Information to help nursing homes monitor their quality of care has been available for some time through the Online Survey Certification and Reporting System (OSCAR) and the Minimum Data Set (MDS). The problem, however, is that the current system to help organize, store, and report this information is underutilized and of questionable benefit to consumers.
OSCAR contains facility-reported site and staff characteristics and health survey deficiencies, while the MDS includes resident-specific information, including functional limitations, medical problems, and emotional states. This information is helpful for policy oversight. However, very little information outside of what goes into the Nursing Home Report Card is stored and collected in electronic form, which means that a lot of information regarding quality of care, care process, and facility-level outcomes is collected but kept locked away in a filing cabinet. The majority of information concerning quality of care and care costs is located only at the facility level. The current system does not aggregate facility-level data alongside the associated costs of services into a consumable report. Currently, real-time information pertaining to staffing, pricing, services, and monitoring can only be obtained by contacting the facility.
In most industries, information about service and product quality is widely available, but in long-term care, this information can be something of an enigma to consumers. The data and information are there and yet they are underutilized by consumers (in the case of the Nursing Home report card) and service providers. The current report card system gives consumers a small snapshot in time and is a huge step in the right direction; however, these data can be out of date and remain disconnected from other information consumers need to make decisions (e.g., costs).
Technological innovations are needed so that real-time quality of care and other facility-level data can be used to enhance both consumer decision-making and quality of care in nursing homes. Enhanced facility level monitoring can be an effective way for nursing home operators to self-correct care deficiencies and promote these successes to prospective residents and their families.
Source: Flores, C. Newcomer, R. 2009. Monitoring quality of care in residential care for the elderly: The information challenge. Journal of Aging and Social Policy 21:225-242.