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More consumers are turning to social media review platforms to help choose a nursing home for family members, but the reviews can be skewed by anecdotal and personal evidence, a new study shows. 

The research analyzed facility reviews posted on Yelp, one of the largest and oldest online consumer comparison sites, as well as the quality ratings put together by the Centers for Medicare & Medicaid Services on Care Compare through surveys and site visits. Recently introduced federal legislation seeks to enhance Care Compare’s visibility among consumers, but Yelp and sites remain a more prominent and established site, the researchers found. 

“Social media has become an indispensable platform for disseminating quality information to consumers across various service sectors,” the study’s authors wrote. “Using nursing home resident admissions as a proxy for consumer demand, we find that higher Yelp ratings led to higher consumer demand, particularly among Medicare-covered consumers. Furthermore, the effect of Yelp ratings was primarily driven by extreme ratings (1-star or 5-star), as opposed to neutral ratings.”

They found that a 1-star increase in a Yelp rating increased a nursing home’s Medicare admissions by 2.6% more than a 1-star increase in the CMS rating did. This effect is primarily driven by the disproportionate number of extreme ratings on Yelp, they said.

While facilities are sometimes required to make changes in response to low ratings or deficiencies found by CMS, no such imperative exists with Yelp critiques.

“We find little evidence that nursing homes made quality improvement in response to their Yelp ratings,” the study, titled “Does Social Media Dominate Government Report Cards in Influencing Nursing Home Demand?” and compiled by an international group of researchers, noted

Yelp has been posting nursing home reviews since 2005 but less than 30% of facilities in the US have received any consumer ratings, according to the study. Facility reviews also tend to be “highly polarized” with platform users giving either 1- or 5-star ratings with few opting for anything in the middle. While Care Compare provides standardized information about nursing homes, what’s presented on Yelp is up to the individual posting the review, the study said. 

“It’s very rigorous,” Lauren Lu, a professor at Dartmouth College – Tuck School of Business, said of Care Compare in an interview posted to Tuck’s website. “[A]nyone can view the full inspection results and reports, which detail the number of complaints, reported issues, infections, and even how much time nurses spend on each resident compared to national averages.”

The authors suggested that CMS take cues from Yelp and other social media platforms to increase public awareness of Care Compare, adding that consumer confidence in government ratings took a hit during COVID. 

“We believe it might be beneficial for CMS to recognize the importance of social media platforms as alternative sources of quality information and to consider collaborating with well-known social media platforms,” study authors said. “Similar efforts have shown success in the restaurant industry, where displaying government hygiene scores on Yelp leads to a significant decrease in consumers’ purchase intentions for restaurants with low hygiene scores. Furthermore, we recommend that CMS enhance the transparency of nursing home quality reports by incorporating patient satisfaction metrics.”The study is available online now and  will be published in a future issue of Manufacturing & Service Operations Management, according to the Tuck School. In addition to Lu, the authors are Yuanchen Li of Tongji University – Advanced Institute of Business in Shanghai, China, and Susan F. Lu with Purdue University – Krannert School of Management.