Background

The Division of Health Care Quality recently completed the third survey of responsible party satisfaction with the personal care, services and environment for residents in nursing homes across Massachusetts. We are pleased to announce the 2009 results and comparisons with the 2007 results. These results can assist the public when they are choosing a nursing home and providers as they evaluate the quality of services in Medicare and Medicaid certified facilities. The survey measures the satisfaction of a daughter, son, spouse or other responsible party in six domains: a nursing home's staff and administration, physical aspects of the home, activities provided to residents, personal care, food and meals and residents' personal rights. Additionally, the survey measures overall satisfaction, satisfaction that residents' needs are met and a new question was added in 2007 asking whether responsible parties would recommend this nursing home to a friend or family member. A full report on the survey and results can be found at the Executive Summary Report.

Market Decisions in Portland, Maine, a commercial research firm, conducted all three of the surveys. The survey itself was extensively tested prior to 2005. Market Decisions sent the survey to responsible parties and tracked the returns. Based on a statistically valid analysis, they have prepared a facility specific report for each nursing home along with a guide for interpreting results and an executive summary with aggregated results. The study was conducted with the assistance of the Massachusetts Senior Care Association and Massachusetts Aging Services Association.

About the Results

The survey asked a total of 54 questions. Respondents rated their satisfaction on a scale of 1-5, with 1 = very dissatisfied; 2 = dissatisfied; 3 = neither satisfied; nor dissatisfied; 4 = satisfied; and 5 = very satisfied. This site displays the average domain score for all facilities with statistically significant response rates. In addition, statewide averages are displayed for each domain. The question added in 2007 on whether a respondent would recommend the home to a friend or family member requires a yes or no reply.

Average statewide scores for overall satisfaction and each domain are reported. Averages are calculated by adding up all the scores on the 1-5 scale for a domain and dividing by the total number of responses. Both the 2007 and 2009 results are shown, but not the 2005 results. In 2007, participation by nursing homes was made mandatory. As a result 100% of facilities participated in 2007 and 2009 where a smaller number participated in 2005. Because the populations are different, comparisons between 2005, 2007 and 2009 are not valid and do not appear in this report.

The domain scores are reported as weighted averages along with 95% confidence intervals. The confidence interval is a measure of statistical reliability of an average score. Caution should be exercised in comparing scores that are near each other since small differences in average scores may not be statistically significant. For more information on confidence intervals and interpreting differences in scores, please see the Executive Summary Report.

Interpreting the Results

The survey provides a baseline measure of satisfaction. Consumers can choose to look at an individual facility's results or at facilities within a particular town. They can make the following comparisons:

  • Compare a facility's results to other facilities across the State.
  • Compare a facility's averages to statewide averages.
  • Compare a facility's average to those of others in the same town.
  • Compare a facility's average to others for each of the six domains.
  • Compare a facility's scores between 2007 and 2009 for those facilities who participated in both years.

The Results

Following the 2007 decision to make participation by nursing homes mandatory, 100% of the 430* eligible facilities in the State did participate in 2009 and 100% of the 439 eligible facilities participated in 2007. Surveys in 2009 were first mailed in October, 2009 and responses through the end of December, 2009 are represented in the results. A total of 20,435 surveys were returned giving a response rate of 60%. This response rate is comparable to 2007 when the response rate was 61%. In 2009, slightly more half of the respondents report that their resident had been in the facility for more than two years. Most respondents visited at least once a week, usually during the day on weekends. Almost two thirds are female. The majority are between the ages of 50-69 years old. The demographics were the same in 2007.

Respondents continue to rate their overall satisfaction with the care and services provided by nursing homes highly. The 2009 survey indicate a slight upward trend from 2007 in overall satisfaction and in most domain scores. Nearly half of the item level scores are also trending upward. There were statistically significant increases from 2007 in the following areas: overall satisfaction, physical aspects of the home, care provided to residents, residents' personal rights and food and meals; though food and meals and activities remain the lowest rated domains. The highest rated scores are for staff and administration and the physical aspects of a home.

How to Use the Site

Individual facility scores can be found by going to Individual Average Statewide Scores. Individual scores are listed alphabetically by facility name, which is in the first column on the left hand side of the page. They are listed alphabetically. You need to scroll down the page until you find the facility for which you want to see the results. The next listing to the right is the city for each facility. The next set of columns, also to the right, contains the results:

  • Overall Satisfaction
  • Satisfaction that resident needs are met
  • Satisfaction with the administration and staff
  • Satisfaction with the physical aspects of the home
  • Satisfaction with the activities provided residents
  • Satisfaction with personal care
  • Satisfaction with food and meals
  • Satisfaction with protection of personal rights.

Please see Individual Questions to see the actual survey.

* Nineteen facilities agreed to participate, but had response rates that were too low to include on the individual facility results page. Their survey responses are included in the state averages, however. They are listed under Other Facilities.

Other Data Sources

The Massachusetts Department of Public Health continually updates the website Nursing Home Survey Performance Tool , which provides survey results for all Medicare and Medicaid facilities in the State. The Federal Centers for Medicaid and Medicare Services has a similar site called Nursing Home Compare ( www.medicare.gov/NHCompare/home.asp) that gives consumers current information on quality measures, staffing and survey results.

<strong>Resources List</strong>
Both government organizations and private associations provide information and services to those residing in a nursing home, making a placement or seeking information on a variety of subjects.

Choosing a Nursing Home

Choosing a nursing home for yourself or a loved one is a very important decision. Discuss the issue thoroughly with the individual involved and his or her personal physician. Consider what the travel limits are for those who will be visiting the person receiving services and identify the communities and nursing homes within those limits.

<strong>Suggested Topics and Questions</strong>
As you seek to learn about a specific facility or are comparing facilities, you can consider a range of topics to assist you.

Copies of the Report and Questions

If you need a hard copy of the Executive Summary Report or if you have any questions about the survey, please call Peter Bilodeau at 617-753-8140 or email peter.bilodeau@state.ma.us.

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