An evaluation of the quality assurance system for skilled nursing facilities in New York state

A new quality assurance system for nursing homes was implemented by the New York State Department of Health in 1981 in response to widespread dissatisfaction with the previous survey and Inspection of Care programs. The new program combined the Inspection of Care, which is a patient centered review, and the survey, which is a structurally oriented facility review. In this study, the old and new quality assurance systems are compared with respect to (1) the amount of surveillance staff resources spent on on-site and off-site activities, (2) the types and quantity of deficiency citations issued, and (3) the correction of deficiencies. The results indicate that the new system devotes more resources to on-site activities and identifies more patient care deficiencies, hut also has led to the identification of more repeat deficiencies.