Nursing homes that have higher levels of staff and less deficiencies tend to have more satisfied residents, according to a new analysis, but activities and food are still areas for improvement.

Researchers at University of Rochester Medical Center Department of Public Health Science, the University of California, San Francisco, and the University of California, Irvine, found that nursing homes with higher satisfaction rates often had higher staffing levels and fewer deficiency citations. Non-profit and government owned nursing home tended to score higher than their for-profit counterparts.

The results came from three years’ worth of consumer satisfaction surveys in Massachusetts. The researchers hoped their analysis would help the Centers for Medicare & Medicaid Services decide whether to make consumer surveys a part of national nursing homes’ report cards. Five other states have already evaluated consumer satisfaction.

Massachusetts residents who completed the surveys, along with their families, were asked to grade their overall satisfaction and whether they’d recommend the facility to a friend. They were also asked to score specific areas, such as staffing and administration, the home’s physical environment, activities offered, their personal care, meals and personal rights.

The scores varied drastically, with 25% of surveyed homes receiving “less than satisfactory” scores. However, on a scale of one to five, with a five being “very satisfied,” the average satisfaction rate for overall care was 4.22-4.31, and the satisfaction rate that overall residents’ needs were met was 4.09-4.16 on the five number rating basis.

Ninety percent of those surveyed said they would recommend their particular facility.

“Satisfaction scores are clearly an important indicator of the quality of care in nursing homes,” said Yue Li, Ph.D., an associate professor at URMC’s Department of Public Health Sciences and lead author of the study. “When used with other quality of care indicators, these assessments have great potential to empower consumers to make choices, incent improvements by nursing homes, and inform pay-for-performance.” 

The study is published in the August issue of Health Affairs.