WBB's Thought Leadership

Federal and Social Measures of Quality for Nursing Homes Differ

November 15

Comparison between federal NHC quality measurement of nursing homes and their Yelp ratings shows little correlation.
Researchers compared NHC and Yelp ratings for 675 NHs that had both ratings, and found weak correlation between the scores. The Yelp ratings for NHC 5-star facilities were significantly lower, but higher than the NHC Inspection rating.

WBB Take: While the NHC measurement framework and assessment method may be more reliable and have higher construct validity, Yelp ratings are likely to have far higher influence on public opinion, and patient behavior.
From a QI perspective, Yelp ratings (although raw), are a direct source of “Customer Voice,” and should therefore not be dismissed. However, Yelp reviews lack the transparency, validity, and reliability of the NHC ratings. This creates a dilemma that can be resolved by greater transparency of Yelp ratings, and close inspection to see if patients are identifying risks, issues, and opportunities at NHs that are not being measured by the NHC measurement framework.
It may well be that NHC measures are not adequately capturing elements that are important to patients, and incorporation of facets of the Yelp assessment may improve NHC measurement validity, and enable the framework to be more patient centered.

Cited by Matthew Loxton

Excerpt: “This study found that when consumers rate [nursing homes (NHs)] on Yelp, their ratings differ considerably from NHC ratings, a finding in keeping with similar studies of NH quality measurement. Further research is needed to analyse the content of Yelp reviews and compare the themes and topics consumers identify with those reported on NHC.”
“Two strategies for rating the quality of [NH] in the USA are exemplified by the Nursing Home Compare (NHC) website, launched by the federal Centers for Medicare and Medicaid Services in 1998, and Yelp.com, an online consumer review site that has grown in popularity since its founding in 2004. Both sites feature a 5-star rating system. While much is known about NHC ratings, little is known about NH Yelp ratings. This study examines Yelp ratings for NHs in California and compares these ratings with NHC ratings. Understanding how these ratings relate can inform efforts to empower consumers and enhance NH decision-making.”
“We collected NHC and Yelp ratings for all California NHs between September and November 2016. For each NH with a Yelp review, we recorded the star rating and the total number of reviews. We also recorded the NHC 5-star rating and NHC ratings for inspections, staffing and quality measures (QMs). We conducted descriptive statistics and frequencies for these variables. We conducted correlations and tested means to compare the ratings.”
“A total of 675 NHs (68.1% of the total sample of 991 NHs) had both Yelp ratings and NHC ratings. Correlations between the Yelp and NHC ratings were relatively weak. The Yelp rating was significantly lower than the 5-star NHC rating and the NHC ratings for staffing and QMs. It was significantly higher than the NHC inspection rating.”

Source: BMJ Quality & Safety


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