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Resident- and Facility-Level Correlates of Resident-Reported Quality of Life in Assisted Living Facilities in
Tetyana P Shippee1, Romil R Parikh1, Molin Ji1
1Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.
Objectives:
Ensuring high-quality care in assisted living (AL) is a growing priority, yet little is known about factors shaping resident-reported quality of life (QoL). In the United States, Minnesota recently implemented statewide measurement and public reporting of AL resident-reported QoL. Leveraging these unique data, we evaluated resident- and facility-level factors associated with 7 validated QoL domain scores: staff, environment, food, engagement, autonomy, culture, and security.
Design:
Cross-sectional survey.
Setting And Participants:
Eleven thousand six hundred eighty-four AL residents in facilities with more than 5 beds, who participated in the 2024 statewide QoL survey (90% aged ≥65 years, 66% female, and 84% White).
Methods:
We identified resident- and facility-level correlates of AL resident-reported QoL in 7 domains, using multivariable linear mixed regression with facility-level random intercept to account for facility-level clustering.
Results:
Mean domain-specific QoL scores ranged from 1.6 to 1.9 out of 2, with food and engagement rated lowest and environment highest. Older residents reported significantly higher scores across most QoL domains (β = 0.02-0.08; P < .05). Females rated food and security significantly lower (β = -0.04 and -0.02; P < .05), whereas American Indian/Alaskan Native residents reported significantly lower scores in culture, security, staff, and environment (β = -0.05 to -0.10; P < .05). Smaller facilities (<25 beds) had significantly higher scores in food, staff, and autonomy (β = 0.02-0.07; P < .05). Facilities with dementia care unit licensure had significantly higher food scores but significantly lower autonomy, staff, and security scores (β = - 0.02 to -0.03; P < .05).
Conclusions And Implications:
Our findings indicate sociodemographic differences in AL residents' QoL, with lower QoL among vulnerable subgroups. Patterns in resident-level and facility-level correlates of residents' QoL scores differ by QoL domain, underscoring the need for targeted interventions and policy efforts to enhance resident well-being in AL.
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