Quality of residential settings for elderly adults

Based on the Multiphasic Environmental Assessment Procedure (MEAP), an instrument for evaluating residential settings for elderly adults, eight indices of quality were formulated to cover both the structure and process of care. MEAP data were available for 244 facilities from throughout the United States, including 127 nursing homes (NHs), 55 residential care facilities (RCs), and 62 congregate apartments (APTs). The three types of facilities differed predictably on the quality indices. Nursing homes were more supportive and restrictive than were APTs, and RCs generally scored between NHs and APTs on the quality of care measures. These indices of quality tended to be independent of one another, suggesting that quality of care is multidimensional. Larger facilities and nonprofit facilities tended to score higher on the quality indices, although the effects of size varied somewhat with facility type and ownership. These indices may be useful for describing and comparing settings and for analyzing the correlates of quality.