Research reveals what makes SNF residents, families happy

What are the keys to resident and family member satisfaction with nursing homes? Higher nursing staffing levels, fewer citations for deficiencies and non-profit or government ownership, according to new research.

Facilities with these characteristics tend to perform better on satisfaction surveys, found researchers led by Yue Li, PhD, an associate professor in the University of Rochester Medical Center Department of Public Health Sciences. Their findings, published in Health Affairs, could take on added significance as the Centers for Medicare and Medicaid Services (CMS) considers moves that could change the way nursing homes are reimbursed for the care they provide.

The investigators looked at data collected in Massachusetts in 2005, 2007 and 2009. The state was one of six that in 2005 began asking nursing home residents and their families to rate their overall satisfaction as well as their happiness with facility factors such as staffing and administration, physical environment, activities, personal care, meals and personal rights. The surveys also asked respondents to indicate whether they would recommend to a friend the particular nursing home they were grading.

Physical and social activities for residents, as well as food served, were areas that nursing homes could look to improve, according to the satisfaction survey results.

As CMS considers expanding nationally the state quality report cards it began making public in 2002, Li and colleagues said, it should think about including consumers’ perspectives as a way to improve them. Adding consumer data to the report cards could prompt improvements in the quality of patient-centered care, they said, but it requires further thought. Currently, the report cards include clinically oriented performance measures such as staffing levels, citations and patient outcomes.

A national expansion of the surveys by CMS could change how nursing homes are reimbursed for care, the researchers believe, rewarding nursing homes for the quality of care they provide.

“Satisfaction scores are clearly an important indicator of the quality of care in nursing homes,” Li said. “When used with other quality of care indicators, these assessments have great potential to empower consumers to make choices, incent improvements by nursing homes and inform pay-for-performance.” 

The study was funded by the National Institute on Aging and also included investigators from the University of California, San Francisco, and the University of California, Irvine.

Lois Bowers

Lois A. Bowers was senior editor of I Advance Senior Care / Long-Term Living from 2013-2015.