Organizational Features and Employee Well-Being in Home Health Care and Rehabilitation: A Cross-Sectional Study in the Republic of Croatia

Background/Objectives: Population ageing and the policy shift toward care at home elevate the importance of how home and community-based services (HCBS) are organized and staffed. We aimed to describe provider and workforce characteristics, quantify core employee outcomes, and examine prespecified associations between organizational context, work organization, and quality-monitoring practices in HCBS for older adults. This cross-sectional study was conducted in home health care and rehabilitation settings in the Republic of Croatia. Methods: We conducted a cross-sectional analysis of two coordinated surveys: institutions providing home or community nursing and rehabilitation (N = 60) and their employees engaged in direct care (N = 517). Only aggregate tabulations were available to the authors. Descriptives included counts, percentages, means, and 95% confidence intervals. Bivariate analyses used Spearman’s ρ for ordinal–ordinal relations, χ² tests with Cramér’s V for categorical associations, and Mann–Whitney or Kruskal–Wallis tests with η²_H for ordinal outcomes. Complete-case procedures were applied with α = 0.05. Results: Private ownership predominated among institutions (85.0%). Referral pathways were universally anchored in primary care and patient or family self-referral (both 100%), with hospitals reported by 58.3%. The workforce was predominantly female (86.7%) and experienced (mean tenure and home-care experience ≈10 years). Job satisfaction was high (27.3% very satisfied, 68.1% satisfied) and turnover intention low (4.9%). Satisfaction correlated inversely with turnover intention (ρ = −0.513, p < 0.001) and positively with willingness to recommend the job (ρ = 0.265, p < 0.001); turnover intention correlated inversely with willingness to recommend (ρ = −0.210, p < 0.001). Institutions differed by area and managerial presence in measuring patient satisfaction and reporting annual performance (V ≈ 0.36–0.50), whereas headcounts did not vary by area (η²_H ≈ 0.00–0.02). Longer inter-visit travel was associated with more frequent heavy lifting (χ²(3) = 11.259, p < 0.05; V ≈ 0.15). Conclusions: In this HCBS context, employee attitudes were favorable and showed coherent gradients, while organizational variation concentrated in governance and quality-monitoring practices rather than scale. Findings support targeted managerial and measurement capacity building, alongside ergonomic prevention, and motivate multilevel and prospective studies.