Survey methods for a nationally representative sample of assisted living and residential care communities

Survey research is important in tackling the complexity of the increasing numbers and types of assisted living and residential care communities (ALCs) and the services provided, as well as the staffing challenges affecting long-term care settings. We describe the methodological experience of conducting a nationally representative survey of administrators.

The sampling frame was drawn a directory of ALCs that were licensed, certified, or otherwise regulated by states in 2019. From October 2021 to October 2023, the administrator from each randomly selected ALC was mailed a questionnaire about end-of-life care and cover letter with a username and password for web-response if preferred. Tailored follow-up was conducted with nonresponders.

A total of 2084 ALCs participated overall response rate = 43.4%. Research staff made a total of 36,258 contacts with administrators in all sampled ALCs for an average of 9 min per contact. The likelihood of obtaining a completed survey increased with additional contact attempts, with the most gains occurring within seven attempts. More contacts were required for large, urban ALCs as well as those with specialized memory care. Accounting for all direct costs, the average cost per survey completion was $195 exclusive of incentives.

To obtain representative, high-quality data about the characteristics of residents and the care provided within the large and growing sector of ALCs, sufficient resources must be available to continue to develop and refine cost-effective, novel survey methods for recruitment and data collection.