Families' and Residents' Perspectives of the Quality of Nursing Home Care: Implications for Composite Quality Measures.
Dana B Mukamel, Debra Saliba, David L Weimer and 1 others
PMID 33229306WHAT IT FOUND
Residents and families rated attentiveness, personal care, routine medical care, physical environment, cleanliness, social environment, food and communication as contributing more to overall nursing home quality than the 5-Star rating.
Short-stay residents and families also valued physical therapy.
Key findings
01For long-stay respondents, attentiveness to residents was associated most strongly with overall quality (1.79), followed by personal care, routine medical care and physical environment; the 5-Star rating was not significant.
02For short-stay respondents, attentiveness (1.95) and personal care (1.83) were associated most strongly, and physical therapy (0.95) was significant unlike in the long-stay model.
03Overall quality was rated median 75 and mean 72 on a 0 to 100 scale; residents rated it median 80.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The sample was an online panel with a 0.82% response rate, so it may not represent all U.S. residents and families. Almost 90% of respondents were family members, not residents, and family and resident ratings differed. Only one or two respondents were available for each nursing home, so the study cannot report or rank quality scores for specific facilities. The long-stay resident subgroup had only 86 respondents, so no reliable estimates were presented for that group. People with severe cognitive impairment or language barriers may be underrepresented; about 50% of nursing home residents have severe cognitive impairment. The analysis is cross-sectional and observational, so regression weights show association with overall ratings, not that changing a dimension improves quality.
Declared interests
None of the authors declared conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not read these weights as proof that nursing homes with better attentiveness, personal care or physical therapy deliver better care. The study only shows how respondents' overall ratings were associated with their dimension ratings, and it was not designed to score individual facilities.