The State of States' Assisted Living Websites: Information Available to Consumers

BACKGROUND AND OBJECTIVES

Assisted living (AL) is a growing sector of the U.S. long-term care market, with its development driven largely by private market choices. However, consumers need information to choose the right AL community (ALC). This paper examined information available on U.S. state websites concerning ALC quality, costs, and services.

RESEARCH DESIGN AND METHODS

Based on prior research and their analysis of a sample of state websites, researchers identified 39 key informational elements and grouped them into four categories, (a) ALC characteristics, (b) payment and services, (c) quality, and (d) website usability. Researchers then examined the presence of the 39 elements on 51 websites (U.S. states and the District of Columbia), meeting regularly to discuss findings and resolve differences.

RESULTS

A majority of states provided basic information about individual ALCs (e.g., number of beds, ownership). Only 35% listed payment(s) accepted (e.g., Medicaid), and 31% indicated the availability of memory care. Nearly 70% posted inspection results, while only 43% provided information about complaints. Many met basic usability guidelines (e.g., type size), but locating content on many sites required multiple steps, and none met 5th-grade-or-below readability standards.

DISCUSSION AND IMPLICATIONS

A majority of websites provided important information, such as inspection results. However, many were lacking key elements concerning payment accepted and services. Finding what was available was burdensome. More work is needed to help states provide information that enables consumers to find ALCs that meet their needs. The lack of such information puts older adults at risk of inappropriate placements.

Measuring administrators' and direct care workers' perceptions of the safety culture in assisted living facilities

BACKGROUND

Further understanding of patient safety in health care is still needed. This is particularly evident in long term care settings, where relatively little information exists. Safety culture has emerged as a critical component of efforts to improve patient safety; it is strongly associated with iniatatives that influence patient safety and quality of care. The safety culture of a large sample of assisted living (AL) facilities was examined.

METHODS

The Nursing Home Survey on Patient Safety Culture (NHPSC) was modified and used to examine safety culture. A random sample of AL settings from all 50 states was selected to participate. Respondents were AL administrators and direct care workers (DCWs) who completed the modified safety culture survey. The applied properties of the instrument are examined. A summary score for administrators and DCWs for each NHPSC item is also presented. These summary scores have a range from 0 to 100, with low scores representing a poor safety culture (and vice versa).

RESULTS

Information was received from 572 administrators (response rate = 57%) and 3,620 DCWs (response rate = 51%). The scores, using the 0-100 scale, fell into the 48-72 range for administrators and the 40-68 range for DCWs. Many of the scores were similar to those previously found in nursing homes.

CONCLUSIONS

AL is recognized as one of the fastest-growing institutional components of the long term care industry. The modified NHPSC performed well. Some areas of safety culture were perceived less favorably than in nursing homes. As such, some further attention to safety culture in AL is warranted. This study provides a first step toward assessing safety culture in this underexamined setting.

Consumers' use of internet-based nursing home report cards

BACKGROUND

Few studies have addressed the extent to which consumers use nursing home report cards and how they use this information. These questions, which are significant because the nursing home market presents several challenges to the effectiveness of report cards, were pursued in a study.

METHODS

Data used in this investigation came from three mail surveys conducted in 2006 of family members of nursing home residents (N = 4,754), family members of assisted-living residents (N = 496), and elders living in high-rise buildings (N = 1,252).

RESULTS

Some 31% of family members of nursing home residents, 53% of family members of assisted-living residents, and 23% of elders living in high-rise buildings used the Internet in looking for a nursing home. In general, these different types of consumers look for different types of nursing home information.

DISCUSSION

According to the results, most consumers who used the Internet to look for a nursing home also used a report card. In addition, between 6% and 17% of consumers specifically identified using Nursing Home Compare when looking for a nursing home. The highest use of report cards was reported by family members of assisted-living residents, followed by family members of nursing home residents. Many consumers primarily used the report cards simply to find the location of nursing homes-a useful first step when examining the facility choices available. Yet relatively few consumers primarily used report cards for the arguably more important step of comparing quality information. Future research should investigate why the quality information is not used to a greater extent and what hinders consumers from using this information.

The Search and Selection of Assisted Living Facilities by Elders and Family

BACKGROUND

In this study, we examine factors associated with the search, selection, and satisfaction of residents and family members in assisted living.

METHODS

Data were collected from 375 residents of 25 assisted living facilities matched with 375 family members. We conducted face-to-face interviews with the residents to determine: (1) the principal decision maker; (2) the process of searching for a facility; (3) the factors crucial to facility selection; (4) the time frame from the relocation decision to relocation; and (5) satisfaction with selection. Similar questions were asked of family members, using a mail survey.

RESULTS

Residents described themselves as extremely influential in 39% of cases when searching for a facility, and in 27% of cases when selecting a facility. Quality, cost, and location were the most influential factors for both residents and family members in selecting a facility. Almost all residents and family would use different search and selection processes if they had to select a facility again, and almost all were dissatisfied with the sources of information available.

CONCLUSIONS

Consumers and policy makers both favor the use of assisted living settings; but, the information available to choose a setting is far from ideal, and may represent a barrier to both consumer and policy makers' agendas.