraged me.


Ed. D.; A dissertation submitted to the faculty of the University of Tennessee at Chattanooga in partial fulfillment of the requirements of the degree of Doctor of Education.




Medical ethics; Medical jurisprudence


Patient abuses in Tennessee; Health care fraud and abuse; Health care offenders; Criminal analysis of health care practitioners

Document Type

Doctoral dissertations




xii, 90 leaves