NURSING HOME SATISFACTION MEASURES: WHAT IS THEIR RELATIONSHIP TO QUALITY?

Consumers and their families need information to help choose nursing homes (NHs) that best suit them. Government, too, needs good information to perform its oversight and program management functions, incentivize better performance, and respond to consumers’ information needs. Incorporating consumer perspectives could improve public reporting of NH quality. Little is known, however, about the relationship between resident/family satisfaction, and quality of life (QoL) and/or other quality measures and whether they supplement existing quality measures. This study investigates these relationships, and explores how different factors predict satisfaction. Using resident/family satisfaction survey data from 2887 NHs in all 50 states, along with data on NH characteristics and performance (using CASPER, LTCFocus, and NH Compare data), we found that, in 2013, overall satisfaction was high, averaging 3.3 for both residents and family members (on a scale of 1 to 4). Satisfaction was highest for families regarding nursing care quality, and for residents in feeling safe; it was lowest for families in staffing adequacy and for residents in meal quality. Overall satisfaction had near-zero or very low Pearson correlations with staffing variables. Nor was the link to quality measures strong: correlations with CMS NH star ratings were low (0.24 for residents and 0.31 for families), and with NH deficiencies near-zero. These results suggest that resident/family perspectives indeed add a unique component to the assessment of overall NH quality, and support the call to add satisfaction and experience ratings to public reports of NH quality.