Research Brief: Key factors for family satisfaction with nursing homes

Nursing home

In recent months, news headlines have included numerous investigations into cases of nursing home staff shortages and resident maltreatment — many of which were reported by the families of vulnerable residents.

A study led by University of Minnesota School of Public Health Associate Professor Tetyana Shippee, in collaboration with colleagues at Miami University of Ohio, compared factors that impact family member satisfaction with nursing home care across Minnesota and Ohio. The study, co-authored by Ph.D. student Weiwen Ng and Miami University faculty Amy Roberts and John Bowblis, was published in the Journal of Applied Gerontology.

Shippee compared nursing home family satisfaction surveys from both states and linked it to federal data on facility characteristics. Minnesota and Ohio are among the few states with validated measures of family satisfaction collected from a representative sample of residents. Both states also have different nursing home occupancy rates, percentage of for-profit versus nonprofit providers, reimbursement rates and other key factors and policies.

The study found that despite differences across these states in their long-term care policies, a number of factors were consistent in affecting family satisfaction. Specifically, among families in both states, higher nursing home satisfaction was associated with:

  • facilities that have a higher number of registered nurses, certified nursing assistants, and activities staffing;
  • higher Medicare payer-mix and less need for intensive nursing care among patients;
  • facilities that are smaller in size, located in rural areas, not owned by a for-profit company or affiliated with a chain, and have higher percentages of their beds occupied.

“The findings show that facility-level factors associated with higher family satisfaction are rather similar to the ones we already know predict resident satisfaction as well,” said Shippee. “This report reinforces that the role of family members is so important as residents often can’t advocate for themselves, especially those with dementia and cognitive impairment, who are at highest risk for injury and premature death. It also shows that they can be those missing eyes we need to help keep watch on nursing homes and ensure quality of care for residents.”

Shippee is continuing her research by looking at measures of family satisfaction and how facility characteristics influence them, and the ways those scores can be used in developing nationwide nursing home assessment tools.


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