New 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 (CMS) in 1998, the report card has undergone periodic improvements to the point of currently containing 15 quality measurements (i.e. 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. However, the question of frequency usage and the extent consumers understand the information remain open.
These researchers developed a retrospective survey of families who had recently made decisions about nursing home care. A sample of nearly 5000 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 had found from the internet; however only 12% had 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 homes 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 regarding nursing home choice.
Efforts to educate discharge planners in hospitals and family members who make nursing home decisions on the importance of quality nursing home care are needed so that resources such as the report card do not go under-utilized.
Source: Castle, N. 2009. The nursing home compare report card: Consumers’ use and understanding. Journal of Aging and Social Policy 21:187-208.