Choosing a Nursing Home: What Do Consumers Want to Know, and Do Preferences Vary across Race/Ethnicity?

Abstract

Objective.To identify what consumers want to know about nursing homes (NHs) before choosing one and to determine whether information preferences vary across race/ethnicity. Data Sources/Study Setting. Primary data were collected in Greater Boston ( January 2013-February 2014) from community-dwelling, white, black, and Latino adults aged 65+ and 40-64 years, who had personal/familial experience with a NH admission or concerns about one. Study Design. Eleven focus groups and 30 interviews were conducted separately by race/ethnicity and age group. Principal Findings. Participants wanted detailed information on the facility, policies, staff, and residents, such as location, staff treatment of residents, and resident conditions. They wanted a sense of the NH gestalt and were interested in feedback/reviews from residents/families. Black and Latino participants were especially interested in resident and staff racial/ethnic concordance and facility cultural sensitivity. Latino participants wanted information on staff and resident language concordance. Conclusions. Consumers want more information about NHs than what is currently available from resources like Nursing Home Compare. Report card makers can use these results to enhance their websites, and they should consider the distinct needs of different racial/ethnic groups. Future research should test methods for collecting and reporting resident and family feedback/reviews. Key Words. Nursing homes, consumer information, public reporting, race/ ethnicityThe health care market has embraced public reporting, and The Centers for Medicare and Medicaid (CMS) alone has report card websites for hospitals, home-health providers, nursing homes (NHs), dialysis facilities, and physicians, with more to come for other providers like hospice and inpatient

Patients Are Not Given Quality-Of-Care Data About Skilled Nursing Facilities When Discharged From Hospitals

“…27 For example, Dana Mukamel and colleagues found that personalized SNF report cards led to greater satisfaction with the discharge planning process and greater likelihood of selecting a high-quality facility, 26 and Jennifer Hefele and colleagues found that patients would like information beyond what is currently available on the Nursing Home Compare website. 27 In addition, despite efforts by CMS to make Nursing Home Compare data easily understood, multiple studies have found that the website has had limited impact on consumer selection of nursing facilities. 28–30 Consumers are largely unaware of its existence, 31,32 and those who do visit or are shown the website find it difficult to understand and use.…”

Nursing home Facebook reviews: who has them, and how do they relate to other measures of quality and experience?

“…In the most recent examination, only six sites provided any sort of resident satisfaction information on state-sponsored NH report card sites 1. Yet it appears that this is the sort of information that consumers want when looking for an NH; a recent study found that consumers want to hear about current and prior resident/family experiences when deciding on an NH for themselves or a loved one 52. This confirms earlier findings where focus groups participants consistently identified reputation/recommendations from/experiences of family and friends as a top factor for NH selection 53.…”

Selecting a Skilled Nursing Facility for Postacute Care: Individual and Family Perspectives

“…Additionally, residents themselves largely do not play a substantial role in choosing; physicians and family members often make nursing facility decisions . With regard to factors that are important in this decision‐making process, nursing facility quality is rarely the deciding factor, and factors that are important in nursing facility selection include location, recommendations from family and friends, prior experience, and staff treatment …”

“…Public reporting tools and quality measures such as the Medicare Nursing Home Compare website may help guide consumer choice, but research on whether and how people use these measures and tools to help guide their choices is also limited. Although consumer response after initial implementation of Nursing Home Compare was minimal, research after implementation of their star rating system indicated that people were more likely to end up in higher‐quality facilities, although research has also found that many do not use the Internet to look for nursing facility information; that consumers are often unaware of resources like Nursing Home Compare; and that if they are aware of or are using resources like Nursing Home Compare, the factors they are interested in, such as reviews or feedback from other residents, are not typically available . Additionally, people may not have the computer, numeracy, or health literacy skills necessary to access the public reports or to make sense of information that lay audiences cannot easily interpret (e.g., How should an individual weigh the relative importance of measures for pressure ulcer care versus pain management?).…”

“…Additionally, people may not have the computer, numeracy, or health literacy skills necessary to access the public reports or to make sense of information that lay audiences cannot easily interpret (e.g., How should an individual weigh the relative importance of measures for pressure ulcer care versus pain management?). There is some evidence that consumers would like more information about public reporting resources like Nursing Home Compare and more guidance about the measures it includes …”