I can't think of a better use for evidence than to help people select a nursing home for a loved one. In the U.S., Medicare certifies some facilities to participate in their program, and gathers lots of evidence along the way. Using that evidence, they've developed a set of resources for the general public, available at Nursing Home Compare. Overall, I believe NHC does a reasonably good job of presenting useful information, and helping people find evidence for themselves: This includes a search tool, checklists, and plain-English descriptions of rating criteria.
I've written before about the difficulty of gathering evidence to compare hospitals in a meaningful way -- and the difficulty of getting people to use that evidence once it becomes widely available. I'm guessing the same holds true for efforts to rate nursing homes. But the NHC search tool is easy to use. Within the search results are ratings such as these, based on a 5-star system:
Evidence for everyone. To evaluate a nursing home, Medicare provides lots of hard evidence that one could consider, such as health inspection results or number of nurses/resident. But anyone who's stayed in a hospital or other care facility knows many things influence the success of a stay -- so I'm glad to see they're encouraging people to consider a wide range of factors, including the # of miles from family members, the noise levels in dining rooms, and lighting throughout the facility. Here's a sampling of the checklist provided:
Self-reported evidence. Some of the 5-star rating criteria, such as quality measures, are based on data that's self-reported to Medicare by the nursing homes themselves. That could be problematic. The NHC site explains it this way:
The NHC database is available for download: "You have the option of downloading the data that is used by the Nursing Home Compare tool onto your computer. The data will be downloaded as zipped Microsoft Access databases. This function is primarily used by health policy researchers and the media." These data are grouped into five categories, providing details about nursing homes, inspection results, residents, the nursing home staff, and facility ratings.
Not all facilities are included, however. Those listed on Nursing Home Compare 1) are certified to participate in Medicare and/or Medicaid, and 2) provide so-called "skilled" care (skilled nursing or rehabilitation staff). Other homes may be licensed by state agencies. The site also identifies and explains some long-term care alternatives to nursing homes.
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