Research from the University of Pittsburgh indicates that only 12% of consumers remember factoring in the Nursing Home Report Card in their decisions to move (either themselves or a loved one) into a nursing home.
On the surface, the Nursing Home Report card appears very useful. Created by the Centers for Medicare and Medicaid Services in 1998, the report card has undergone periodic improvements to the point of currently comprising 15 quality measurements (e.g., pressure sores, restraint use, etc.), which were added to other information, such as deficiency citations and staffing levels.
The type of information in the report card provides a decent starting point for consumers to compare nursing homes on a range of quality indicators. But questions of usage frequency and the extent to which consumers understand the information remain open.
Researchers developed a retrospective survey of families who recently made decisions about nursing home care. A sample of nearly 5,000 family members of nursing home residents was drawn from 200 randomly selected nursing homes. They found that 31% of nursing home consumers utilized the Internet when choosing a nursing home and another 18% had obtained second-hand information that other family members found on Internet. Only 12% remembered using the Nursing Home Report Card. On a range of 0 to 8, with 8 being 100% comprehension of the quality measures, the average comprehension in the study was 5.87, indicating that the average respondent had a basic understanding of how to interpret nursing home quality indicators and make decisions accordingly.
The difficulty of making informed choices in the long-term care market is compounded by the fact that many people wind up choosing the nearest nursing home to their house, regardless of quality, and that nearly half of nursing home admissions (in the sample) came through hospital referral. Hospital referrals often curtail information-seeking by family members.
Educating discharge planners in ways that promote empowering family members to make critical choices regarding nursing home care decisions is important. Increasing the visibility of important resources such as the report card is important so that they do not go underutilized.
Source: Castle, N. 2009. The nursing home compare report card: Consumers’ use and understanding. Journal of Aging and Social Policy 21:187-208.