Stakeholders' opinions regarding important measures of nursing home quality for consumers

This article reports on a survey of opinions about specific categories and indicators of quality used by the Health Care Financing Administration in the survey and certification process for nursing homes in the US. The survey was conducted of a selected sample of administrators, directors of nursing, state survey agency training coordinators, state ombudsmen, and nursing home advocates in 1996. General patterns of agreement were found across all respondent groups that the 3 most important categories of quality were as follows: quality of care, quality of life, and residents' rights. The 3 most important quality-of-care survey items were as follows: general quality of care, maintenance of activities of daily living, and appropriate treatment for impairment in activities of daily living. The 3 most important quality-of-life items were as follows: dignity, self-determination and participation, and accommodation of resident needs. Important residents' rights items were as follows: to be able to exercise general rights, to be informed of one's condition, and to be free of reprisal when making complaints. Quality assurance should focus greater attention on the areas considered to be the most important by the various stakeholders in nursing home care.