A Facility-Level Analysis of Nursing Home Compare Five Star Rating and Maryland's Family Satisfaction with Care Survey

This study aimed to compare two care quality frameworks, one based on observable factors and one on family satisfaction.RESEARCH DESIGN AND METHODS: We merged publicly available 2021 Maryland nursing facility data. The Maryland Health Care Commission surveys long-term care residents' family satisfaction across seven domains. CMS' five-star ratings aggregate inspections, staffing, and quality measures. We used univariate and bivariate statistics to compare the frameworks.RESULTS: The dataset included 220 facilities and 4,610 survey respondents. The average facility rating was 7.70/10 and overall 77% of respondents would recommend the facility. Eighty-six percent of respondents from 5-star facilities, 79% from 4-star facilities, and 76% from 3-star facilities would recommend the facility compared to 65% from 1-star facilities (p < 0.001, p < 0.01 and p < 0.05, respectively). Four or 5-star facilities received significantly higher ratings (8.33, p < 0.001; 7.75, p < 0.05, respectively) than 1-star facilities (7.07).DISCUSSION AND IMPLICATIONS: Our results corroborated earlier findings of strong associations between CMS ratings and satisfaction at the extremes of the five-star system. These associations are inconsistent across family-reported domains. This suggests overlap between the frameworks. CMS ratings address care quality; family satisfaction measures quality of life and care quality. High satisfaction is associated with high care quality and quality of life...
Source: The Gerontologist - Category: Geriatrics Authors: Source Type: research